Binge Drinking

By Lauren Smith

Last updated: 28 July 2023 & medically reviewed by Dr. Kimberly Langdon

What is binge drinking?

Binge drinking is the consumption of large volumes of alcohol in a short span of time. It can also be understood as drinking to get drunk.

Our bodies can only process one standard drink, or around one shot, per hour. When you drink more than this, the alcohol accumulates in your bloodstream and tissue, producing the effects of intoxication. As your blood alcohol concentration (BAC) rises, you become increasingly impaired. 

Binge drinking makes it difficult to keep track of how inebriated you’re becoming until it's too late. The effects of a binge can also linger for hours as your body slowly metabolizes the backlog of alcohol in your bloodstream.

How many units is considered binge drinking?

Definitions of binge drinking vary. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of drinking that takes your blood alcohol concentration (BAC) to 0.08 percent (or 0.08 grams of alcohol per deciliter) or higher, the legal limit for driving. 

For a standard male adult, that’s five or more standard drinks in two hours, and for the standard female, it’s four or more standard drinks in two hours.^[1] This is known as the “5/4 definition.”

But a standard drink doesn’t necessarily mean a glass of wine or a bottle of beer. Instead, it’s the equivalent of 14 grams of pure ethanol (alcohol). The amount of the beverage that contains that amount of alcohol depends on its strength or alcohol by volume (ABV), represented as a percentage.^[2]

Beer

Beer is usually around 5% alcohol, so 12 ounces of beer is a standard drink. Conveniently, that’s one typical can or bottle of beer.

Therefore, binge drinking is drinking five or more cans/bottles of beer in two hours, or four cans/bottles if you’re a woman.

Some light beers will be around 4% alcohol, while others will be higher. IPAs, for example, have an alcohol content of between 6.3% and 7.5% ^[3] This adjusts the calculations.

Wine

On average, the alcohol content of wine is 12%. However, it can vary from 5% to 20%. Red wines usually have a higher alcohol content than white wines.^[4]

But if we assume 12% alcohol content, one standard drink is 5 ounces of wine. That used to comfortably fit in wine glasses, but as glasses have expanded, so have our pours. One standard drink of alcohol may look very small in your jumbo glass. 

A bottle of wine is usually 25.4 ounces, so one standard drink is one-fifth of it. For men, binge drinking is consuming 25 or more ounces of wine in two hours—just around a bottle. For women, it’s 20 ounces.

Spirits

Liquor like whiskey, rum, gin, vodka, and tequila is usually 40% alcohol or 80 proof. One standard drink is 1.5 ounces of liquor—a single shot. 

Binge drinking for men is taking five or more shots of liquor in two hours. For women, it’s four or more shots. 

Caution must be taken with mixed drinks and cocktails: the ingredients may add up to more than one standard drink. For instance, gin and tonics usually have 2 ounces of gin, and Long Island iced teas have a total of 2.5 ounces of several types of liquor.

Liquors like grain alcohol, 151 proof rum, or Everclear have much higher concentrations of alcohol and one standard drink of them may be less than a shot. ^[5]

Read here to learn more about the different types of alcohol.

What are the health risks of binge drinking?

Binge drinking is associated with a wide spectrum of health risks. 

• accidents and injuries: Intoxication impairs your coordination, balance, vision, reaction times, and judgment, making accidents more likely. These range from falls to car crashes. Annually, more than 1,500 college students die of alcohol-related unintentional injuries each year.^[6] Among students who binge drank, 11% reported getting injured or physically ill as a result of their drinking, while 15% admitted to engaging in unsafe driving.^[7]

• alcohol poisoning: Alcohol poisoning occurs when someone’s blood alcohol concentration reaches toxic levels through binge drinking. This can cause vomiting, hypothermia, unresponsiveness, unconsciousness, irregular or slow breathing, coma, brain damage, and death. Each year 2,200 people die of alcohol poisoning in the U.S.^[8]

• brain damage: Just one drinking spree can cause atrophy of the corpus callosum detectable on an MRI five weeks later.^[9] Regular binge drinking leads to deficits in memory and executive function (emotional and impulse control, working memory, planning, organization, and flexible thinking). People who frequently binge drink may struggle to maintain attention, learn from their mistakes, and make good decisions.^[10] In fact, regular binge drinking can cause brain damage more quickly and severely than chronic drinking due to the neurotoxic effects of frequent withdrawals.^[11] These brain changes in adult binge drinkers don’t seem to persist if they become abstinent. But animal studies suggest that the effects on the developing brains of adolescents may be permanent.^[12]

• STIs and unwanted pregnancy: Binge drinking is associated with a higher likelihood of unplanned and unprotected sex, with an increased risk of unwanted pregnancy and sexually transmitted infections, including HIV. ^[13][14] 

• suicide: A dose-dependent association has been made between suicide and acute intoxication.This means people are more likely to attempt and die by suicide while drunk, and the drunker they are, the higher the likelihood.^[15] There is also a link between long-term alcohol abuse and mental health conditions such as depression. 

• alcoholic hepatitis and pancreatitis: Inflammation of the liver (hepatitis) and the pancreas (pancreatitis) most commonly occur following years of alcohol abuse. However, they can happen to otherwise healthy people following a single incident of binge drinking.

• stroke: Binge drinking elevates the risk of stroke by 10 times.^[16] It can also increase the risk of other kinds of sudden death, including brain hemorrhages and heart attacks. This is often associated with end-stage alcoholism.

If you’re regularly binge drinking, you’re also at risk of some of the same health complications that alcoholics are, including liver disease and a variety of cancers. 

Binge drinking statistics

Binge drinking is very prevalent in the United States, especially among adolescents and young people. Many people who engage in binge drinking don’t know that their drinking habits are hazardous. Indeed, they’re often normalized in their social environment.

One in six (16.65%) adults in the US engage in binge drinking, representing 38.5 million people. Among people aged 18 to 34, the prevalence is 25%.

Among adults who binge drink, half did so at least twice in the previous month. A quarter binged at least weekly and a quarter consume at least eight standard drinks during each binge. ^[17]

Binge drinking is particularly present on university campuses. One in three college students reported binge drinking in the previous month, according to the Substance Abuse and Mental Health Services Administration's (SAMHSA) 2019 National Survey on Drug Use and Health. 8.2% reported binge drinking on five or more days in the past month. Both figures were higher among students than among those not attending college.^[18]

Other research has put the prevalence of binge drinking at 50% of male students and 39% of female students.^[19]

Many students began binge drinking years earlier, in high school. In 2015, 17.7% of high school students were binge drinkers, although this was down from 1999 when 31.5% binged.^[20]

Binge drinking and alcohol addiction

Not everyone who binge drinks is addicted to alcohol. According to one population-level study, a third (31%) of Americans are “excessive drinkers,” a category that encompasses episodic binge drinkers and those who drink too much across a week. However, only 10% of that group could be diagnosed with alcohol use disorder.^[21]

However, binge drinking is often a precursor and warning sign of alcoholism. For a portion of heavy drinkers, social binge drinking—normalized through parties and drinking games—will escalate into alcohol addiction. 40% of alcoholics report that they drank heavily during adolescence.^[22]

Others may already be alcohol dependent, with symptoms including strong urges to drink, difficulty reining in their drinking despite adverse consequences, and withdrawals when they reduce or stop drinking. 

Again, researchers looked at the student population, where binge drinking is rife. According to one study, 31% of students met the criteria for an alcohol abuse diagnosis in the previous 12 months, while 6% could be diagnosed as alcohol dependent. More than 40% of students reported at least one symptom of alcohol abuse or dependence.^[23]

But you don’t need to be an alcoholic to experience negative consequences and health impacts from your drinking, as discussed above.

Who is most likely to binge drink?

Binge drinking cuts across all demographics in the US, but it’s more common in certain groups:

• college students: 33% of college students binge drink compared to 27.7% of non-college students of the same age.^[18]

• young people: 24% of adults between ages 18 and 24 and 26% of those ages 25 and 34 binge drink, compared to just 5% of those over 65.

• men: 22.5% of men binge drink compared to 12.6% of women

• non-Hispanic whites: 19.7% of whites binge drink, compared to 16.3% of Hispanics and 13.4% of non-Hispanic Blacks.

• veterans: 20.9% binge drink compared to 17.1% of non-veterans

• wealthier households: incidence of binge drinking rises with household income, from 14.6% of those earning less than $25k to 21.4% of those earning more than $75k

• Midwesterners: Binge drinking is most common in Wisconsin (25.8%) and other states in the Midwest and least common in Mormon-heavy Utah (10.5%).^[17]

How common is binge drinking in America?

Overall, one in six U.S. adults reported recent binge drinking: consuming more than four or five drinks in two hours or less. 

That’s 38.5 million people binge drinking in the US. They consume a total of 17 billion binge drinks annually. That’s an average of 467 binge drinks for every binger.^[13]

America has a drinking problem

In 2019, 5.3% of Americans, or a total of 14.5 million Americans, could be diagnosed with alcohol use disorder, according to the SAMHSA. [14] For many of these people, alcohol dependence slowly emerged from weekend binge drinking at university and among friends at parties.

But even if you don’t meet all the DMS criteria for alcohol use disorder, drinking could still be negatively impacting your health, relationships, career, and other aspects of your life. You may also need help trying to stop. 

Binge drinkers are encouraged to seek treatment for their alcohol use. This may include inpatient rehab, CBT, other forms of talk therapy, mutual aid groups, and medication to handle cravings. Some binge drinkers may be able to drink in moderation, while others will find that they must avoid alcohol entirely. 

To explore treatment options near you see, click here.