Binge Drinking

What is binge drinking

The definition of binge drinking has been open to debate, but has tended to become increasingly more inclusive the higher binge drinking rises up the political agenda. Traditional medical definitions of binge drinking tended to assume a period of intense drinking extending over several days, whereas now journalists and increasingly many politicians seem to use the term to refer to any public drunkenness.

The British Medical Association (BMA) says "binge drinking" used to refer to heavy drinking over a period of two days or more where the drinker gives up their normal activities such as work or family time to drink to intoxication. This chimes with the definition held by the Journal of Studies on Alcohol, which insists authors refer to binge drinking as drinking over an extend period of time with a sole focus on getting drunk.

Now, the BMA notes, binge drinking has been adopted into common usage to refer to any evening of heavy drinking.

One definition of binge drinking is consuming more than half of the recommended weekly maximum alcohol units in one sitting. For women a binge is therefore seven units of alcohol - equivalent to three large glasses of 12 per cent wine - and ten units for a man - equal to four pints of five per cent beer or lager.

Alcohol Concern adopts a stricter measure and says consuming too much alcohol in too short a time is likely to count as a binge. It classes this as six units of alcohol for women or eight units for men.

The Office for National Statistics defines a heavy drinker as a man drinking eight or more units in one sitting at least once a week and a woman drinking six units.

The Department of Health recommends women drink a maximum of two to three units a day and men three to four. People should also abstain from alcohol for two days after a heavy session, the department states, and warns against drinking at the upper limit for a prolonged period of time.

Background

Despite the continued enthusiasm among politicians and the media to discuss the scourge of binge drinking, public drunkenness is far from a 21st century phenomenon. Archaeological finds suggest Britons were discovering fermentation as far back as 12,000 years ago. Since then, the heavy drinker has been a regular character in British social history, literature and satire.

The previous government's aspiration towards a continental café culture underscored the fact Britons appear to drink differently to their European neighbours. Switzerland, Germany, Portugal, Austria, Denmark, Beligum and the Netherlands all have a lower legal drinking age (16) but fewer problems with alcohol abuse. Only Malta stands out among southern European countries for emulating the UK's drinking style. While Britons often drink standing up and with their sole focus on intoxication, drinkers in France or Spain tend to pace their drinks and consume them with food, lessoning the effects.

The perception of widespread alcohol abuse, especially taking place in public spaces such as town squares, has pushed drinking firmly onto the public health agenda. Government has made it a stated aim to encourage responsible drinking, as well as uphold existing laws on underage sales and drink driving.

Public policy on alcohol is driven by the Department of Health but also incorporates the Home Office and, to a lesser extent, the Department for Transport. The Department of Health sets guidelines for responsible drinking and warns of the dangers of excessive consumption - as well as footing the bill of alcohol-related illnesses. The Home Office is responsible for reducing drink-related anti-social behaviour and crime.

Controversies

With its concerted push to reduce alcohol consumption, the previous government risked accusations of presiding over a 'nanny state'. It is by no means clear, however, that the government was motivated by a paternalistic desire to improve the nation's health or a self-interested awareness of the costs of binge drinking.

In 2003, the prime minister's strategy unit estimated binge drinking cost the UK £20 billion a year. Hangovers resulted in 17 million lost working days, costing employers £6.4 billion. Health problems cost the NHS around £1.7 billion while the Home Office incurred further costs from alcohol-related crime and social disorder.

The Department of Health admits that drinking in moderation is acceptable. The challenge for the government therefore is how to balance respect for an individual's right to drink - alcohol is after all one of the few legal drugs in the UK - and the growing health problems caused by excessive consumption. Public health campaigns therefore tend to focus on moderation, or "know your limits" rhetoric. A few exceptions exist including underage drinking and drink-driving.

The rising cost to the NHS is a matter of economic concern for the government and, unless it is forced to raise taxes, has little bearing on the wider public. Political pressure on the government stems from public concern over alcohol-fuelled public disorder.

The Home Office stated that in 44 per cent of violent incidents the offender was under the influence of alcohol, rising to 54 per cent in "stranger violence" cases. The perception town centres are "no go areas" on Friday and Saturday nights is also politically problematic for ministers.

The previous government attempted to tackle low-level alcohol related disorder through its Respect Agenda. This gave the police and local communities greater powers to demand premises close and increased penalties for licensees selling to underage drinkers.

The 2003 Licensing Act, which brought in 24-hour drinking, was also designed to reduce drunken disorder. Rather than create a bacchanalian nation with round the clock drinking for all, the government said this would enable premises to stagger closing times, thereby preventing "flashpoints" for confrontation at 11pm and 2am.

Controversy dogged the act from its inception and, with a lack of conclusive evidence of its impact, continued. Critics claimed alcohol-related admissions to A&Es had risen as a result of the act, with longer opening hours encouraging excessive drinking.

It has been argued that the focus on drinking in bars and clubs is misguided if the overall aim is to reduce the level of problem drinking. There was said to be increasing evidence that people were drinking more heavily at home, often before going on to a bar or club. The Alcohol Health Allowance identified the rise of "pre-loading," where people drink cheap alcohol at home before an evening out. After focusing on younger binge drinkers, the government turned its attention to middle class people drinking at home.

The previous government introduced a number of measures designed to reduce problem drinking.
Small scale pilots, such as night life marshals in Wakefield and dispersal notices in Camden were piloted to tackle the immediate effects of anti-social disorder. 'Pop-up' urinals were also introduced in some town centres to deal with specific problems.

Attempts to force a longer-term change in behaviour are more problematic. Promotional messages themselves have been subject to controversy. One campaign warning younger drinkers of the effects of 'beer goggles' was criticised for condoning promiscuity.

Evidence from drink-driving campaigns suggested government action could change behaviour, however. A change in the law combined with public education campaigns was reported to have dramatically cut the number of people killed in drink driving deaths, from 1,600 in 1970 to 560 in 2005.

Statistics

A survey of 2,000 young adults showed some worrying attitudes to drinking, extreme drunken behaviour and subsequent regret of that behaviour.

The key findings include:
One in three (30%) 18-24 year olds think it is acceptable to wake up without knowing how they got home after a drinking session.
In the last 12 months, 27% of young adults, have done this and a third (33%) of those have felt regret.
More than a third (35%) of 18-24 year olds think it is appropriate to have a one night stand as a result of drinking. 18% say they have done this in the past year and two fifths (40%) have regretted their behaviour.
One in 25 (4%) young adults think it is OK to end up in hospital as a result of drinking too much alcohol. According to the survey, 3% have done this in the last 12 months and three fifths (61%) of these regret their behaviour.

Source: Drinkaware - September 2010

Quotes

"binge drinking is a blight on UK society - it affects individuals, families and local communities and tarnishes our reputation on the global stage. There is no doubt we must tackle the issue and partly this means individuals taking responsibility for their own behaviour."

Drinkaware chief executive Chris Sorek - September 2010

"Alcohol Concern believes that a twin approach is needed to tackle what is becoming one of the biggest public health problems in the UK: We need more support for individuals and their families who experience problems with alcohol and better regulation and monitoring of the drinks industry."

Alcohol Concern - 2010

"The coalition government's programme on alcohol includes commitments to:

Ban the sale of alcohol below cost price.
Review alcohol taxation and pricing to ensure it tackles binge drinking without unfairly penalising responsible drinkers, pubs and important local industries.
Overhaul the Licensing Act 2003 to give local authorities and the police much stronger powers to remove licences from, or refuse to grant licences to, any premises that are causing problems.
Allow councils and the police to shut down permanently any shop or bar found persistently selling alcohol to children.
Double the maximum fine for underage alcohol sales to £20,000.
Permit local councils to charge more for late night licences to pay for additional policing."

Home Office - September 2010