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Hans House explains the importance of being responsible on your birthday and not over celebrating.

Across North America, celebrating birthdays as an adult sometimes involves binge drinking.  And the milestone of achieving legal drinking age involves more binge drinking than most.  This risky behavior is likely to result in social and medical consequences.

Researchers at the University of Northern British Columbia have found further evidence for the negative consequences of birthday-related binge drinking; it is associated with a spike in ER visits.  In a study published in the journal Addiction, ER visits increased 114% among males and 164% among females during the week of their 19th birthday (the legal drinking age in Ontario, Canada, where the study was conducted).

In its introduction, the article reviews other study results that found 40 percent of American college students ages 18 to 22, and 45 percent of adults ages 21 to 25 binge drank in the previous month. Moreover, studies that looked at when these binges occurred found that binge drinking occurred the most during 21st birthday celebrations. Even more than on Christmas or Spring Break.

I have seen this problem firsthand in my emergency department in Iowa City, Iowa, which is in close proximity to University of Iowa.  It is not unusual for me to treat unconscious birthday partiers decorated with multiple wristbands documenting their journey through the local bar scene.  They are wheeled into the ER by ambulance after being scraped off the sidewalk where they are found unconscious.  Or they are brought in by police, belligerent and handcuffed, with varying degrees of facial trauma from a bar fight. 

How do we mitigate this problem?  One step would be to curb irresponsible drink promotions for this at-risk group.  Several bars in Iowa City that cater to undergraduate students offer 21 pitchers of beer for $21 on your 21st birthday.  Is it any surprise these patients get into trouble?

Another approach would be to target young adults with direct messaging.  The Foundation for Advancing Alcohol Responsibility teamed up with Dr. Brian Suffoletto and the Emergency Medicine Foundation to research a way to reduce binge drinking with text messaging and it was successful.

Dr. Suffoletto’s study of 765 young adults who were identified with past hazardous drinking behavior in four urban emergency departments in western Pennsylvania, found that participants who received text messages prompting them to respond to drinking-related queries and received text message responses offering feedback on their answers, lowered their drinking occasions by one to two times a month from their baseline of three to four times a month. No drinking occasions at all were reported by nearly 15 percent of the participants who received the text message intervention, and the number of drinks consumed per weekend drinking day lowered among them, as well.

The Canadian study was published July 22 in the journal Addiction, and our study will be published in the August 2014 issue of Annals of Emergency Medicine and is now available for free online.

This blog was authored by:

Hans House, MD, MACM, FACEP

Vice Chair of Education and Interim Vice Chair of Research

Department of Emergency Medicine

University of Iowa

*The views and opinions expressed in this blog are solely those of the author and do not necessarily reflect the views of The Foundation for Advancing Alcohol Responsibility or any Foundation for Advancing Alcohol Responsibility member.*