SINGAPORE: Up until a year ago, Andrew (not his real name) would go out drinking with friends at least four days a week.
“I was drinking pretty much every Thursday, Friday, Saturday and Sunday,” said the 28-year-old, adding that he would have between four and six drinks at each session.
The turning point for him, he said, was when he noticed that his body was not tolerating alcohol changes as well as before.
“I started to realise that my body couldn’t take the alcohol and break it down as quickly as compared to before. I wasn’t recovering as quickly as I used to the next day,” he said.
These days, Andrew has decreased the frequency of his drinking sessions to once every two months.
But he has never considered himself to be a binge drinker, even though his previous drinking habits fall within the definition of one, according to a recent survey by the Ministry of Health (MOH).
Binge drinking is defined as five or more alcoholic drinks for men and four or more alcoholic drinks for women in a session.
“For me, even though I was drinking quite regularly in the past, it was for a social reason and not for the sake of drinking. It was an activity I did with friends,” said Andrew.
“I would think that binge drinking is like forcing yourself to drink, but I never did that.”
Published on Nov 18, MOH's annual National Population Health Survey 2020 found that binge drinking is becoming more common in Singapore, particularly among men and younger adults.
The survey also found that younger adults in the 18 to 39 years age group were more likely to binge drink compared to other age groups.
Despite this, young adults CNA spoke to said they did not consider themselves binge drinkers, even though they typically consume at least four drinks in each session.
“I don't think four drinks is over the limit. I think binge drinking is perhaps when you have maybe 10 glasses in a single session,” said Kelly (not her real name).
“Personally, I pace myself well. So if I have four or five drinks a night, this would be across a five-hour social gathering or session, which I think is quite reasonable,” said the 28-year-old.
For 29-year-old David (not his real name), who drinks less than twice a week, what constitutes binge drinking is more about the mindset than numbers.
“I don't think it’s fair to assign a number to binge drinking and it’s not a good gauge because there are many factors at play, including gender and size,” he said.
“I have some bosses who at 4pm every day say ‘I need a drink’. Whereas some people may drink a lot in one sitting during a celebration or special event but don’t really see the need to drink that often,” he added.
“So in this case, I would think those who drink at more frequent intervals than those who drink a lot in one sitting would be considered binge drinkers.”
THE RISE OF PANDEMIC DRINKING
MOH's survey results came amid a global rise in "pandemic drinking", with studies finding more people turning to booze to cope with the toll COVID-19 has taken on mental health and addiction.
In the US, a survey conducted by the Johns Hopkins Bloomberg School of Public Health and the University of Maryland, Baltimore County, published in December last year, found that 60 per cent of its more than 800 respondents were drinking more during the pandemic.
In MOH's survey, 10.5 per cent of respondents said they had a habit of binge drinking, up from 8.8 per cent in 2017.
The ministry said it will continue efforts to reduce binge drinking, largely by raising awareness in schools and collaborating with government agencies to include messages on responsible drinking.
Dr Victor Lee, a general surgeon at Mount Elizabeth Hospital’s digestive and liver surgery department, said there appeared to be two distinct groups of binge drinkers in Singapore – infrequent and frequent binge drinkers.
The infrequent binge drinkers were more likely to be younger and unmarried. They also had higher educational levels and higher incomes, said Dr Lee. Those who were frequent binge drinkers were older, had lower educational levels and lower incomes.
Interventions against binge drinking can, thus, be targeted at different socio-economic profiles to be more effective, he said.
“Policy decisions and health education are probably the more effective strategies in curbing binge drinking. Increased alcohol taxation may have limited impact as this strategy may not impact the higher income infrequent binge drinkers.”
THE SLIPPERY ROAD TO ALCOHOLISM
While having a drink or two with friends can be considered recreational drinking, experts CNA spoke to said binge drinking can put a person at risk of developing future alcohol dependency.
Dr Adrian Wang, a consultant psychiatrist at Gleneagles Medical Centre, said this can lead to problems such as memory loss, irrational and impulsive behaviour, accidents and injuries, and loss of consciousness.
“I have seen patients who binge drink and then get into fights – for example with taxi drivers because they are too intoxicated to pay their fare – misplace their mobile phones and wallets, and even engage in risky sex,” he said.
Repeated binge drinking may also be an early warning sign of someone who is unable to moderate their alcohol intake, said Dr Guo Song, a senior consultant at the Institute of Mental Health’s National Addictions Management Service (NAMS).
“Although there is no immediate risk for alcohol use disorder, binge episodes can gradually increase until alcohol is consumed or required on a daily basis, and the individual thereby develops an alcohol use disorder over a period of time,” he said.
He added that signs of alcohol use disorder include a strong and continuing compulsion to drink in order to "feel the buzz" as well as giving up or reducing important social, occupational or recreational activities.
Responding to queries from CNA, NAMS said it has not seen a significant increase in the number of alcohol addiction cases during the COVID-19 pandemic.
However, it noted that stocking up on alcohol at home and ordering alcohol deliveries have become more commonplace amid dine-in restrictions.
“Increased accessibility to alcohol at home, unusual pressures in relation to the pandemic and a lack of social outlets may lead to higher risk of developing alcohol use disorder,” said Dr Guo.
"Habitual drinking may occur as a convenient but maladaptive method of coping with stressors, and a substitute for healthy social activities which includes exercise and hobbies,” he added.
Ultimately, experts say drinking alcohol should be done in moderation.
Dr Lee suggested limiting alcohol to two drinks a day for men and one a day for women.
“Younger adults are not less susceptible to alcohol-related diseases, as the health effects are largely dose-dependent,” he said, adding that increased consumption can increase the risk of alcohol-related diseases.
WHERE YOU MAY SEEK HELP
Alcoholics Anonymous Singapore: 8112 8089, or help [at] singaporeaa.org
National Addictions Management Service: 6 RECOVER or 6732 6837 (8am-11pm)
We Care Community Services: 3165 8017 (Monday to Friday, 10am-7pm), or help [at] wecare.org.sg
Samaritans of Singapore: 1 767 (24 hours)
Singapore Association of Mental Health: 1800 283 7019 (Monday to Friday, 9am-6pm)
Emergency Helpline (Institute of Mental Health): 6389 2222 (24 hours)
Care Corner Counselling Centre (Mandarin): 1800 353 5800 (10am-10pm)
Tinkle Friend: 1800 274 4788 (Monday to Friday, 2.30pm-5pm)