Binge Drinking Vs. Alcoholism: What's The Difference? - Healthline

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What's the Difference Between Binge Drinking and Alcohol Use Disorder?

Medically reviewed by Alyssa Peckham, PharmD, BCPP — Written by Emily Swaim on April 8, 2022

Binge drinking
Alcohol use disorder
Potential risks
Professional support
Takeaway

man in yellow checked aweater and baseball cap drinking beer out of cup 1 — HOWL/Stocksy United

If you drink alcohol, you might have found yourself wondering a time or two, “How much alcohol is too much?”

This question doesn’t always have a straightforward answer, since every person has their own limit when it comes to alcohol. That said, certain patterns of alcohol use do pose some cause for concern.

Binge drinking, one of these patterns, involves consuming several drinks in a short period of time. An episode of binge drinking can bring your blood alcohol content (BAC) to dangerous, even life-threatening levels. As a result, you might experience a blackout, vomit, or even pass out.

Alcohol use disorder (AUD), formerly known as alcoholism and alcohol addiction, describes a long-term pattern of alcohol use that becomes difficult to control. You might, for instance, feel an urge to drink even when you no longer want to, and have cravings when you try to avoid alcohol. In short, your relationship with alcohol may have started to disrupt your daily life and activities.

Below, we’ll compare and contrast these two patterns of alcohol use in more detail, plus offer some guidance on identifying your options for getting treatment and support.

What’s binge drinking?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) defines binge drinking as an episode of alcohol use that raises your blood alcohol concentration (BAC) to 0.08 percent (0.08 grams of alcohol per deciliter) or higher.

This means you have 80 milligrams of alcohol per 100 milliliters of blood in your bloodstream. At this point, almost all states consider you too intoxicated to legally drive.

How much can you drink before reaching 0.08 BAC?

That depends, in part, on what beverage you’re having. Generally speaking, a standard drink contains 14 grams of alcohol. You can get this amount of alcohol from:

12 ounces of beer
5 ounces of wine
1.5 ounces of spirits (vodka, whiskey, rum, gin, and so on)

Experts typically define binge drinking by the number of standard drinks you consume in a single period of 2 hours or less. Your age and the sex you were assigned at birth determine your threshold.

For the typical person, an episode of binge drinking would mean a 2-hour period where you consume:

Adult men: 5+ drinks	Adult women: 4+ drinks
Boys ages 16 to 17: 5+ drinks	Girls ages 16 to 17: 3+ drinks
Boys ages 14 to 15: 4+ drinks	Girls ages 14 to 15: 3+ drinks

Of course, these categories offer only guidelines, not hard-and-fast criteria. Other factors, like height and weight, can also have an impact on how alcohol affects you.

For example, a woman over 6 feet tall may be able to safely drink more alcohol than a woman who barely clears 5 feet. Similarly, a short man with a lower body weight may become intoxicated more quickly than a tall man with a higher body weight.

What’s more, many people simply don’t digest alcohol easily, so a lower tolerance for alcohol doesn’t always relate to body size or gender.

Here’s one important distinction between binge drinking and AUD: If you binge drink on occasion, that doesn’t necessarily mean you have an addiction to alcohol. Binge drinking is best understood as a behavior, not a mental health condition. But if you binge drink on a regular basis, you may have a higher chance of developing AUD.

Fast facts about binge drinking

According to the Centers for Disease Control:

About 1 in 6 adults binge drink.
Among adults who binge drink, 1 in 4 do so on a weekly basis.
Binge drinking is most common among adults between the ages of 25 and 34.
Men are twice as likely to binge drink as women.

What’s alcohol use disorder?

The most recent edition of the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5)” includes AUD as a mental health diagnosis.

You may have AUD if you continue to drink despite any physical, emotional, and social consequences you experience. Perhaps you even want to drink less, or stop drinking entirely, but find yourself unable to quit.

Before diagnosing this condition, a professional will consider whether you meet at least two of the following criteria:

You spend a lot of time drinking or recovering from drinking.
You often drink more than you meant to.
You sometimes have a hard time thinking of anything else but drinking.
Your drinking has put your safety at risk more than once, such as through drunk driving.
You have tried to cut back on your drinking multiple times, but you just couldn’t.
Drinking interferes with your daily activities, including work or family time.
You keep drinking even though it’s caused problems with friends and family.
You’ve sacrificed hobbies or meaningful projects because they competed with your drinking.
Even when drinking makes you feel depressed or anxious, you still can’t seem to stop.
You need to drink more than you used to in order to get the same “buzz.” (This is called alcohol tolerance).
You get withdrawal symptoms, such as shakiness or nausea, when the alcohol wears off. (This is called alcohol dependence.)

If you have:

2 to 3 symptoms: You meet criteria for mild AUD.
4 to 5 symptoms: You meet criteria for moderate AUD.
6 or more symptoms: You meet criteria for severe AUD.

As you might have noticed, none of these criteria specify an amount of alcohol. But you don’t need to binge drink to experience AUD.

If you spend most workdays hungover, daydreaming of the glass of wine you’ll have as soon as you get home, that’s still a concern. It doesn’t matter how tiny the glass is, or how little you drink before becoming intoxicated.

Fast facts about AUD

According to the NIAAA:

Among adults in the United States, 5.6 percent live with AUD.
Among U.S. adolescents ages 12 to 17, 1.7 percent live with AUD.
Only 6.4 percent of adolescents and 7.3 percent of adults with AUD get treatment.
You’re 5 times more likely to develop AUD if you started drinking before age 15 than if you waited until 21.

What are the risks?

Even though alcohol is legal in most places, it’s still a toxin, and a potent one at that.

Excess drinking can affect your physical and mental health in many different ways.

Risks of binge drinking

According to a 2020 study of young adults, binge drinking appears to double the risk of alcohol-related consequences, compared to typical drinking. Students who binge drank in the past 12 months reported the following unwanted alcohol-related consequences:

11 percent got injured or physically ill
13 percent felt depressed, anxious, or ashamed
15 percent engaged in unsafe driving
40 percent experienced conflict and other relationship concerns
60 percent behaved in ways they later regretted

Another potential risk? Alcohol poisoning. The higher your BAC level, the higher your chance of alcohol poisoning.

Signs of alcohol overdose include:

confusion
cold, clammy skin that may appear bluish, grayish, or paler than your typical skin color
vomiting
slow breathing (fewer than 8 breaths a minute)
trouble staying awake

If you or a loved one show signs of overdose, contact your local emergency services immediately. Alcohol poisoning can get dangerous quickly, and it’s sometimes fatal. The sooner you get help, the greater your chances of recovery.

Risks of alcohol use disorder

Maybe you never binge drink. All the same, consuming large amounts of alcohol over a longer period of time can still contribute to serious health issues, including:

cancers of the mouth, esophagus, liver, breast, colon, or rectum
cardiovascular disease, or high blood pressure, irregular heartbeat, and stretching of heart muscle
liver diseases, such as fatty liver, liver inflammation, and irreversible liver scarring
pancreatitis, or inflammation in the pancreas

According to the World Health Organization’s Global Status Report on Alcohol and Health 2018, roughly 70 percent of alcohol-attributable deaths happen as a result of health issues. The rest are due to injuries.

Keep in mind, too, that AUD can have effects that extend beyond your physical health.

Excessive alcohol use can also contribute to:

family dysfunction
relationship difficulties and conflict
worsened symptoms of mental health conditions, including depression, anxiety, and bipolar disorder
changes in your performance at school or work
thoughts of self-harm or suicide

Need support now?

If you’re having thoughts of hurting yourself or ending your life, know that you’re not alone.

You can always get free, confidential, compassionate support from a trained crisis counselor by:

calling the National Suicide Prevention Lifeline at 1-800-273-8255
texting “HOME” to 741-741 to reach Crisis Text Line

Find more suicide prevention resources.

How to get help

If you want to cut back on your drinking — or quit drinking alcohol altogether — you have plenty of options.

Medication

The Food and Drug Administration (FDA) has approved three medications for treating AUD. These medications may help make it easier to quit drinking.

Disulfiram. This disrupts your body’s metabolism of alcohol and makes you feel flushed or nauseous when you drink. It creates a negative association with alcohol so you become less tempted to drink, but it doesn’t target cravings — the core symptom of AUD.
Naltrexone. This drug reduces the feelings of euphoria when you drink alcohol. Unlike Disulfiram, which causes unpleasant side effects, naltrexone discourages drinking by removing the pleasurable effects of alcohol.
Acamprosate. If you’ve quit drinking, this drug can help you stay sober. The drug is thought to “reset” the neurons affected by alcohol use, so to speak, and help reduce cravings.

Doctors typically prescribe medication in combination with counseling to address the psychological elements of addiction.

Therapy

Research supports counseling as an effective treatment for addressing alcohol use. Your options for therapy include:

Motivational interviewing. This approach can help you understand the underlying reasons why you drink and why you might want to stop. Clarifying your motivations can make it easier to commit to change.
Cognitive behavioral therapy (CBT). This approach can help you recognize specific moods and situations that trigger your urge to drink. The two of you can then devise a plan to cope with cravings and address other symptoms.
Community reinforcement approach. This approach can help you build a life beyond drinking by addressing the issues that may have driven you to start drinking alcohol in the first place. For example, your therapist might help you explore skills to cope with the social anxiety you experience during sober get-togethers.
Behavioral couples therapy (BCT). This approach can help you repair your bond with your partner, if drinking has strained your relationship, and draw appropriate boundaries around alcohol.

Mutual support groups

Mutual support groups are exactly what you might imagine: groups of people who have all engaged in problematic drinking in the past and now offer each other support in recovery.

Most mutual support associations are nonprofits. Meetings, usually run by trained volunteers, are free to join.

Well-known associations include:

Alcoholics Anonymous (AA)
LifeRing
Moderation Management
Self-Management and Recovery Training (SMART)

Their web pages offer both local and online groups, so you can choose whichever option works best for you.

The bottom line

Unlike AUD, binge drinking isn’t considered a mental health condition. Still, both patterns of drinking can lead to health concerns and affect your overall well-being and quality of life.

Treatment tends to have more benefit when you address unwanted patterns of drinking sooner rather than later. So, you don’t have to wait until alcohol use feels uncontrollable before reaching out for help.

Whether you want to address your long-term relationship with alcohol or break a pattern of binge drinking, a recovery professional can offer guidance and support.

Emily Swaim is a freelance health writer and editor who specializes in psychology. She has a BA in English from Kenyon College and an MFA in writing from California College of the Arts. In 2021, she received her Board of Editors in Life Sciences (BELS) certification. You can find more of her work on GoodTherapy, Verywell, Investopedia, Vox, and Insider. Find her on Twitter and LinkedIn.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Alcohol’s effects on the body. (n.d.).https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body
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Binge drinking. (2022).https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm
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Drunk driving. (n.d.).https://www.nhtsa.gov/risky-driving/drunk-driving
Global status report on alcohol and health 2018. (2018).https://www.who.int/publications/i/item/9789241565639
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Ray LR, et al. (2018). State-of-the-art behavioral and pharmacological treatments for alcohol use disorder.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430676/
Understanding alcohol use disorder. (2021).https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/understanding-alcohol-use-disorder
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What medications are used to treat alcohol use disorder? (2013).https://www.niaaa.nih.gov/sites/default/files/publications/video-RSA2017/Mason_508.pdf

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Medically reviewed by Alyssa Peckham, PharmD, BCPP — Written by Emily Swaim on April 8, 2022

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