The bottle and the damage done


18 March 2013

What do you consider a ‘binge’ asks Shane Cochrane – falling down drunk in the street. . . or ‘a few quiet pints’?

Social drinking: Many underestimate the amount they drink – in a UK survey 80pc of overly heavy drinkers classed their intake as moderate

Older people may be drinking to cope with stress and anxiety, or loneliness

There’s a general belief that binge drinking is defined as drinking until you fall over, so many readers may be surprised to hear that the World Health Organisation considers five or more standard drinks per episode as a binge.

Some might sneer at this. However, a number of recent studies have found that binge drinking at this level is doing considerable damage to our bodies.

Earlier this year, the Icahn School of Medicine reported that binge drinking increases the risk of Type 2 diabetes. They discovered that binging once a week, regardless of diet or other factors, is enough to cause the insulin resistance that leads to the condition.

“Previously it was unclear whether binge drinking was associated with an increased risk for diabetes, since a person who binge drinks may also tend to binge eat, or at least eat too much,” says Dr Claudia Lindtner, who led the study.

“Our data show for the first time that binge drinking induces insulin resistance directly and can occur independent of caloric intake.”

Particularly worrying for men are the findings of a study by the Santo Tomas University in Columbia. They looked at the effects of drugs – including cocaine, heroin and alcohol – on men’s sexual performance. Alcohol abuse was found to have the biggest negative effect on men’s arousal – a potentially permanent effect.

But what’s causing most concern is the growing evidence of brain damage associated with binge drinking. Given that the brain does not “mature” until about 25 years of age, researchers in Australia believe that adolescent binge drinking is interfering with the maturation process.

The researchers found that binge drinking can cause shrinkage in adolescent brains, and disrupt the parts of the brain responsible for functions like planning, attention and decision-making.

Scientists at the University of California, San Diego, discovered that adolescent alcohol use was also interfering with the brain’s white matter.

It’s white matter that connects the different regions of the brain and allows them to communicate, and when compromised, cognitive functions such as memory and attention are severely affected.

However, the problem is not restricted to the young. At the University of Exeter they studied the drinking behaviour of 5,000 people aged 65 and over, for a period of eight years. Their research uncovered a definite link between binge drinking and cognitive decline.

“That’s a real worry because there’s a proven link between cognitive decline and risk of dementia,” says Dr Iain Lang. “Those who reported binge drinking at least twice a month were more than twice as likely to have higher levels of decline in both cognitive function and memory.”

Older “problem drinkers” drink more per week, and have more binge episodes per month than younger drinkers. But we rarely consider this group when we talk about binge drinking.

“Policy makers and public health specialists should know that binge drinking is not just a problem among adolescents and young adults.

“We have to start thinking about older people when we are planning interventions to reduce binge drinking.”

However, it would be wrong to suggest that this is all social drinking.

“Older people may be drinking to cope with stress and anxiety, or loneliness,” says Fiona Ryan of Alcohol Action Ireland. “It is a very real issue.”

It’s also becoming evident that many of those most at risk do not realise it. A recent survey by the UK’s Department of Health found that 80pc of people who classed their drinking as moderate were actually drinking more than the recommended amount.

The survey also found that people are very bad at estimating their alcohol consumption. Participants were asked to estimate their consumption, and then record their actual alcohol intake over a two-week period.

On average, the drinkers were consuming 40pc more than their estimates.

This highlights the fine line between binge drinking and drinking in moderation that Megan Anderson of Rutgers University believes puts many people at risk.

Anderson has studied the effects of alcohol on the brain’s ability to produce new brain cells. She found that consuming just five drinks could reduce the production of new cells by up to 40pc.

“Moderate drinking can become binge drinking without the person realising it,” she says.

“In the short term there may not be any noticeable motor skills or overall functioning problems, but in the long term this type of behaviour could have an adverse effect on learning and memory.”

Alcohol Action Ireland favour the minimum pricing approach, believing that raising the cost of alcohol will reduce consumption.

This is something that is being considered on both sides of the border.

But while the best approach for dealing with binge drinking is still being debated, the evidence for the damage being done is not. Consistent results are being produced that highlight the mental and physical toll of binge drinking.

And if five drinks per session can cause diabetes, brain damage and permanent sexual problems, we can only imagine what the Irish average of eight drinks per session is doing.