Binge drinking
March 2005
Physiological effects of high alcohol intake
The risks to an individual who binge drinks only once in their lifetime, suffering from immediate shot-term effects and more immediate behavioural costs [go to reference 16] is quite distinct from an individual who binge drinks regularly and therefore have both episodic very high levels of alcohol with the associated toxicity and long term health problems.
Binge drinking and severe intoxication can cause muscular incoordination, blurred vision, stupor, hypothermia, convulsions, depressed reflexes, respiratory depression, hypotension and coma. Death can occur from respiratory or circulatory failure or if binge drinkers inhale their own vomit [go to reference 17].
It is well known that binge drinkers are at increased risk of accidents and alcohol poisoning. A growing body of research suggests that binge drinkers also have a higher all-cause mortality rate than those who have the same average alcohol consumption but drink more frequently. Epidemiological studies have identified this association across a range of countries including the US [go to reference 18], Denmark [go to reference 19], and Finland [go to reference 20].
An emerging body of research hypothesises that binge drinking can be a catalyst producing acute ischaemia. While moderate consumption of alcohol has protective effects on cardiovascular disease, several studies have noted a pronounced Monday peak in cardiovascular mortality and morbidity in countries with known weekend binge drinking [go to reference 21]. Much of this research has focused on eastern Europe, Russia and countries in the Commonwealth of Independent States.
Similar trends have also been found in Scotland. A study of Scottish mortality between 1986 and 1995 found an excess of deaths from coronary heart disease outside of hospitals on Mondays among people with no previous admission for coronary heart disease. This peak in cardiac events may be partly attributable to increased drinking in Scotland at weekends, which is reflected in the highly significant weekly variation in emergency admissions for alcohol abuse [go to reference 22]. Similarly, in Northern Ireland, high blood pressure readings are recorded on Mondays among drinkers. These levels decrease until Thursday and seem likely to reflect the binge drinking pattern observed in Northern Ireland, where 66 percent of alcohol consumed is drunk on Fridays and Saturdays [go to reference 23].
A physiological basis for this correlation between binge drinking and cardiovascular deaths has been proposed:
‘In binge drinkers, cardioprotective changes in high-density lipoproteins are not seen, and adverse changes in low-density lipoproteins are acquired. Irregular drinking is associated with an increased risk of thrombosis, occurring after cessation of drinking. It predisposes both to histological changes in the myocardium and conducting system and to a reduction in the threshold for ventricular fibrillation. [go to reference 24]' It has been suggested that the myocardium may be especially sensitive during withdrawal periods, as will occur after weekend binges [go to reference 21].
The effects of drinking pattern on mortality and morbidity are less well known than the effects of total alcohol consumption [go to reference 25] and there is still much research to be done to establish the specific physiological consequences of binge drinking. While a growing body of research links binge drinking to cardiovascular deaths, others studies have found no association between episodic binge drinking and cardiovascular mortality when controlling for smoking and other risk factors [go to reference 26].
For some people, binge drinking is an occasional event. For others, it is part of a chronic drinking pattern (sustained drinking above weekly guidelines) [go to reference 7]. The chronic effects of alcohol can lead to many serious health problems including cancer, liver cirrhosis, strokes, hypertension, fertility problems, mental health problems, neurological problems and impotence [go to reference 27]. The Chief Medical Officer’s annual report 2001 documented a worrying increase in the occurrence of liver cirrhosis, possibly due to binge drinking patterns. In 2000, among people aged 25 to 44, cirrhosis accounted for nearly 500 deaths in men and 300 deaths in women [go to reference 28].
The following are further sources of information on the health effects of alcohol:
Alcohol Concern (2002) Health impacts of alcohol
Go to - http://www.alcoholconcern.org.uk/files/20030819_153746_health%20effects.pdf
Alcohol Concern (2003) Factsheet 20. Binge drinking
Go to - http://www.alcoholconcern.org.uk/files/20031212_114408_Binge%20drinking%20update%20%202003.pdf#search='binge%20drinking'
Institute of Alcohol Studies (2003) Binge drinking: medical and social consequences
Go to - http://www.ias.org.uk/factsheets/binge-drinkingmed.pdf