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Abstract
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BACKGROUND AND AIMS: The threshold of 4+/5+ drinks per occasion has been used for decades in alcohol research to distinguish between non-risky vs. risky episodic drinking. However, no study has assessed the validity of this threshold using event-level data. This study aimed to determine the optimal thresholds for the detection of five acute alcohol-related consequences (hangover, blackout, risky sex, fights and injury) using data from two event-level studies.
DESIGN: An event-level study to assess the ability to use the number of drinks consumed to discriminate between nights with and without consequences using the area under the receiver operating characteristic (AUROC) curve. Optimal thresholds were determined using the Youden Index based on sensitivity and specificity. Separate thresholds were estimated for gender and age groups (16-17 vs. 18-25). SETTING: Lausanne and Zurich, Switzerland. PARTICIPANTS: 369 participants, aged 16 to 25 years. MEASUREMENTS: On 3,554 weekend nights, participants reported total number of alcoholic drinks consumed the previous night and acute consequences (hangover, blackout, risky sex, fights and injury) FINDINGS: Hangover was the most frequently reported consequence and injury the least for both genders. Across age groups and studies, optimal thresholds for any consequence, and for hangover only, were equal to 4+/5+ (40+/50+ grams of alcohol) while those for blackouts, risky sex, fights and injuries were up to three drinks higher. Adolescents tended to experience consequences more often and at slightly lower drinking levels than adults did. For all consequences but injuries, the optimal thresholds were one to two drinks lower for women than for men.
CONCLUSIONS: Among young Swiss drinkers, heavier drinking levels are associated with increased risk of acute alcohol-related consequences (hangover, blackout, risky sex, fights and injury). Binge drinking thresholds of 4+/5+ (women/men) drinks, equivalent to 40+/50+ grams of pure alcohol, accurately predict the occurrence of consequences in general but are too low to predict severe acute alcohol-related consequences.
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Language: en |