# High-Intensity Drinking over the Life Course: Identifying High-Risk Subgroups through Event-based and Population-Based Approaches

> **NIH NIH P50** · PUBLIC HEALTH INSTITUTE · 2021 · $291,120

## Abstract

ABSTRACT: High-Intensity Drinking over the Life Course: Identifying high-risk subgroups through
 event-based and population-based approaches
Binge or heavy episodic drinking (HED) of ≥4/ ≥5 drinks for women/men in a single occasion or day has been a
key marker of harmful drinking in general and clinical populations and has been widely used in alcohol
epidemiology to capture the public health burden from alcohol use. Yet critics have raised the issue that the HED
threshold fails to capture the impact of high-intensity drinking (HID) and implies the same average risks to all
heavy drinkers regardless of whether they consume 5 or 15 drinks. Recent studies have raised attention to HID
of consuming double (8+/10+ drinks) or even triple (12+/15+ drinks) the HED amount. As amounts per day reach
extreme levels, risks for consequences and alcohol use disorders (AUD) increase greatly, even when average
intake remains the same. This proposed Center project will trace trends in harmful drinking patterns with special
attention to HID occurrence and rates over a 40-year period, identify a range of alcohol-related precursors and
problems through event-based and population-based approaches, and situate harmful patterns within contexts
to inform early screening and interventions for high-risk groups. We will employ sophisticated statistical
methods to examine associations and consequences involved with HED and HID, using two adult general
population and two heavy drinker event-based samples, each type of data designed to generate
complementary and new knowledge about HID. We carry forward ARG's rich history in alcohol epidemiology
and measurement expertise, and the Center mission to reduce alcohol-related disparities, in all our study aims.
In response to NIAAA's priorities, and to ensure direct translational impact of study findings, we incorporate
specific theory and practice for each study aim. Our definitions of HED/HID include both threshold (5+, 8+ and
12+) and amounts drunk in any day (from 5-7, 8-11, and 12+ drinks). Aim 1 takes a life course perspective to
document harmful drinking trends over time from 1984 to 2024 and by priority groups (e.g., women; middle-aged
to older adults; socially disadvantaged groups including racial/ethnic minorities and those with lower education;
and people with history of AUD treatment or in recovery). Aim 2 characterizes event-level factors that heighten
the risks for HID compared to HED levels. Sensitivity analyses will compare whether adjustments for drink
size/strength and drinking rate (estimated BAC) will improve accuracy of how HID predict alcohol problems (e.g.,
AUD). Aim 3 situates harmful drinking patterns involving HID within the socioecological model to examine risk
and protective factors both currently and across the life course that are strongly associated with HID. Also in Aim
3 we assess the extent that HID elevates the public health burden of AUD and other problems above that of
HED and non-HED levels for a...

## Key facts

- **NIH application ID:** 10056013
- **Project number:** 2P50AA005595-41
- **Recipient organization:** PUBLIC HEALTH INSTITUTE
- **Principal Investigator:** Camillia K. Lui
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $291,120
- **Award type:** 2
- **Project period:** 1981-07-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10056013

## Citation

> US National Institutes of Health, RePORTER application 10056013, High-Intensity Drinking over the Life Course: Identifying High-Risk Subgroups through Event-based and Population-Based Approaches (2P50AA005595-41). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10056013. Licensed CC0.

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