Alcohol misuse or abuse is defined as recurrent alcohol use that has negative consequences, such as drinking in dangerous situations (e.g., before driving), or drinking patterns that result in academic, professional, interpersonal, or legal difficulties. Alcohol-use disorder, or what has been called alcoholism, involves more extensive problems with alcohol use, usually including physical tolerance and withdrawal. Various experts use different definitions to describe problems associated with drinking. The important point is that one does not have to be an alcoholic (term not used by the DSM-5) to have problems with alcohol. The person who drinks only once a month, perhaps after an exam, but then drives while intoxicated is an alcohol abuser. (Lab 13.1 includes an assessment to help you determine if alcohol is a problem in your life.)
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How can you tell if you or someone you know has an alcohol use disorder? Look for the following warning signs:
• Drinking alone or secretively
• Using alcohol deliberately and repeatedly to perform or get through difficult situations
• Using alcohol as a way to “self-medicate” in order to dull strong emotions or negative feelings
• Feeling uncomfortable on certain occasions when alcohol is not available
• Escalating alcohol consumption beyond an already established drinking pattern
• Consuming alcohol heavily in risky situations, such as before driving
• Getting drunk regularly or more frequently than in the past
• Drinking in the morning or at other unusual times
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as a pattern of alcohol use that brings a person’s BAC up to 0.08% or above (typically four drinks for men or three drinks for women), consumed within about two hours. The National Survey on Drug Use and Health defines binge drinking as having five or more drinks within about two hours at least once within 30 days. The 2011 survey estimated that nearly 23% of Americans over the age of 12 were binge drinkers. Just over 6% were
A “standard drink” is 12 ounces of beer, 5 ounces of table wine,
2.5 ounces of liqueur, or 1.5 ounces of hard liquor. Use this measurement to determine how much alcohol you ingest, and remember that actual drink sizes may be much larger than a standard drink.
Binge drinking is very common among American college students.
Heavy drinkers, defined as having five or more drinks on the same occasion on each of five or more days in the past 30 days.
According to the NIAAA, 80% of all college students drink, including 60% of students age 18-20. More than 40% of college students binge drink. Binge drinking is a common form of alcohol abuse on college campuses, and it has a profound effect on students’ lives. Frequent binge drinkers were found to be three to seven times more likely than nonbinge drinkers to engage in unplanned or unprotected sex, to drive after drinking, and to get hurt or injured. Binge drinkers were also more likely to miss classes, get behind in schoolwork, and argue with their friends. The more frequent the binges, the more problems the students encountered. Despite their experiences, fewer than 1% of the binge drinkers identify themselves as problem drinkers.