What is considered excessive drinking
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Understanding Excessive Drinking: Definitions, Impacts, and Detection
Definition of Excessive Drinking
Excessive drinking encompasses a range of alcohol consumption patterns that can lead to health consequences. It includes risky alcohol use, harmful alcohol use, and alcohol dependence, which are collectively referred to as alcohol use disorder (AUD) in the DSM-5 . Binge drinking (BD), a common form of excessive drinking, is defined as consuming a large amount of alcohol in a short period, typically leading to a blood alcohol concentration (BAC) of 0.08% or higher . For women, this usually means consuming four or more drinks on a single occasion, and for men, five or more drinks .
Prevalence and Patterns Among Youth
Excessive drinking is particularly prevalent among young people, including university students and adolescents. Studies have shown that a significant proportion of university students engage in binge drinking, with notable differences in drinking patterns between those who binge drink and those who do not . For instance, in a study of university students, 38.03% were classified as binge drinkers, and a substantial percentage of these individuals were also identified as risky drinkers or having probable alcohol dependence .
Among adolescents, excessive drinking is also a significant concern. A study involving 14-16-year-old schoolchildren in London found that 32% had engaged in at least one episode of excessive drinking, defined as consuming 10 or more units of alcohol per drinking occasion . This behavior was associated with other problem behaviors such as cigarette smoking, cannabis use, low educational aspirations, and delinquency .
Health and Social Impacts
The health and social impacts of excessive drinking are profound. Excessive alcohol consumption is linked to a range of somatic complications, including liver disease and cardiovascular problems, as well as increased risks of accidents, violent behavior, and suicide . Economically, excessive drinking imposes a significant burden, costing the U.S. approximately $249 billion in 2010, with binge drinking accounting for the majority of these costs . These costs include healthcare expenses, lost productivity, and criminal justice costs .
Detection and Screening
Detecting excessive drinking can be challenging, but several tools and markers are available. Traditional markers include liver enzymes such as gamma-glutamyltransferase (GGT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT), as well as mean corpuscular volume (MCV) . However, these markers have limitations in sensitivity and specificity.
Screening questionnaires like the Alcohol Use Disorders Identification Test (AUDIT) are widely used and have been validated in various languages and settings. The AUDIT is effective in identifying hazardous drinking and alcohol dependence, often outperforming other screening tools like the CAGE and MAST questionnaires . In clinical settings, brief interviews such as the Brief MAST and the Reich interviews have also shown high efficacy in detecting excessive drinking and alcoholism .
Conclusion
Excessive drinking, particularly binge drinking, is a widespread issue with significant health, social, and economic impacts. It is prevalent among young people and is associated with various risky behaviors. Effective detection and screening are crucial for addressing this public health challenge, with tools like the AUDIT questionnaire playing a key role in identifying individuals at risk. Addressing excessive drinking requires a multifaceted approach, including prevention strategies, early detection, and intervention.
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