Distinguishing High-Intensity Drinking from Heavy-Episodic Drinking Events Among Heavy-Drinking U.S. adults

High-intensity drinking (HID) poses significant health risks, yet research on its prevalence and contextual factors, among general adult populations, remains limited. To identify intervention points among heavy drinkers, this study compared event-level factors that were associated with higher risk for HID compared to heavy episodic drinking (5+ drinks).

We surveyed 756 adults (ages 18-65) who engaged in past-year 5+ drinking, answering questions on recent past 12-month drinking events at HED 5-7 drinks and HID 8-11 and 12+ drinks. Bivariate analyses were conducted to compare within-person differences between HED and HID events. Weighted conditional logistic regression models estimated within-person associations between event-specific (e.g., beverage type, day of the week, total hours spent drinking, drug co-use, drinking motives) characteristics and HID drinking levels (8-11 drinks and 12+ drinks separately), versus the HED drinking level (5-7 drinks).

Bivariate analyses revealed significant differences for several event-specific characteristics (beverage proportion, total hours, day of the week, group size, tobacco co-use, and drinking motives) between HED 5-7 and HID (8-11 and 12+ drinks). Conditional logistic regression models revealed longer drinking periods and the intention to drink a lot were associated with increased odds of a HID event (8-11 and 12+ drinks) versus a HED event. Drinking in small groups was also associated with increased odds of a HID event (8-11 drinks), while marginally significant for a HID event (12+ drinks).

Understanding distinct characteristics of HID events compared to HED events provides opportunities to identify prevention and early intervention strategies to reduce HID.