Alcohol misuse: tackling the UK epidemic - London

BMA Board of Science
Alcohol use disorders
A generic term used to denote mental, physical, and behavioural conditions of clinical relevance
and associated with the use of alcohol. The disorders include acute intoxication, harmful use,
dependence syndrome, withdrawal syndrome (with and without delirium), psychotic disorders, and
amnesic syndrome. 2
Binge drinking
The terms ‘binge drinking’ or ‘binge’ have no standard definition. Traditionally, a ‘binge’ has been
used to describe a pattern of heavy drinking occurring over a prolonged period set aside for the
purpose. Recent common use of the term ‘binge’ refers to a single drinking session intended to,
or actually leading to, intoxification. A pattern of repeated ‘binge’ sessions is commonly therefore
referred to as ‘binge drinking’ or ‘heavy episodic drinking’. Alternative definitions of a ‘binge’
focus on specific and objective quantities of alcohol; for example, the UK Prime Minister’s Strategy
Unit (PMSU) defines a ‘binge’ as drinking over twice the recommended guidelines for daily
drinking (see separate definition for recommended drinking guidelines). 3
Blood alcohol concentration
Blood alcohol concentration (BAC) is the concentration of alcohol in blood. It is measured either as
a percentage by mass, by mass per volume, or a combination. In the United Kingdom (UK), BAC is
reported as milligrams of alcohol per 100 millilitres of blood (eg 80mg per 100ml). In many
countries, BAC is measured and reported as grams of alcohol per 1,000 millilitres (1 litre) of blood
(g/1,000 ml). For purposes of law enforcement, BAC is used to define intoxication and provides a
rough measure of impairment. Most countries disallow operation of motor vehicles, boats, aircraft
and heavy machinery above prescribed levels of BAC. Blood alcohol concentration is commonly
referred to as blood alcohol content.
Harmful drinking
Harmful drinking is a pattern of alcohol use that causes damage to physical and/or mental health. 2
Harmful use commonly, but not invariably, has adverse social consequences. Social consequences
on their own, however, are not sufficient to justify a diagnosis of harmful use. 2
Harmful drinking is
included as a diagnostic term in the ICD-I0.
Hazardous drinking
Hazardous drinking is a pattern of alcohol use that increases the risk of harmful consequences for
the individual. 2
In contrast to harmful use, hazardous drinking refers to patterns of use that are of
public health significance despite the absence of any current disorder in the individual user. 2
Hazardous drinking is not included as a diagnostic term in the ICD-10.
Heavy drinking
A pattern of drinking that exceeds some standard of moderate drinking. In the UK, heavy drinking
is defined as consuming eight or more units for men and six or more units for women on at least
one day in the week. 3
Moderate drinking
An inexact term for a pattern of drinking that is by implication contrasted with heavy drinking. It
denotes drinking that is moderate in amount and does not cause problems. 2
Alcohol misuse: tackling the UK epidemic vii