OBJECTIVES-Although a significant percentage of children drink alcohol, there are as yet few established screening instruments for this population. The construction of such instruments is dependent to some extent on estimates of the effects of different levels of intake of alcohol on children. Blood alcohol concentrations (BAC) in children after consumption of different numbers of standard drinks of alcohol have not previously been estimated.
METHODS-The updated Widmark equation to estimate BAC was modified to take account of the differing body composition (total body water) and accelerated rate of ethanol elimination of children. The modified formula was then used with NHANES 1999-2002 data to estimate BAC for over 4,700 male and female children and adolescents at each age from 9 through 17 years old for intake levels from one through five standard drinks. The goal was to determine the number of drinks at each age that led to a BAC ≥ 80 mg/dL, the National Institute on Alcohol Abuse and Alcoholism criterion for binge drinking.
RESULTS-The estimated BAC for children after consuming just three standard drinks within a 2-hour period was between 80 and 139 mg/dL for boys aged 9-13 and for girls aged 9-17, indicating substantial potential alcohol impairment. At five drinks within 2 hours, the level used to define binge drinking among college students, children aged 9-13 were estimated to have BACs two to three times the adult legal limit for intoxication of 80 mg/dL. CONCLUSIONS-Binge drinking assessment in children and adolescents requires substantially lower cut-points than those used for college students. Binge drinking should be defined as 3 or more drinks for 9-13 year olds, as 4 or more drinks for boys and 3 or more drinks for girls aged 14 or 15, and as 5 or more drinks for boys and 3 or more drinks for girls aged 16 or 17.
KeywordsChildren & Adolescents; Alcohol/Drug Use; Assessment & Surveillance; Epidemiology; Intoxication The Surgeon General recently issued a Call to Action on Underage Drinking 1 to draw greater public attention to the problem, to encourage more targeted research, and to develop more effective prevention efforts in the underage population. A further implication was to improve There continues to be little consensus, however, regarding how drinking and hazardous drinking should be defined. Drinking has been defined as any alcohol use 2 , more than a few sips of alcohol 3 , or a full drink of alcohol. 4 Hazardous drinking is often indicated by "binge drinking," defined as 5+ drinks for men or 4+ drinks for women per occasion. 5 This definition is controversial, however. 6-9Recently, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) redefined binge drinking as a drinking pattern that brings a person's blood alcohol concentration (BAC) to 80 mg/dL or above, a level accompanied by significant physical and mental impairment. 10 For the typical adult, this pattern corresponds to five drinks by a man or four drinks by a woman within a 2-hour period.One problem with the NIAAA d...