Fewer high school seniors engaged in binge drinking in 2011 than in 2005, but rates of extreme binge drinking did not change over that period, researchers found.
From 2005 to 2011, the proportion of high school seniors who reported consuming five or more alcoholic drinks in a row declined significantly from 22% to 18.1% (P<0.001) and the proportion of those who reported having 10 or more drinks in a row fell from 10.5% to 9.6% (P<0.01), according to Megan Patrick, PhD, of the University of Michigan in Ann Arbor, and colleagues.
However, rates of the most extreme binge drinking -- consuming 15 or more drinks in a row -- did not change significantly over the study period (P<0.07), they wrote online in JAMA Pediatrics.
"There's a big difference between binge drinkers and extreme binge drinkers," noted Jason Jerry, MD, of the Alcohol and Drug Recovery Center at Cleveland Clinic.
"This may explain why there may be what appears to be conflicting data on this, as over the last 10 to 15 years, rates of teen drinking have been on the decline, while rates of youth reports to emergency rooms have been on the increase," he told MedPage Today, adding that "when you start to look at subpopulations of teen drinkers, we might have an explanation for that apparent contradiction."
Past research for anti-drinking interventions in teens have shown that personality-based interventions reduced risks among binge drinking for students at greatest risk for addiction and mental health issues, while another community-based interventions reduced, but didn't eliminate, substance abuse, delinquency, and other risky behaviors in youths in grades five to 10.
The current authors evaluated the prevalence and demographic data of students in grade 12 who drank five or more, 10 or more, and 15 or more drinks in a row through a nonclinical nationally representative sample of high school seniors participating in the Monitoring the Future study.
The Monitoring the Future study has sampled students since 1975 and has included questions about binge drinking -- consuming five or more drinks in a row -- from its onset. However, in 2005, the study added questions about rates of extreme binge drinking, which included questions about drinking 10 or more and 15 or more drinks at a time.
The survey asked students the number of times over the 2 weeks prior to the survey they had drank five or more, 10 or more, and 15 or more alcoholic drinks in a row. Responses ranged from zero to 10 or more times over the 2-week window, though the researchers grouped these responses as none or any.
Demographic data included sex, race, parental college education (a proxy for socioeconomic status), geographic region of the U.S., population density, and self-reported importance of religion in the respondent's life.
The authors also recorded risk and protective factors, such as grades, college plans, days a student cut school, evenings spent without parents, beliefs about peer drinking habits, attitudes about binge drinking, and smoking status of cigarettes and marijuana over the past 30 days.
Although rates of binge drinking declined overall among high school seniors during the study period, there was no significant change in the proportion of students who reported drinking 15 or more drinks in a row (5.5% in 2005 versus 4.4% in 2011).
Demographically, students from more rural areas, those who were white, or those who were male were more likely to engage in the most extreme levels of binge drinking. Additionally, whites and males were also more likely than any other race to engage in all levels of binge drinking.
Additionally, "students with more educated parents had higher odds of drinking five or more drinks, but lower odds of 15 or greater extreme binge drinking," the authors noted.
Among protective and risk factors, extreme binge drinking was associated with:
- Smoking marijuana: odds ratio 1.17 (95% CI 1.12-1.23)
- Smoking cigarettes: OR 1.35 (95% CI 1.26-1.45)
- Spending evenings out with friends instead of family: OR 1.16 (95% CI 1.07-1.25)
- Days of cutting school: OR 1.11 (95% CI 1.05-1.17)
- Friends getting drunk: OR 1.83 (95% CI 1.67-1.99)
"It's important for parents to talk to their teens about alcohol use," noted Lindsay Squeglia, PhD, of the University of California San Diego, adding that parents play a key role in preventing abusive behavior by "teaching them what normative drinking behavior is, and what drinking at these high levels can do to teens developmentally, cognitively, and socially or when looking for a job."
In an accompanying editorial by Ralph Hingson, ScD, MPH, and Aaron White, PhD, both of the National Institute on Alcohol Abuse and Alcoholism in Bethesda, Md., the editorialists also cautioned healthcare professionals of the adverse effects of consumption of large quantities of alcohol.
"At the high blood alcohol levels reached by consuming 15 drinks on occasion, the risks of serious injury or overdose are dramatically elevated," they wrote. These include associated crash risks, fatal crash risks, suspension of cognitive abilities and breathing, increased risk of suppressed gag reflex and choking on one's own vomit, and compounded risks from co-use of other substances.
The authors cautioned that their study was limited by absent data on high school drop outs, framing binge drinking quantities the same for males and females, and self-report of consumption.
They added that future research should investigate contexts of drinking, duration of drinking occasions, and consequences of drinking.
The study was supported by a grant from the National Institute on Drug Abuse.
The authors and editorialists declared no conflicts of interest.
- Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner
JAMA PediatricsSource Reference: Patrick ME, et al "Extreme binge drinking among 12th-grade students in the United States: prevalence and predictors" JAMA Pediatr 2013; DOI: 10.1001/jamapediatrics.2013.2392.
JAMA PediatricsSource Reference: Hingson RW, White A "Trends in extreme binge drinking among U.S. high school seniors" JAMA Pediatr 2013; DOI: 10.1001/jamapediatrics.2012.3083.