Alcohol is one of the leading causes of health issues around the world, including in the United States. The Centers for Disease Control and Prevention (CDC) found that about 88,000 people die every year from alcohol-related causes, which include acute problems like car accidents and chronic problems like liver cancer. Excessive drinking is the cause of 10 percent of deaths among working-age adults, between 20 and 64 years old.
Alcohol use disorder (AUD) on the rise in the US, but it is not the only cause of alcohol’s impact on health. Heavy drinking and binge drinking are large contributors to deaths and chronic health problems associated with alcohol.
What Is the Definition of Binge Drinking?
The liver can metabolize about one serving of alcohol per hour. Serving sizes for alcohol include:
- One 12-ounce bottle of beer
- One 5-ounce glass of wine
- One 1.5-ounce shot of hard liquor
Drinking more than one serving of alcohol per hour increases the likelihood that the person will become intoxicated. The legal limit for being considered intoxicated is 0.08 percent blood alcohol concentration (BAC). At this point, it is no longer legal to drive or operate heavy machinery. People who are drunk in public are also at risk of being cited or arrested for public indecency, depending on how drunk they are.
- Four drinks or more in two hours for women
- Five drinks or more in two hours for men
According to the CDC, binge drinking is a huge problem in the US. Adolescents and young adults, typically high school and college students, are most often associated with binge drinking problems, but middle-age and older adults are binge drinking more often as well.
- About 90 percent of American adults reported binge drinking at least once in the past month.
- The average binge is about eight drinks per occasion.
- Binge drinking is most common among adults ages 18-34, although older adults ages 65 and older are binge drinking more often.
- Men are twice as likely as women to binge drink, although women are binge drinking more.
- Binge drinking is more common among middle and upper middleclass households, with household incomes of $75,000 or more.
- When adolescents drink alcohol, it is more likely to be via binge drinking than other forms of problem drinking.
Binge drinking increases the risk of alcohol poisoning, which can cause spontaneous death. If a person is suffering from alcohol poisoning, call 911 immediately. They need emergency medical attention.
Other effects of binge drinking, which can be harmful to health, include:
- Loss of coordination, leading to falls
- Poor impulse control
- Reduced decision-making skills
- Illness from hangover the next day
- Low body temperature
What Is a Blackout?
Blackout is a general term for a loss of memory, and the most common cause is a rapid increase in blood alcohol levels. This is sometimes called alcohol-induced amnesia. Problems forming new memories and blackouts are consequences of a rapid increase in BAC, most often caused by binge drinking. However, the effect of alcohol on memory can vary among different people, including the BAC that will cause a blackout or “grayout.”
Usually, a person’s BAC must reach 0.14 percent – almost twice the legal limit – to induce a blackout. When sober, memories are formed after sensory input is processed in short-term memory through a process called transfer encoding, then moved through a similar process into long-term memory. When a person remembers something, their brain retrieves the memory from long-term storage and puts it into short-term memory while the individual re-experiences the event. Scientists have known for a long time that alcohol interferes with transfer encoding and retrieval between short-term and long-term memory storage.
There are two forms of alcohol-caused blackouts: complete and partial or fragmentary.
- En block (complete) involves total memory loss until the body’s BAC lowers and memory processing returns.
- Partial (fragmentary) means that the person may not immediately remember what happened, but certain cues can trigger memories to return.
There is a huge difference between blacking out and passing out. When a person passes out, they lose consciousness are in a state similar to being asleep, although they are not likely to respond to stimuli like being spoken to or touched. When a person blacks out, they may continue to make decisions, hold conversations, and even continue to drink. They appear to be conscious, but they will not remember what happened. This is extremely risky, as the person may attempt to drive, have sex, or perform other risky behaviors that can lead to permanent harm and even death.
During the blackout, the person will be able to remember events before their BAC reached very high levels, and drinking too much inconsistently will typically not damage these memories.
Who Is at the Most Risk from Alcohol Blackouts?
Women are at greater risk of blacking out than men, and young adults are at greater risk of blacking out compared to older adults.
Differences in hormones, body composition, and physical size mean that women cannot drink as much alcohol as men before becoming intoxicated. This is why the definition of binge drinking is different between genders. Because women become drunk on less alcohol, they are also at greater risk of blacking out because their BAC rises faster.
Typically, adolescents and young adults are more likely to binge drink, and when they do, they are more likely to drink more alcohol per binge. However, they also do not have as much experience drinking in moderation or drinking consistently, so they are more likely to overestimate how much they can consume or underestimate how much they have already consumed. This is very risky and puts young people at serious risk of experiencing legal, financial, academic, and personal consequences, such as illness, mood disorders, sexual assault, physical violence, and hospitalization.
The 2008 National College Health Assessment (NCHA) found that 30 percent of students reported that they consumed too much alcohol. A later study conducted by Duke University Medical Center surveying 772 college students found that:
- 2% reported drinking in the past two weeks
- 4% experienced a blackout in that time
- 40% reported blacking out in the past year
Adolescents and young adults are still developing, physically, mentally, and emotionally. Consuming a lot of alcohol can damage the brain while it is forming, so young people who binge drink and experience blackouts are more likely to have memory problems for the rest of their lives.
Are Binge Drinking and Blacking Out Signs of Addiction?
While medical professionals agree that binge drinking is not the same as alcohol use disorder, drinking too much frequently increases the risk of developing alcohol dependence and compulsive behaviors around alcohol consumption. Blackouts were once considered one of the three main indicators of AUD, but blacking out is currently understood to be related to a rapid increase in BAC, not heavy drinking or AUD, which is characterized by a tolerance to and dependence on alcohol, making it harder for the body to respond to certain levels of alcohol.
If a person understands that blacking out is very dangerous, they may stop drinking, or they may be more careful to moderate their drinking. People who experience consistent blackouts from drinking too much may have AUD. They need medical treatment for this condition, including supervised detox and evidence-based rehabilitation.