Relationship between level of consumption and harms in assessing drink cut-points for alcohol research: Commentary on "Many college freshmen drink at levels far beyond the binge threshold" by white et Al

In this commentary, we describe the use of a 5/4 drink summary measure of heavy episodic alcohol consumption, or "binge" drinking, in survey research and its usefulness for preventing negative alcohol-related consequences. Data from 4 nationally representative surveys of more than 50,000 college students are utilized to examine the utility of this measure in comparison with alternative cut-points. Our analysis demonstrates that while higher drink threshold measures incrementally improve the ability to identify correctly students who experience harms or who meet DSM-IV diagnostic criteria of alcohol abuse and dependence, they capture only a small proportion of those college students experiencing harms. We conclude that the selection of a measurement tool should be consistent with the purpose for which it is to be used. The 5/4 measure of binge drinking provides a valuable means for understanding and preventing alcohol-related harms in a college population and can be utilized as a screen to identify students who may need additional clinical assessment for intervention.