Binge drinking – How does this affect your health?
Studies carried out over the past few years have revealed that binge drinking is on the rise, particularly among adolescents. Moneybags journalist Jessica Anne Wood investigates the problem of binge drinking in South Africa and what the possible health effects could be.
You may think that having a couple of drinks with friends makes you the life and soul of the party. Alcohol may even give you the confidence that you need to socialise in a crowd. Or having a couple of ‘tots’ may be the release that you so desperately crave after a heavy working week. But what you consume could actually be too much for your body and mind to handle and this is referred to as binge drinking.
So what is binge drinking? It’s defined as “drinking five or more units on one or more occasions”, according to the Department of Trade and Industry (DTI). Heavy drinking, by comparison, is “drinking 15 or more units of alcohol.”
Binge drinking is no laughing matter. Accidents and falls are common because being drunk can affect your balance and co-ordination. In extreme cases you can die and overdosing is a danger too. According to DrinkAware.co.uk, a British site dedicated to highlighting the consequences of alcohol abuse, overdosing on alcohol could stop you from breathing or stop your heart. Binge drinkers have also been known to die from choking on their own vomit. Drinking too much can also affect your moods, memory and can lead to serious mental health problems.
Liane Lurie, a clinical psychologist, adds: “Binge drinking is essentially defined as drinking an excessive amount of alcohol in one sitting, such that one experiences a level of impairment.”
Even if you can tolerate your tipple you could still be a binge drinker. Mich Robb, managing director, Mental Wellbeing Interventions, highlights that even if a person has built up a tolerance to alcohol, if they consume five or more drinks at one sitting, it is binge drinking.
Under a measure called The Diagnostic and Statistical Manual of Mental Disorders V (DSM-5), a sliding scale is used to determine if a person has an alcohol use disorder. The American Psychiatric Association explains: “DSM contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It provides a common language for clinicians to communicate about their patients and establishes consistent and reliable diagnoses that can be used in the research of mental disorders.”
Lurie elaborates: “The DSM-5 no longer refers to categories of substance abuse and substance dependence. It rather chooses to use a classification of substance use based on the intensity of use- mild, moderate or severe. An individual is recognised as having a substance use disorder when the repeated use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home.”
Robb notes that there are 11 criteria used for determining whether or not a person has an alcohol use disorder. “You could suffer from a mild case of alcohol use disorders, or to a moderate case, or to severe case. And it depends on how many of the criteria you can tick off as being your problem. If somebody is binge drinking they could be suffering from a moderate, or even a severe alcohol use disorder. So they are not defining it as either an addiction or not an addiction, how they define it now is as the extent of the problem.”
Is an alcoholic also a binge drinker?
The difference between a binge drinker and an alcoholic is that a binge drinker can go several days without alcohol without a problem, whereas an alcoholic will start to suffer from withdrawals.
According to Robb, and several studies conducted on how South Africans consume alcohol (see below), binge drinkers often binge on the weekend. While they do not have the same ‘need’ to drink as an alcoholic, when they start to drink they may find it difficult to stop or they drink in excess.
For more information on alcoholism and addiction, click here.
Binge drinking in South Africa
According to the Global status report on alcohol and health 2014 by the World Health Organisation (WHO), in 2009 the combined tangible and intangible cost of harmful use of alcohol on the South African economy was about R300 billion, or 10 to 12% of gross domestic product.
Furthermore, the DTI highlighted that a study into the drinking practices of 20 African countries found that on weekends, cases of heavy drinking by South Africans is up to five times higher than on weekdays.
The study also revealed that while 23% of South Africans had drunk alcohol in the previous week, 48% of these drinkers had binged, and 29% could be categorised as heavy drinkers.
Reports indicate that patterns of hazardous and harmful drinking, including binge drinking, is on the rise among adolescents and young adults.
The DTI highlighted in the study that a majority of South African learners agreed that alcohol consumption among the youth was becoming more socially acceptable and tolerated.
“Many learners, who consume alcohol, have been drunk or engaged in ‘binge drinking’ with disturbing consequences which impact on education either directly or indirectly. Reported consequences include; drunkenness, violence, motor car accidents, irresponsible sexual behaviour and criminal activities. Learners generally consume alcohol at social events over weekends and mainly do so to be socially acceptable,” explained the DTI.
According to the DTI report, the biggest harm caused by drinking is from binge drinking. The research reveals that in South Africa 45.4% of drinkers have weekly heavy episodic drinking occasions, compared to the global average of 11.5%.
The South African Depression and Anxiety Group (SADAG) says that 49% of school learners are engaged in underage drinking nationally.
Robb adds: “If someone starts drinking before they are 15 years old, that’s if they just start drinking, not binge drinking or anything, they are five times more likely to develop an alcohol problem or become abusive later in life than those who started drinking after they were 21. That’s because the adolescent brain is still developing, and alcohol affects that development. It can be long term permanent damage, or an effect that can be created. The younger somebody starts the more likely there is a problem. And the more they binge drink, the greater the likelihood that there will be a problem.”
Identifying and treating the problem
According to Lurie, many etiological factors are taken into account when exploring someone’s pattern of drinking. For example, she would pose several questions to determine the cause: “Is there a family/genetic history of alcoholism? Does the individual suffer from an anxiety or depression that he/she may be using alcohol to self-medicate? Is the individual surrounded by a social circle that supports excessive drinking on a regular basis? Does the person have a history of other self-harming behaviours and possibly struggle with emotional self-regulation? Do they persistently feel empty or lonely?”
Lurie adds: “An individual’s choice of treatment depends very much on both the severity of the problem, their recognition of the problem and whether they are ready for change. Treatment very often feels scary or threatening as the individual may fear losing a coping mechanism. We look at the degree to which the problem is affecting the person’s life and then decide on whether an inpatient versus outpatient programme is needed. The AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) also provide ongoing support in the form of daily meetings and a therapeutic community, which often becomes an essential part of the person’s recovery.”
The health impacts of binge drinking
Binge drinking can affect you in a number of ways and this varies depending on your life stage. Robb points out: “An adolescent that binge drinks is going to affect their brain development. Adolescents who binge drink statistically stand a chance of permanently reducing their IQ levels, not from 100 IQ down to 60, but it can drop from five up to 10 points with regular binge drinking.”
In addition to the effect that alcohol can have on mental development and brain function, there are other more physical impacts that it can have on a person.
“From a physical point of view, it’s not unusual that people who binge drink start suffering from alcohol induced blackouts, so they will forget what happens. And these blackouts can become increasingly more severe the more that they binge drink. Again binge drinking physically, because you are taking in an excess of a substance, will affect a person’s liver in the same way that an alcoholic would be affected. Your liver would then recover a bit if you don’t drink for a few weeks and then you binge drink again and then your liver gets hammered again,” explains Robb.
Lurie states: “It impacts upon the person’s health, mood and concentration. Alcohol is able to cross the blood-brain barrier and ultimately can lead to huge impairments in memory and thinking such as alcohol induced dementia. Liver damage is also common. The person may stop functioning effectively at work and their home life may be negatively affected. Frequent interactions with the law are also common.”
Binge drinkers may also suffer from depression and anxiety. “Alcohol is basically a poison and anybody could drink themselves to death, they could carry on drinking and die from the alcohol because it is a depressant and their body will arrest, it will stop,” adds Robb.
There are a number of other physical effects that alcohol consumption can have on a person. However, in addition to these, there are the effects that alcohol can have on a person’s behaviour and decision making, which can also have a big impact on their lives.
Where can you get help?
If you are a binge drinker, or you have a family member or friend who is, there are places that you can go to for help.
Robb notes: “In terms of treatment, firstly there needs to be an education element to it. People need to understand what is happening. If somebody had to come and see me for treatment for binge drinking, I would treat it in much the same way as I would treat any addiction. They actually need to stop drinking because the pattern will just repeat itself. It’s very rare that somebody who was a binge drinker can revert back to being a responsible social drinker and have one or two drinks and stop there.”
Alcoholics Anonymous (AA) is probably one of the better known treatment programmes available, and they host meetings around the country.
Cape Recovery is another organisation you can turn to. Operating in the Western Cape, it aids people with a range of addiction problems, including drinking. It can also offer advice or assistance in staging interventions with family and friends.
Simon Turner, director of Cape Recovery, emphasises that the first stage to recovery is acknowledging that there is a problem to begin with. If the person with the drinking problem does not view it as a problem, they will not see the point in receiving treatment for it.
Renate Netzel, a counsellor at LifeLine Johannesburg, points out that counselling can also be a helpful tool in addressing any underlying issues or traumas which may lead to the drinking problem.
For more information on the treatment of alcoholism, click here.
Useful contact details:
Alcoholics Anonymous – 0861 435 722
Cape Recovery – 082 635 9419
LifeLine Johannesburg – 011 728 1347
Mental Wellbeing Interventions – 011 483 2427 or 082 920 5129
The South African Depression and Anxiety Group (SADAG) – 011 234 4837
If you’re driving but have been drinking you could get a ride home for free. For more on how to get a ride home after a night out, click here.