The criteria used to assess blood alcohol concentrations (BACs) and binge drinking behaviors in children and adolescents should be based on pediatric rather than adult physiology, according to a new University of Pittsburgh study in the June issue of Pediatrics.

Current standards for BACs and binge drinking in children under 18 are based on adult criteria. However, a Pitt researcher found that updating the current BAC formula to take into account differing body composition and the rates at which children and adolescents eliminate alcohol from their bodies, would redefine how many drinks constitute binge drinking for boys and girls 9 to 17 years of age.

"There is little consensus on how hazardous drinking should be defined in adults, let alone in kids," said John E. Donovan, Ph.D., author and associate professor of psychiatry and epidemiology at the University of Pittsburgh School of Medicine and the Graduate School of Public Health. "This study, for the first time, looked at how hazardous drinking should be estimated for children and teenagers."

The definition of binge drinking is controversial, however, noted Dr. Donovan. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recently defined binge drinking as a drinking pattern that brings a person's BAC to greater than 0.08 grams per deciliter (g/dL), which is a level accompanied by significant physical and mental impairment and the level currently used to define drunk driving throughout the U.S. Typically, this means five drinks for a man or four drinks for a woman within a two-hour period.

"The NIAAA definition of binge drinking was developed for adults and not for kids under 18," added Dr. Donovan. "Both children and young adolescents weigh substantially less than adults and likely would achieve considerably higher BACs with five drinks within a two-hour period or would reach a BAC greater than 0.08 g/dL with significantly fewer drinks."

Dr. Donovan examined child, adolescent and adult body compositions and alcohol elimination rates from the 1999-2002 National Health and Nutrition Examination Survey. He then used the updated formula to estimate BACs for more than 4,700 kids and teens ages 9 to 17 for alcohol intake levels of one to five standard drinks to determine the number of drinks at each age that led to a BAC of greater than 0.08 g/dL.

These estimations suggest that binge drinking should be defined as three or more drinks for 9- to 13-year-old children; four or more drinks for boys and three or more drinks for girls ages 14 or 15; and five or more drinks for boys and three or more drinks for girls ages 16 or 17. These results also suggest that the definition for heavy drinking should be modified as well.

"When kids and young teens use alcohol, it puts them at heightened risk for later alcohol and drug dependence, delinquency, early pregnancy and sexually transmitted diseases, as well as involvement in motor vehicle crashes," added Dr. Donovan. "Since considerably fewer drinks are needed to get high BAC levels in children, pediatricians and nurse practitioners who screen kids for alcohol use should intervene at much lower levels of alcohol involvement than previously thought."

Dr. Donovan's research is funded by grants from the National Institute on Alcohol Abuse and Alcoholism.

Source
University of Pittsburgh School of Medicine