Heavy episodic drinking: determining the predictive utility of five or more drinks

Area of Science:

• Psychology
• Public Health
• Addiction Science

Background:

• The standard definition of heavy episodic drinking (HED) uses a threshold of 5+ drinks (or 4+ for women).
• This widely used threshold lacks empirical validation for predicting adverse drinking outcomes.
• There is a need to establish evidence-based thresholds for HED.

Purpose of the Study:

• To empirically determine the threshold for heavy episodic drinking (HED) that best predicts proximal and distal adverse drinking-related outcomes.
• To compare the predictive validity of various HED thresholds.

Main Methods:

• An 8-week internet survey assessed daily drinking and next-day hangover in 115 young adults.
• Adverse outcomes, including problem drinking, alcohol-related problems, maximum drinks consumed, and drug use, were assessed 10 months later.
• Thresholds ranging from 1+ to 15+ drinks per occasion were analyzed for their predictive power.

Main Results:

• A threshold of 10+ drinks per occasion demonstrated the strongest prediction for hangover symptoms.
• Different thresholds were identified for predicting long-term adverse outcomes, with higher thresholds correlating with greater outcome severity.
• Findings suggest that a 10+ drink threshold is optimal for predicting acute negative consequences like hangovers.

Conclusions:

• The conventional 5-drink threshold for HED is not empirically supported for predicting adverse outcomes.
• A threshold of 10+ drinks per occasion appears more effective for identifying risky drinking patterns related to hangovers.
• Establishing evidence-based HED thresholds is crucial for effective prevention and intervention strategies in young adults.