Relationship Between Level of Consumption and Harms in Assessing Drink Cut-Points for Alcohol Research: Commentary on "Many College Freshmen Drink at Levels Far Beyond the Binge Threshold" by White et al

Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Alcoholism Clinical and Experimental Research (Impact Factor: 3.21). 07/2006; 30(6):922-7. DOI: 10.1111/j.1530-0277.2006.00124.x
Source: PubMed


In this commentary, we describe the use of a 5/4 drink summary measure of heavy episodic alcohol consumption, or "binge" drinking, in survey research and its usefulness for preventing negative alcohol-related consequences. Data from 4 nationally representative surveys of more than 50,000 college students are utilized to examine the utility of this measure in comparison with alternative cut-points. Our analysis demonstrates that while higher drink threshold measures incrementally improve the ability to identify correctly students who experience harms or who meet DSM-IV diagnostic criteria of alcohol abuse and dependence, they capture only a small proportion of those college students experiencing harms. We conclude that the selection of a measurement tool should be consistent with the purpose for which it is to be used. The 5/4 measure of binge drinking provides a valuable means for understanding and preventing alcohol-related harms in a college population and can be utilized as a screen to identify students who may need additional clinical assessment for intervention.

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    • "Earlier clinical definitions did not always make this distinction, with the number of these instances increasing as one retrospectively examines the literature (c.f., Plant & Plant, 2006). In addition, despite its general acceptance, there is still some controversy over the 4/5 rule of the NIAAA definition (2004; for some pros and cons see Goldman, 2006; Wechsler & Nelson, 2006; White et al., 2006). On the other hand, as reviewed by Bell et al. (2013) "
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    ABSTRACT: Binge alcohol drinking continues to be a public health concern among today's youth and young adults. Moreover, an early onset of alcohol use, which usually takes the form of binge drinking, is associated with a greater risk for developing alcohol use disorders. Given this, it is important to examine this behavior in rat models of alcohol abuse and dependence. Toward that end, the objective of this article is to review findings on binge-like drinking by selectively bred alcohol-preferring (P) and high-alcohol-drinking (HAD) lines of rats. As reviewed elsewhere in this special issue, the P line meets all, and the HAD line meets most, of the proposed criteria for an animal model of alcoholism. One model of binge drinking is scheduled ethanol access during the dark cycle, which has been used by our laboratory for over 20 years. Our laboratory has also adopted a protocol involving the concurrent presentation of multiple ethanol concentrations. When this protocol is combined with limited access, ethanol intake is maximized yielding blood ethanol levels (BELs) in excess, sometimes greatly in excess, of 80 mg%. By extending these procedures to include multiple scheduled ethanol access sessions during the dark cycle for 5 consecutive days/week, P and HAD rats consume in 3 or 4 h as much as, if not more than, the amount usually consumed in a 24 h period. Under certain conditions, using the multiple scheduled access procedure, BELs exceeding 200 mg% can be achieved on a daily basis. An overview of findings from studies with other selectively bred, inbred, and outbred rats places these findings in the context of the existing literature. Overall, the findings support the use of P and HAD rats as animal models to study binge-like alcohol drinking and reveal that scheduled access procedures will significantly increase ethanol intake by other rat lines and strains as well.
    Alcohol (Fayetteville, N.Y.) 10/2013; 48(3). DOI:10.1016/j.alcohol.2013.10.004 · 2.01 Impact Factor
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    • "For example, in 2004 the US National Institute on Alcohol Abuse and Alcoholism (NIAAA) defined binge drinking as "a pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram percent or above. For the typical adult, this pattern corresponds to consuming 5 or more drinks (male), or 4 or more drinks (female), in about 2 hours"[12]. While almost all episodes of zapoi would meet this definition of a binge, very few episodes of binge drinking in Western countries would be classed as zapoi. "
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    ABSTRACT: In the post-Soviet period, Russian working-age men have suffered unusually high mortality rates. Earlier quantitative work found that part of this is attributable to hazardous and harmful patterns of alcohol consumption, which increased in the period of transition at a time of massive social and economic disruption and uncertainty. However, there has been very little work done to document and understand in detail the downward life trajectories of individual men who died prematurely from alcohol-related conditions. Building on an earlier case-control study, this unique qualitative study investigates the perceived interplay between men's drinking careers, their employment and family history, health and eventual death. In-depth interviews were conducted with close relatives (most often the widow) of 19 men who died between 2003 and 2005 aged 25-54 years whose close relatives reported that alcohol contributed to their death. The study was conducted in a typical medium-sized Russian city. The relative's accounts were analysed using thematic content analysis. The accounts describe how hazardous drinking both contributed to serious employment, family and health problems, and was simultaneously used as a coping mechanism to deal with life crises and a decline in social status. The interviews highlighted the importance of the workplace and employment status for shaping men's drinking patterns. Common themes emerged around a culture of drinking in the workplace, peer pressure from colleagues to drink, use of alcohol as remuneration, consuming non-beverage alcohols, Russian-specific drinking patterns, attitudes to treatment, and passive attitudes towards health and drinking. The study provides a unique insight into the personal decline that lies behind the extremely high working-age mortality due to heavy drinking in Russia, and highlights how health status and hazardous drinking are often closely intertwined with economic and social functioning. Descriptions of the development of drinking careers, hazardous drinking patterns and treatment experiences can be used to plan effective interventions relevant in the Russian context.
    BMC Public Health 06/2011; 11(1):481. DOI:10.1186/1471-2458-11-481 · 2.26 Impact Factor
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    • "Some studies note that the frequency of drinking episodes is associated with drinking-related problems (Borsari, Neal, Collins, & Carey, 2001; Wechsler, Davenport, Dowdall, Moeykens, & Castillo, 1994). Other studies highlight that greater average quantity consumed per drinking episode (measured by number of drinks or estimated blood alcohol level) correlates with increased undesirable consequences, including difficulties with the police, risky sexual behavior, injury, and emergency room visits (Turner, Bauerle, & Shu, 2004; Wechsler & Nelson, 2006). It is not only likely that college students will face comparable alcohol use risks while studying abroad but also plausible that they will experience several consequences more than others. "
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    ABSTRACT: This study contributes to the scarce research on U.S. college students studying abroad by documenting general and sexual negative alcohol-related risks and factors associated with such risk. The manner of drinking (quantity vs. frequency), predeparture expectations surrounding alcohol use while abroad, culture-related social anxiety, and perceived disparity between home and host cultures differentially predicted consequences abroad. The findings include important implications for student affairs professionals in developing study abroad-specific interventions and resources to maintain student well-being while abroad.
    12/2010; 47(4):421-438. DOI:10.2202/1949-6605.6134
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