Can Binge Drinking Lead to Alcoholism?
Binge drinking, as defined by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), is when a person brings their blood alcohol concentration (BAC) up to 0.08 g/dL, which is considered the legal limit for driving under the influence in all 50 American states. Usually, a man can bring his BAC up to binge drinking levels when he drinks five drinks in a two-hour timespan; for a woman, it generally takes four drinks consumed in the same amount of time. Factors like food consumption, metabolism, race, body mass, and other genetic, biological, and environmental aspects can contribute to how quickly a person can raise their BAC and how much alcohol it will take to do so.
The Centers for Disease Control and Prevention (CDC) reports that within the United States, binge drinking is considered the most deadly, expensive, and frequent pattern of excessive alcohol use. Nearly one-third of American adults reported past-month binge drinking in 2015, according to NIAAA. The CDC reports that one out of every six adults in the United States binge drinks around four times a month, drinking as many as eight drinks in a sitting.
Binge drinking is a risky pattern of alcohol consumption that can cause a wide range of potential issues, including heightened danger for getting into an accident or being the victim of a crime, a host of physical health problems, unsafe sexual practices, increased risk-taking behaviors, memory and learning issues, and social and emotional problems. Binge drinking can also potentially lead to alcohol dependence and addiction.
Binge drinking is considered a high-risk type of alcohol consumption. While not everyone who binge drinks battles alcohol addiction, regular bouts of binge drinking can increase the odds that a person will develop issues with alcohol, including the possibility of alcoholism.
Tolerance and Dependence
Alcoholism is a disease with many contributing factors. For instance, NIAAA reports that genetics may account for around half of the risk for alcohol addiction. Other factors may include biological and environmental aspects, the presence of a co-occurring disorder, polysubstance abuse, and the level of physical dependence to alcohol. The more a person drinks and the more often they do so, the more likely they are to develop a strong dependence on the mind-altering substance. Therefore, episodes of binge drinking can increase the odds for developing a tolerance to and then dependence on alcohol.
Tolerance occurs when the brain and body get used to certain amounts of alcohol being consumed and adapt to them. It will then take more alcohol for a person to get drunk or feel the effects of alcohol. A person is then likely to drink more to feel the way they want to. Increasing the amount of alcohol consumed each time and bumping up the frequency of drinking episodes can lead to alcohol dependence more quickly.
Alcohol makes changes to the way the brain sends messages throughout the central nervous system, Forbes reports. It increases the presence of the inhibitory neurotransmitter GABA (gamma-aminobutyric acid), therefore acting as a depressant. GABA is responsible for suppressing functions of the central nervous system; it lowers blood pressure, body temperature, heart rate, and anxiety levels while leading to relaxation and drowsiness. Alcohol also affects levels of excitatory neurotransmitters in the brain, like glutamate. Alcohol inhibits the natural release of glutamate in the brain, one of the chemical messengers responsible for energy levels and brain activity in general. Conversely, alcohol also stimulates the release of dopamine, a neurotransmitter that interacts with the brain’s reward center and is responsible for feelings of pleasure.
The more a person drinks, the more the brain is impacted. When binge drinking episodes are repeated regularly, the brain may stop working the way it was meant to. These chemical messengers may not be produced, transmitted, and reabsorbed the way they were designed to be, and the brain may now rely on alcohol to stay “balanced.” Dopamine and GABA levels may then drop without alcohol, and glutamate may spike dangerously high. Withdrawal symptoms may occur when alcohol processes out of the body, and these symptoms can range from uncomfortable to potentially fatal.
Dependence is formed at this point. When a person struggles with alcohol dependence, they may continue to drink in order to avoid the difficult withdrawal symptoms and cravings that can occur without alcohol’s influence. Compulsion to continue drinking may become a factor, and a person may lose their ability to control how much and how often they consume alcohol, leading to addiction.
Alcohol Addiction Defined
The American Society of Addiction Medicine (ASAM) calls addiction a chronic brain disease that interferes with normal brain function. It is indicated by compulsive behaviors and a lack of control over these behaviors and related actions. Drinking on a regular basis, especially binge or heavy drinking, can lead to alcohol dependence and also potentially alcoholism. Not everyone who binge drinks will suffer from alcoholism; however, the more frequently a person engages in high-risk drinking patterns, the more likely they are to develop problems with alcohol.
The current Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines the specific criteria that are used to diagnose addiction, as published by NIAAA:
- Spending significant time drinking and recovering from drinking
- Inability to control how much alcohol is consumed at a time and for how long
- Several attempts to stop drinking that are unsuccessful
- Alcohol interfering with regular obligations (e.g., family, work, school, etc.)
- Less interest in activities that do not involve alcohol to the point of giving up previously important events or activities
- Drinking in hazardous situations or conditions
- Needing to drink more each time to feel the effects of alcohol (tolerance)
- Alcohol dependence and withdrawal symptoms when alcohol wears off (can include nausea, headache, dizziness, irregular heart rate, vomiting, diarrhea, difficulty thinking straight, memory problems, muscle and stomach aches, sweating, insomnia, tremors, hallucinations, delirium, sedation, seizures, and significant confusion)
- Drinking despite knowing that alcohol is likely to cause physical and emotional health problems
- Continuing to drink even with the knowledge that there will be significant negative social and behavioral consequences
- Cravings for alcohol
A lack of a good support system, high levels of stress, exposure to trauma, being the victim of abuse or violence, family history of alcoholism or addiction, combining alcohol with other substances, co-occurring mental and/or medical disorders, and biological factors can contribute to issues related to alcohol abuse and also to the onset of addiction. Men are more prone to alcoholism than women, NIAAA publishes.
The CDC reports that nearly a quarter of all American adults reported drinking heavily at least one day (five or more drinks for men and four or more drinks for women) in the year leading up to the 2015 national survey. One episode of binge drinking or heavy drinking is not likely to lead to alcoholism; it is the repeated pattern of excessive drinking that can lead to tolerance, dependence, and even to addiction.
Alcohol addiction often requires specialized treatment and medical detox in the case of severe dependence. Comprehensive treatment programs can help individuals to uncover the root cause of problem and binge drinking patterns and learn how to manage cravings, minimize stress, develop healthy life skills, and reduce instances of relapse for improved overall quality of life.