What, if any, are the real risks associated with binge drinking, especially to long-term health?

As the year comes to a close, the parties—and drinking—are ramping up. Many people who report no problem with drinking under normal circumstances decide to let loose for the holiday season. After all, when the New Year comes it will be all vegan fare and daily runs, right? But for now, people are getting ready to dress up, get down, and go out on the town—which often includes heavy alcohol consumption. The risks of increased social pressure to drink, plus the stress that can for many go hand-in-hand with the holidays, certainly put those who are working to maintain sobriety at increased risk. But even for those who don’t normally overindulge the holidays can be a time of alcohol abuse—socially sanctioned alcohol abuse to boot (or at least, more tolerated than it might be at other times of year). What, then, are the risks associated with binge drinking?

The term “binge drinking” isn’t a specific medical term so much as it is a broad-spectrum term for describing drinking for the primary purpose of becoming intoxicated; sometimes the term “purposeful” is used. (An in-depth study, which you can look at inPDF form here—it’s 85 pages long, however, so be warned— from 2011, by the World Health Organization, uses the term without offering any specific definition.) An often cited rule of thumb, however, suggests that a good working benchmark for binge drinking is the consumption of five or more drinks for men over a two-hour period, and four or more drinks for women over a two-hour period (that is, for instance, the working definition used by the Center for Disease Control). Both worldwide, and in the United States specifically, binge drinking appears to be on the rise. According to the Institute for Health Metrics and Evaluation, binge drinking in the USA is up significantly over the last decade.

The Institute’s study—from this year—reports that “Heavy drinking among Americans has increased sharply, up 17.2% since 2005. The Centers for Disease Control and Prevention (CDC) defines heavy drinking as exceeding an average of one drink per day for women and two drinks per day for men over the past month.” The same study, by the way, also breaks down drinking patterns on a state county basis; if you’re interested, Menominee County, Wisconsin, is in the lead, with a 38% binge drinking rate. Much of the increase in binge drinking is due to an uptick in binge drinking among women, with the IHME study noting that “Nationwide, women showed a much faster escalation in binge drinking than men, with rates rising 17.5% between 2005 and 2012; men, on the other hand, saw rates of binge drinking increase 4.9%.”

Now, for a lot of people, five drinks for men and four for women doesn’t sound so much like binge drinking, as it does a typical couple of hours out with friends on a Saturday night but it’s actually way over the limit of two drinks per day for men, and one for women, that the Centers for Disease Control recommends. So the $65,000 question for anyone who’s planning on going hard at a holiday event or three is this: what, if any, are the real risks associated with binge drinking, especially to long-term health?

The answers are, pardon the pun, sobering.

First of all, the good news: the body has a pretty remarkable ability to bounce back from alcohol abuse. There is, in fact, no evidence to show that binge drinking increases the risk of cirrhosis of the liver, and most of the other negative health effects associated with a single episode of binge drinking seem to be pretty transient. Shrinkage of brain tissue and other neurological effects look to be temporary as well, so if you have a night out when you’ve really overdone it, chances are in a couple of days you’ll have recovered physically from your indiscretions. That’s the good news. The bad news is that binge drinking in a larger context is, unsurprisingly, bad for you in all sorts of obvious, and some non-obvious, ways. Let’s look at the obvious stuff first.

The biggest immediate problem with binge drinking for the purpose of getting drunk is that it works quite well, alcohol being alcohol, and being drunk is not so good for a person’s ability to objectively evaluate how risky their behavior is. Here is a list of things that binge drinking puts you at an increased risk for, and it’s by no means comprehensive: being physically assaulted by somebody; physically assaulting someone; being sexually assaulted; sexually assaulting someone; and, of course, one of the most common causes of morbidity and mortality associated with being drunk: getting behind the wheel of a car while under the influence. Says the WHO study cited above:

“Besides the adverse social impact on family members, relatives, friends and co-workers, people’s drinking can also impact on strangers, who can be victims of road traffic accidents caused by a drunk driver or be assaulted by an intoxicated person. A report on one carnival season in Rio de Janeiro, Brazil, found that at least 16,800 people were reported hurt in fits of violence, street fights, car crashes and accidents from excessive drinking. Intoxicated people commit many crimes where the victims are unknown to the perpetrators, including homicide, robbery, sexual assault and property crimes. The wellbeing of others can also be affected by verbal threats, noise and nuisance from intoxicated people. Again, these offences often also impact the drinker if she or he is arrested and punished.”

Binge drinking will often lead to blackouts (an alcoholic blackout is amnesia that occurs due to alcohol abuse, in the absence of actual unconsciousness.) Blackouts are, to put it bluntly, incredibly dangerous. Many women report sexual assaults that occurred during alcoholic blackouts. Also, judgment is impaired during a blackout so unsafe sexual practices lead to the risk of disease and unintended pregnancy, while even simple choices regarding personal safety are neglected. If you’re a woman, you’re three times more likely to be sexually assaulted if you’re binge drinking; 50% of teenage women who report being the victims of sexual assault are under the influence of either alcohol or something else at the time. Scientific evidence also suggests that those who binge drink on special occasions are at a greater risk of future alcoholism. Additionally, most alcohol poisoning occurs after an episode of binge drinking.

And the fact of the matter is that there are negative health effects associated with binge drinking—especially with repeated episodes of binge drinking. These are pretty much what you would think: increased risk of cirrhosis, damage to the brain, increased risk of tuberculosis, heart damage, hypertension, and outright sudden death from stroke (and that’s just the tip of the iceberg.) One of the most interesting, if alarming, risks associated with binge drinking is an increased risk of cardiac arrythmias—in other words, disruptions to the normal rhythm of the heart; the phenomenon is so common during the holidays, during celebratory binge drinking, that it’s sometimes referred to as“holiday heart.” And, needless to say, repeated episodes of binge drinking are a terrible idea if you’re pregnant (heavy drinking during adolescence, for all that it’s common, is especially bad for the developing brain).

The take-home from all of this isn’t really shocking to anyone with even passing familiarity with the negative effects of alcohol. Yes, drinking during social gatherings is common; yes, binge drinking as defined medically becomes more common during the holidays. But it has, often—all too often—a whole host of ill effects, ranging from medical to criminal to social, and even if the worst thing that happens is that you make a fool of yourself in front of friends and family, that’s still something you want to avoid (to say nothing of the alarmingly increased chance you do something, or have something done to you, that you’ll badly regret, and that wouldn’t have happened if you hadn’t been binge drinking). Read more “the fix”…