I’ve been a psychiatrist for a long time, and my patients say: “I don’t have a problem. I don’t use drugs (alcohol) every day.”

Then they tell me some version of the “binge” story, and I’ve seen some pretty severe ones.

They might start out by saying: “You know, every two weeks, I just have to go out and binge drink.”

And then they say, “I’ll have 12 drinks.” Or. “I’ll have a bottle of wine.”  Or. “I’ll drink vodka and shots.”

Just yesterday, a patient told me: “Every week, just to relax, I’ll take some Xanax with some alcohol and maybe mix it with a 30 mg Roxicodone.”

Still others tell me they never use drugs or alcohol, but once a month, they’ll smoke marijuana with their friends.

Some of my younger clients have told me they will take 15 to 20 drinks with a Xanax. Or 10 to 15 Roxicodone. Or six to 10 Xanax.

With Cocaine, I’ve been told that they take one to three grams in a day, and they’ll say: “Well, I’ll only do that three or four times a year. What’s the problem with that?”

To read the three posts I’ve writing on bingeing, and what the problems are, go here for Alcohol, here for Drugs, and here for Mixing Alcohol and Drugs.


My patients will tell me they take a few drinks of alcohol once a week on Fridays. I’ll ask: “What’s a few drinks to you?” And they say: “Before I go out, I’ll have two beers. I’ll go out and have a bottle of wine. Then, I’ll have two or three shots or whisky at the bar afterwards.”

Adding all that up, it comes to somewhere between 10 and 15 – maybe even 20 – ounces of alcohol. “It’s only once a week,” they say, “and I was productive all that week.”

Well, I’m not buying it. It takes a lot of time to recover from that much alcohol. That alcohol has probably affected their neurochemistry and, therefore, their behavior, for four or maybe five days. So, in truth, five out of seven days, their behavior was impaired.

Bingeing carries consequences. During the time that they were impaired, what happened in their relationships? Were the relationships damaged? Were they behaving appropriately? And what about financially? Did they spend too much money? And at work, were they productive Monday morning? Were they thinking clearly or doing superior work, thus furthering their career? If not, that’s a sure way to stop ambition.

Maybe they did not get a DUI. Or get into a fight. Or get arrested. They didn’t commit any crimes (although that can happen with binge drinking).

But coming home drunk certainly wasn’t appreciated by their spouse.

And, here’s another thing I tell my patients who are binge drinkers. They are reaching toxic levels because their tolerance for the drug is low. They could die.


With drugs, people will come in and say that they smoke marijuana once a month. I’ll ask how much they smoked and they’ll say, a joint or two. That sounds innocent, but marijuana stays in your system for three to four weeks. So, it’s not a coincidence that they smoke every month, because the marijuana is out of their system and it needs to be recharged.

And if they think that the marijuana is not affecting them for the whole month, they are kidding themselves. It’s affecting the level of their ambition, memory, concentration, follow-through, energy, diet, interactions with others, impacts the quality of their work. They are kidding themselves if they say that smoking once a month has no effect. Clinically, that’ not what I see.

For people who binge with Cocaine or Opiates or Xanax or drugs like Benzodiazepines, they’re tolerance is down and surely they can overdose.

Bingeing on opiates is especially dangerous. Those people have told me: “I don’t have a problem. Every once in a while I’ll take a few Roxicodone.” Well that behavior has caused at least ten of my patients to die.

Bingeing is especially dangerous for people who haven’t used them for, let’s say, a month, because they have no tolerance for the drug. So, the drug affects their respiration, their ability to breath, and the ability for their heart to beat. This is lethal. Same thing with bingeing on a 20 or 40 mg. pill of Methadone or 80 mg. of Oxycodone. Their respiration stops and they die. And even if they live through it, they are predisposed to traumatic events because they are not thinking clearly. They’ll fall down and hurt themselves, or nod off while driving. Opiates are a drug that takes five days to clear out of the system, so, if they take it every few days and call that bingeing, they are kidding themselves.


In the class of drugs called Benzodiazepines, Xanax causes real problems with bingeing when it’s mixed with alcohol.

Here’s one of my patient’s recent episode.

He hadn’t taken a Xanax in a couple of months, and went out and a friend gave him a Xanibar, a 2 mg. Xanax. Then he went to a bar. There was an interaction between the drug and alcohol, and his memory blacked out. During that time, he broke into a car, stole things, left the door of the car open, sat next to the car and fell asleep. The police came. He woke up and asked the officer, “What’s going on?”

Here’s the worse scenario that can happen, either because they mixed alcohol and Xanax, or they’ve taken too much Xanax by itself. It suppresses the ability to cough, so they coughed or burped up some of the contents of their stomach and breathed it into their lungs, in other words, they drowned in their vomit. I’ve lost numerous patients like that.

Bingeing is a very dangerous thing to do. It’s really dangerous for people who have addiction problems and haven’t used for years. They think they’ll go out and that they are just going to use a little, but they have no tolerance, they overdose and they die.

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2 Responses to Binging

  1. Gina says:

    I agree, and understand your logic. I was what you would call a ‘binge drinker’ and looking at my behavior, I’m grateful I am still here. I finally, finally, finally came out of denial and learned that I have a problem with alcohol and I can not drink to live the healthy life I desire. It is very freeing, scary and empowering at the same time.

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