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Inventing Binge Drinking

I’ve long railed against the various governmental health department definitions of “binge drinking” as being out of touch with reality and self-serving to anti-alcohol groups. In the U.S., the CDC defines binge drinking as “five drinks in a row” and in the UK it’s too many “units of alcohol” in a given day (or number of hours). But that wasn’t always how it was defined.

In a recent issue of the Social History of Medicine, an Oxford Journal, social scientists Virginia Berridge, Rachel Herring and Betsy Thom published Binge Drinking: A Confused Concept and its Contemporary History.

Here’s the summary of the article:

Binge drinking is a matter of current social, political and media concern. It has a longterm, but also a recent, history. This paper discusses the contemporary history of the concept of binge drinking. In recent years there have been significant changes in how binge drinking is defined and conceptualised. Going on a ‘binge’ used to mean an extended period (days) of heavy drinking, while now it generally refers to a single drinking session leading to intoxication. We argue that the definitional change is related to the shifts in the focus of alcohol policy and alcohol science, in particular in the last two decades, and also in the role of the dominant interest groups.

To me, one of the key points of this article is how the definition has changed to create a panic of increasing binge drinkers when it’s far more likely rates are roughly the same, only the definition has changed so that it not only seems like the problem has grown worse, but so that anti-alcohol advocates have a convenient new method by which they can base ever more draconian policy demands.

Binge drinking as a concept has a distant history: but it also has a recent one. The term has come in recent years to describe two quite distinct phenomena. First, it is used to describe a pattern of drinking that occurs over an extended period (usually several days) set aside for the purpose. This is the ‘classic’ definition, linked to clinical definitions of the disease of alcoholism, as in Jellinek’s 1960 classification. Secondly, binge drinking has come to be used to describe a single drinking session leading to intoxication, often measured as the consumption of more than a specific number of drinks on one occasion, often by young people. There is no consensus on how many drinks constitutes this version of binge drinking—how much alcohol—and a variety of ‘cut-offs’ are used.

The second meaning has become prominent in recent years, is used extensively in research and informs UK policy. The ‘new’ definition has largely, but by no means entirely replaced the ‘classic’ definition, and both terms co-exist, if somewhat uneasily at times, in the alcohol field. Thus, it was evident from our research that there has been a shift in recent history in the meaning of the term. What was less clear was how the current confused definition of binge drinking has come to hold sway in public and policy discussions when it seems to be different from definitions which operated in the past. This is an issue which has implications for policy. But it is also a change which throws light on the relationship between science and policy. Our overall hypothesis, which is set out in this discussion paper, is that the definitional change must be related to the shifts in the focus of alcohol policy and alcohol science, in particular in the last two decades, and also to the role of the dominant interest groups in the alcohol field. It is not a change simply in the types of people drinking and the ways in which they drink, but rather an issue of perception which tells us something about the ways in which science and policy interact. [My emphasis.]

And the perception, as well as the target, has indeed changed. While binge drinkers used to be thought of as solitary older males, today the binge drinking “focus is on women and young people.” Although they’re careful in the wording of the article, I think it’s clear they’re saying that the shift in defining binging has been a bad idea, as it’s taken the focus away from the people who really need help and placed it on a more convenient target that allows neo-prohibitionist groups to sound the alarm about the problems of underage drinking — the children, always the children. People naturally want to protect kids from harm, and so it’s much easier to advance destructive alcohol policy under the rubric of underage drinking issues. I’d argue that this is even likely the reason for the shift in the definition, to advance the anti-alcohol agenda more effectively. Fear is always more effective than truth, sadly, in motivating people.

Among the journal article’s conclusions:

Policy makers should be aware of the context in which they operate. Concepts do not appear out of thin air, but have their own history. This study can in fact be seen as feeding in ‘evidence’ to policy on the rational model. On a more theoretical level, this change of definitions over time is also a case study of evidence and policy itself. It tells us how science interacts with policy making and the policy environment.

Exactly. In this case, the science was manipulated and created to further a specific anti-alcohol agenda over the last two decades. As a result, everyone I know is a binge drinker. That’s what happens when science no longer reflects reality but instead is used to remake it.

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