- By Rita Rubin
Binge drinking calls to mind frat parties and keggers, but it’s also a problem among people who are decades past college age.
True, downing five or more drinks on one occasion if you’re a man and four or more if you’re a woman is most common among people aged 18 to 34, according to the U.S. Centers for Disease Control and Prevention (CDC). On average, young adult binge drinkers consume the most alcohol in one sitting.
Most Frequent Binge Drinkers Are 65+
But binge drinkers 65 and older binge most frequently, the CDC says. And a study published last month suggests that older binge drinkers are likely to die sooner than moderate drinkers who pace themselves.
The binge drinkers in the study didn’t consume more alcohol overall than the other moderate drinkers, but they drank a lot at one time.
Moderate drinking — defined by the National Institute of Alcoholism and Alcohol Abuse (NIAAA) as an average of one-half a drink per day for women and one-half to two drinks per day for men — might have health benefits for older people. But consuming, say, a week’s worth of alcohol on one occasion appears to be harmful.
Nearly half of all binge-drinking episodes among U.S. adults occur among those who meet the definition of moderate drinker, the authors of the new study write in the journal Alcoholism: Clinical and Experimental Research. “Drinking pattern needs to be addressed along with overall consumption to understand alcohol’s health effects,” they write.
Bingers and Mortality
Scientists have come up with a number of explanations for why binge drinkers 65 and older binge more frequently and why that is harmful.
“In general, heavy episodic (binge) drinking concentrates alcohol’s toxicity and is linked to mortality both by damaging body organs and increasing accident risk,” says Charles Holahan, a psychology professor at the University of Texas at Austin and lead author of the recent study about the health effects of binge drinking in older people.
Holahan’s study followed 446 adult moderate drinkers for 20 years. He and his co-authors found that the 74 people who reported binge drinking at the beginning of the study, when they were age 55 to 65, were more than twice as likely to die during the follow-up period as the moderate drinkers who were not binge drinkers when the study began.
The analysis accounted for other factors that could influence the risk of death, such as sex, socioeconomic status, obesity, smoking and physical activity.
Clearly, binge drinking is a public health problem among older Americans, says Dr. Gary Murray, acting director of the Division of Metabolism and Health Effects at the NIAAA. Excessive alcohol use, including binge drinking, accounts for more than 21,000 deaths each year among people 65 and older in the U.S., according to the CDC.
Why Do They Binge?
Why do older binge drinkers do it more frequently? “It could be a crime of opportunity,” Murray says. “Once you become a retired person, you have more time; you have no responsibility to go somewhere.” A drink at lunch could turn into two or three.
Also, "older people have more disposable income," Murray says.
And retirement communities are “like a college campus for older adults” where people drink to be social, says Jennifer Solomon, a public health analyst at the Center for Substance Abuse Prevention at the Substance Abuse and Mental Health Services Administration.
Alcohol and Medications Shouldn’t Mix
Binge drinking is unhealthy at any age, but it might be especially risky for older adults who have other age-related health conditions for which they take a variety of medications, Holahan says.
“Excessive drinking increases a person’s risk of developing high blood pressure, liver disease, certain cancers, heart disease, stroke and many other chronic health problems, as well as a person’s risk of car crashes, falls and violence,” according to The State of Aging & Health in America, a report published last year by the CDC. “Excessive alcohol use can also interact with prescription and over-the-counter medications…”
Depending on the medication, binge drinkers can end up overdosing or underdosing, Murray says. That’s because an enzyme in the gut that helps metabolize alcohol kick into high gear when people drink a lot.
That enzyme “is not very discriminating,” Murray says. “It works on a lot of other drugs in the body.”
The enzyme activates some drugs, so too much of it could result in overdosing. And the enzyme turns off other drugs, in which case high levels of it could lead to underdosing. (Men can credit higher levels of that enzyme for the fact that, at least before age 50, they can drink as much as a woman the same size and age but end up with a lower blood alcohol level. That sex difference eventually goes away as people age, though.)
While certain medications carry warning labels about the danger of mixing them with alcohol, binge drinkers are less likely to pay attention, Murray says. “That, in fact, could lead to a life-threatening incident,” he says.
Confronting the Problem
What should you do if you suspect a loved one is a binge drinker? The first thing is to simply ask, in a non-accusatory way, about how much they drink and what medications they’re taking, Solomon says. A pharmacist can be a good resource for information about medication-alcohol interactions, she says.
You could also ask a spouse or elderly parent if they’d share their lab test results with you, Murray suggests. If their liver enzymes are abnormal, he says, that could be evidence of binge drinking.
Older people sometimes don’t even realize they’ve become binge drinkers, Solomon says, “and then they change their habits once the facts are brought to them.”
Rita Rubin is a former USA Today medical writer who now writes about health and science for publications including Next Avenue, WebMD and NBCNews.com.