Binge drinking: Pathophysiological and psychological aspects

Abstract

Binging is a behavior with undesirable outcomes for drinkers and those around them. A debate over recent years has focused on how this harmful and potentially life threatening pattern of drinking should be defined and how many drinks make up a binge. From a clinician's stand-point, a binge refers to a pattern of drinking to intoxication, usually a solitary activity lasting up to several days and involving loss of control over consumption. The National Institute of Alcohol Abuse and Alcoholism (Bethesda, Maryland, US) defines binge drinking episodes as consumption of five or more drinks (male) or four or more drinks (female) in the space of about 2 hours. However, this definition does not consider the amount of alcohol intake in one binge episode, nor the possibility that some individuals may go on several binges during the same day. Generally speaking, binge drinking implies "drinking too much too fast." Periods of binge drinking (several consecutive days, weeks or months) are typically followed by periods of abstinence or, in some cases, significantly lower levels of consumption. Thus, the nature and severity of the problems that binge drinking causes depends on how frequently it occurs and over how long a period it is maintained. This pattern of drinking is extremely common, especially among young adults, and remains the leading cause of death among college-aged students in the US, with similar worldwide rates of problematic alcohol use across Europe, South America and Australia. Due to the physiological and psychological changes occurring in adolescence and youth, binge drinking may have lasting harmful consequences, including greater risk for the development of alcohol dependence. It is known that alcohol affects virtually every organ system in the body, and in high doses, can cause coma and death. Namely, in the brain it affects several neurotransmitter systems, including opiates, γ-aminobutyric acid (GABA), glutamate, serotonin and dopamine. Increased opiate levels help explain the euphoric effect of alcohol, while its effects on GABA cause anxiolytic and sedative effects. Additionally, binge drinking increases the risk of acute hemorrhagic and ischemic strokes by up to ten-fold. It also leads to cardiovascular problems (atrial fibrillation, known as "holiday heart", sudden cardiac death, etc.). Repeated binge drinking can cause damage to the esophagus resulting in acute hemorrhage, gastritis, pancreatitis and myopathy. For pregnant women, binge drinking has been correlated with harm to the developing fetus, especially during the early stages of pregnancy. This pattern of drinking combined with smoking is responsible for a rise in oral cancer in men and women in their twenties and thirties. Additionally, it is feared that the increase in binge drinking among young women will lead to a significant increase in breast cancer in the next half century. It is well established that binge drinking causes a higher level of psychological morbidity, particularly anxiety and neurosis, than the same amount of alcohol consumed more steadily over a longer period. Interestingly, young binge drinkers are substantially more likely than non-binge drinkers to take illegal drugs. © 2009 Nova Science Publishers, Inc.