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CNS Drugs

, Volume 31, Issue 3, pp 181–186 | Cite as

Binge Drinking: Current Diagnostic and Therapeutic Issues

  • Benjamin RollandEmail author
  • Mickaël Naassila
Current Opinion

Abstract

The concept of binge drinking (BD) refers to patterns of heavy episodic alcohol consumption, with BD primarily occurring among adolescents and young adults. Several official definitions of BD have been proposed, in particular by the World Health Organization, the National Institute on Alcoholism and Alcohol Abuse, and the Substance Abuse and Mental Health Services Administration. Nevertheless, none of these definitions address the psychosocial and medical consequences of the type of alcohol use seen in BD. In practice, BD can thus correspond to either hazardous or harmful use of alcohol (HUA), while the episodic nature of heavy drinking in BD means that it does not meet the criteria for ‘alcohol dependence’. This diagnostic differentiation is important because it determines which type of intervention is recommended. Psychosocial, rather than pharmacological, interventions are recommended as first-line treatment for adults with HUA, while pharmacological treatment is recommended for alcohol dependence; however, HUA appears to be associated with much poorer outcomes in adolescents, which could thus warrant early use of pharmacotherapy in this patient group. For HUA, and especially in adolescents, there is currently a severe lack of data regarding the efficacy and safety of the different drugs that have been approved for adults with alcohol dependence. Various guidelines propose the use of drugs for some types of BD but that use remains off-label and empirical, which raises important safety and ethical concerns. Future research on BD should systematically assess the criteria for HUA to better differentiate its subtypes with actual consequences and better address the heterogeneity of BD in terms of both clinical profiles and outcomes. Regarding pharmacotherapy, some national guidelines have recommended nalmefene for ‘mild’ dependence or second-line treatment for HUA, but such recommendations are not supported by evidence. Only naltrexone has been investigated in HUA but not in adolescents. More clinical trials should be conducted among adolescents with BD and HUA criteria to determine the most appropriate use of drugs in this particularly vulnerable population of subjects.

Keywords

Alcohol Dependence Aripiprazole Naltrexone Baclofen Binge Drinking 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with Ethical Standards

Funding

The work of Benjamin Rolland on BD is supported by a research grant from the Fondation Actions-Addictions (http://actions-addictions.org), an independent French foundation supporting evidenced-based actions against addictive disorders.

Conflicts of interest

Benjamin Rolland has provided expert testimony for Ethypharm and Indivior, and has received lecture fees from Ethypharm, Lundbeck, Indivior, Bouchara-Recordati, Gilead, AstraZeneca, Bristol-Myers-Squibb, Otsuka, and Servier. Mickaël Naassila has received lecture or expert fees from Merck-Serono, Lundbeck, and Bouchara-Recordati. Both authors received grants from the Fondation Actions-Addictions.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.INSERM-ERi 24 (GRAP), Centre Universitaire de Recherche en SantéUniversité de Picardie Jules VerneAmiensFrance

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