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Binge drinking: death sentence for young adults by L. Blumenthal, M.D.,  MUSC Student Health Services “Wine makes a man better pleased with himself; I do not say that it makes him more pleasing to others,” quotes Samuel Johnson. Well publicized alcohol related deaths at America’s most prestigious colleges have brought increased attention to the subject of alcohol use and abuse in this country.  Current statistics show that 90 percent of the adult United Sates population drink alcohol; 10 to 20 percent of men and 3 to 10 percent of women will have persisting problems of alcohol dependence/abuse.  Of concern is a pattern of use called “binge drinking” that usually begins in late adolescence, and is characterized by episodic use of  alcohol to the point of intoxication during a short period of time.  This pattern of use can have dire social and medical consequences, and subsequently is the leading cause of death in young adults.  A 1998 Harvard School of Public Health Survey of 140 colleges found that: two out of five students were binge drinkers, one in five were abstainers, one in five was a frequent binge drinker, and four of five residents of fraternities or sororities were binge drinkers. A formal definition of what amount of alcohol actually constitutes a “binge”  has yet to be agreed upon by researchers.  The Harvard study defined a “binge” as five or more drinks “on an occasion” for males, and four or more for females; two or more binges in a two week period was considered frequent binging.  This “five/four” definition has been criticized because it fails to define the time interval and context during which the alcohol was consumed, as well as the size of the drinker. A woman who consumes four glasses of wine during the course of a three-hour dinner party is clearly not in the same risk category as a woman who takes four shots of tequila in an hour, yet both would be considered binges under this definition.  Many are surprised to learn that there are equivalent amounts of alcohol (10 grams) in one 12-ounce beer, one four-ounce glass of wine, and one shot of 80 proof whiskey.  A 150-pound male can metabolize one drink an hour without becoming intoxicated. At two drinks an hour, he will overwhelm the enzymes that metabolize alcohol with sharper rises in blood levels, reaching intoxication in 2.5 hours. Motor and visual impairment are seen at blood alcohol levels (BAL) of (.05 to .06 percent), with legal intoxication in South Carolina being .1 percent, so even “legal” amounts of alcohol can be unsafe. Consequences: During early adulthood, almost half of all male drinkers will experience some alcohol related problem (DUI, argument, arrest, blackout, etc).  Accidental deaths     Forty percent of all fatal motor vehicle accidents are alcohol related (U.S. National Safety Council)  Sixty-eight percent of South Carolinians were drinking prior to their crashes (coroner’s report) Alcohol is the major cause of death in 15 to 24 year-olds [45 percent related to alcohol use]  Violence    Fifty percent of fighting-related injuries seen in ERs are alcohol related.    Two out of three of male sexual offenders reported being intoxicated at the time of the offense (1965 study)  While there is no conclusive proof that alcohol causes aggressive behavior, in 50 percent of the cases, alcohol was associated with being the perpetrator or victim of sexual violence. Medical acute intoxication is associated with increased incidence of cardiac arrhythmias, hypertension, stroke, suppression of immune system, blackouts, gastritis, hepatitis. Defining drinking behavior with absolute numbers and imprecise terms mislabels many drinkers; it also both overestimates and underestimates the true risk. The physical and  behavioral effects of alcohol, as well as the context and time interval it is consumed, are more important considerations. It may be more useful to think in terms of safe and unsafe use of alcohol. To drink safely you should: Know how alcohol affects you socially and physically. Try to anticipate how much you care to drink before you go out. Monitor your behavior while you are drinking. Have a friend/spouse monitor your behavior (preferably  if they have had less alcohol than you).  Make arrangements for safe travel. Pace yourself to about one drink an hour. If you find yourself drinking at a faster pace, substitute nonalcoholic beverages between drinks. Don’t drink on an empty stomach. Food slows absorption of alcohol into the bloodstream.  Alcohol Awareness Week  Oct. 18-22 Activities calendar Monday, Oct. 18 College of Dental Medicine “The New South Carolina Recovering Professionals (RPP) and the Impact on Dentists” Noon, room 302 Basic Science Building College of Nursing (free lunch) “Handling a Patient Under the Influence of Alcohol” 1:30 to 2 p.m., room 104 College of Nursing; Julie Taylor, R.N.  College of Pharmacy “Characteristics of Pharmacists Who Develop Substance Use Disorders” Noon, Basic Science Building Auditorium; Merrill Norton, R.P.h, Director, Recovering Pharmacists Program, Talbott Recovery Campus, Atlanta; Lunch provided for College of Pharmacy students and faculty College of Health Professions “Alcohol in the Workplace, Recognition and Response” Noon, 2W Amphitheater; Michael Saladin, Ph.D.  College of Medicine “Interviewing Alcoholic Parents: Asking the Right Questions” Noon, Baruch Auditorium; Patricia Halligan, M.D., Assistant Professor, Department of Psychiatry  Tuesday, Oct. 19 (Free lunch) “Co-occurrence of Alcohol and Other Psychiatric Disorders” Noon, Basic Science Building Auditorium; Kathleen Brady, M.D., Ph.D., Professor, Department of Psychiatry Wednesday, Oct. 20 (Free lunch) “Mock Trial, Driving Under the Influence” Noon, Basic Science Building Auditorium; Honorable Janette Harper; Michael Seeking, Charleston Defense Attorney; Brucie Howe Hendricks, Assistant United States Attorney; Lt. Michael McCurdy, Isle of Palms Police Department Thursday, Oct. 21 (Free lunch) “MUSC Alcohol Use and Binge Drinking” Noon, Basic Science Building Auditorium; Kasey Hamlin, Ph.D., Counseling and Psychological Services; Robert Malcolm, M.D., Professor, Department of Psychiatry Friday, Oct. 22 (Free lunch) “Survival Skills for the Party Host” Noon, Basic Science Building Auditorium; Keith Purdy, Owner, Southern Bartending   “Alcohol's Disruptive Effects on the Expression of Aversive Olfactory Memories:  An Ontological Approach” 5:30 p.m., Oct. 20 Gazes Heart Center Conference Room Marcello Lopez, Ph.D., Post Doctoral Fellow,  Center for Drug and Alcohol Programs Sponsored by the Post Doctoral Scholars Association