High‐intensity drinking and hours spent drinking

Abstract

BackgroundHigh‐intensity drinking (HID) is associated with negative consequences, but it remains unclear whether a time qualifier (i.e., time spent drinking) is needed to identify those at highest risk. In order to improve the measurement and conceptualization of HID, we sought to examine the utility of adding a time qualifier to define what constitutes an occasion of HID using repeated daily surveys in a sample of young adults.MethodsParticipants were selected from a nationally representative sample of 12th grade students in the U.S. who participated in the Monitoring the Future (MTF) study in Spring 2018. In 2019 and 2020, young adults (at modal ages 19‐20) responded to annual and daily (14 consecutive days per year) online surveys about their alcohol use.ResultsComparing moderate drinking (less than 4/5 drinks for women/men), binge drinking (4‐7/5‐9 drinks), and HID days (8+/10+ drinks), HID days had the longest duration of drinking (5.2 hours), highest peak estimated blood alcohol concentration (eBAC, 0.30%), and greatest drinking pace (2.58 drinks/hour). HID was associated with a greater number of negative consequences relative to both moderate and binge drinking; adjusting for time spent drinking did not impact this interpretation. HID was reported on 10.9% of days; when defined as 8/10+ drinks in 4 hours or 2 hours, HID was reported on 4.8% and 1.0% of days, respectively. Nearly all differences in eBAC and negative consequences persisted across drinking intensity despite the introduction of time constraints.ConclusionsHID days were characterized by both a longer time spent drinking and a higher pace of drinking. Adding a time qualifier to the definition of HID would restrict variability by only describing the minority of days and did not improve distinguishing between levels of risk.

Autopsy study of alcohol‐associated unnatural deaths in Thailand, 2007–2019

“…The generally agreed-upon definition was a pattern of consuming, during a period of a few hours, at least four "standard" drinks by a female and at least five "standard" drinks by a male. The defining level of purealcohol ingestion was at least 50 g for females and at least 60 g for males -the difference in quantity reflecting generally acknowledged differences in male-female metabolism of alcohol (Gmel et al, 2003;Graham et al, 1998;Jackson, 2008;Lange & Voas, 2000;Patrick & Azar, 2018). In 2004, the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA) attempted to provide a more precise definition by assigning HED a BAC threshold value ≥0.8 g/L for both males and females alike (NIAAA, 2004(NIAAA, , 2022.…”

High-Intensity Drinking among Adolescent and Emerging Adult Risky Drinkers

“…11 HID is associated with other substance use 12,13 , academic/occupational problems, blackouts, impaired control and driving, injury, and altered brain functioning. 9,[14][15][16][17] Emerging adults with HID of 15þ drinks are likely to endorse continued drinking despite serious problems (e.g., blackouts, fighting, legal issues). 18 Further, alcohol-use disorder prevalence among those with HID is more than twice that of those who binge drink only, 19 underscoring the need for targeted prevention interventions, 2,18 which should be tailored for young people.…”

“…For example, HID is more common on holidays, special occasions, and during sporting events, which commonly involve socializing with peers. 17 Similarly, college students not residing with parents are more likely to report HID. 10 Parent relationship quality is protective for heavy episodic drinking during the transition to emerging adulthood; 34 thus, it is plausible that parental factors may be protective against HID.…”

“…HID is associated with other substance use 12 , 13 , academic/occupational problems, blackouts, impaired control and driving, injury, and altered brain functioning 9 , 14 – 17 . Emerging adults with HID of 15+ drinks are likely to endorse continued drinking despite serious problems (e.g., blackouts, fighting, legal issues) 18 .…”

“…Despite the robust role of social influences on youth drinking, 31 – 33 social factors are under-explored but likely associated with HID. For example, HID is more common on holidays, special occasions, and during sporting events, which commonly involve socializing with peers 17 . Similarly, college students not residing with parents are more likely to report HID 10 .…”