Academic journal article Alcohol Research

Adolescent Binge Drinking Developmental Context and Opportunities for Prevention

Academic journal article Alcohol Research

Adolescent Binge Drinking Developmental Context and Opportunities for Prevention

Article excerpt

Compared with adults, adolescent drinkers tend to consume higher quantities of alcohol per occasion but drink less frequently.1 Thus, underage drinkers ages 12 to 20 typically consume 4 to 5 drinks per drinking episode, which is nearly double the average of the 2 to 3 drinks usually consumed by adults (older than age 25).1 Most of the alcohol consumption of underage drinkers occurs during "binge" episodes characterized by drinking high quantities.2,3 This binge pattern of consumption has been linked to serious alcohol-related harm, such as alcohol poisoning, as well as to sometimes fatal injuries and accidents resulting from acute intoxication.4 The adverse consequences of adolescent binge drinking affect not only the adolescents but also their families, peers, and community.5

This article reviews various definitions of binge drinking, the acute adverse consequences associated with binge drinking, the prevalence of adolescent binge drinking, and demographic factors (e.g., gender and race/ethnicity) associated with adolescent binge drinking. It then discusses the developmental context of adolescent binge drinking, including adolescent-specific sensitivity to certain alcohol effects that may contribute to episodes of high-volume alcohol consumption in adolescence. After a summary of trajectories of binge drinking in adolescence, trajectory correlates representing risk factors and young-adult outcomes, and possible neurocognitive consequences of adolescent binge drinking, the implications of research on adolescent binge drinking for prevention efforts are briefly reviewed.

Definitions of Binge Drinking for Youth

Binge drinking, or an episode of high-volume alcohol consumption, has been defined in various ways.6,7 (For more information, see Drinking Patterns and Their Definitions in this issue.) According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA),8 "binge drinking" refers to alcohol consumption that brings the blood alcohol concentration (BAC) to .08 g/dL, which is commonly associated with acute impairment in motor coordination and cognitive functioning.9 BACs of more than .08 g/dL typically occur in men after consuming five or more drinks in about 2 hours, and in women after consuming four or more drinks. This is known as the "5+/4+" binge definition. This definition is consistent with epidemiological data indicating an association at the population level between greater frequency of 5+/4+ binge episodes and more adverse drinkingrelated consequences.10

When applied to adolescents, binge-drinking definitions based on adult levels of alcohol intake (e.g., 5+/4+ drinks per occasion) often are too high. Children and adolescents are likely to reach BACs of more than .08 g/dL at lower levels of consumption due, in part, to factors such as smaller body size. Donovan used an updated Widmark equation and population data on average body weight in boys and girls to estimate the levels of drinking that would produce BACs of more than .08 g/dL in youth ages 9 to 17.11 For those ages 9 to 13, a binge episode was estimated to occur with intake of 3 or more drinks within a 2-hour period; for those ages 14 to 15, with 4 or more drinks for boys and 3 or more drinks for girls; and for those ages 16 to 17, with 5 or more drinks for boys and 3 or more drinks for girls. These proposed binge-drinking thresholds for youth are theoretical and based on estimated, rather than observed, BACs. Nevertheless, the identification of lower drinking-quantity thresholds to define binge drinking for younger drinkers suggests that the use of standard adult-based binge definitions may underestimate the prevalence of drinking behavior that leads to BACs of more than .08 g/dL, particularly among females and youth.

Extreme binge, or high-intensity, drinking involves the intake of dangerously high quantities of alcohol per occasion. (For more information, see High-Intensity Drinking in this issue.) Thresholds of 10 or more drinks (i. …

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