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Related Experiment Video

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Murine Drinking Models in the Development of Pharmacotherapies for Alcoholism: Drinking in the Dark and Two-bottle Choice
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After how many drinks does someone experience acute consequences-determining thresholds for binge drinking based on

Florian Labhart1,2, Michael Livingston3,4, Rutger Engels5,6

  • 1Addiction Switzerland, Research Institute, Lausanne, Switzerland.

Addiction (Abingdon, England)
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PubMed
Summary

The traditional 4+/5+ drinks threshold for episodic drinking accurately predicts general alcohol-related consequences but is too low for severe outcomes like blackouts or injuries. Optimal thresholds vary by gender and age, with adolescents and women often experiencing consequences at lower drink levels.

Keywords:
Alcohol-related consequencesYouden Indexbinge drinkingevent-level studyoptimal thresholdyoung adults

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Area of Science:

  • Alcohol research
  • Public health
  • Addiction science

Background:

  • Episodic drinking thresholds (4+/5+ drinks) have long been used to define risky alcohol consumption.
  • Previous research lacked event-level data to validate these established thresholds.
  • This study investigates optimal drink quantity thresholds for acute alcohol-related consequences.

Purpose of the Study:

  • To determine accurate, event-level thresholds for acute alcohol-related consequences.
  • To assess the validity of the traditional 4+/5+ drinks threshold.
  • To identify optimal thresholds for specific consequences (hangover, blackout, risky sex, fights, injury) across different demographics.

Main Methods:

  • Utilized event-level data from two studies involving 369 participants aged 16-25.
  • Analyzed 3554 weekend nights, correlating drinks consumed with reported consequences.
  • Employed receiver operating characteristic (AUROC) curves and the Youden Index to determine optimal thresholds, stratified by gender and age.

Main Results:

  • Hangover was the most frequent consequence; injury was the least.
  • Traditional 4+/5+ drink thresholds were optimal for general consequences and hangovers.
  • Higher thresholds (up to 3 drinks more) were needed for blackouts, risky sex, fights, and injuries.
  • Adolescents experienced consequences more frequently and at lower drinking levels than adults.
  • Optimal thresholds were 1-2 drinks lower for women than men for most consequences.

Conclusions:

  • Event-level data collection is effective for establishing alcohol consequence thresholds.
  • While 4+/5+ drinks (40+/50+ g alcohol) predict general consequences, they underestimate risks for severe outcomes.
  • Refined, demographic-specific thresholds are necessary for accurately assessing acute alcohol-related risks.