Alcohol Binge Drinking in Adolescence: The Who, the How, and the Why

During the last decade, alcohol binge drinking (BD) has become an increasing health and social concern, particularly among adolescents. It is characterized by the ingestion of large quantities of alcohol in short intervals of time, with the goal of achieving alcohol intoxication for leisure purposes. Worldwide, approximately 45% of adolescents between 15 and 19 years old engaged in BD behaviors during the last 3 months. This prevalent way of consumption during youth supposes a potential health problem due to the highest vulnerability of adolescent’s brain against deleterious effects of alcohol neurotoxicity. Along this developmental period, the central nervous system goes through intense changes, maturing and refining its anatomical and functional properties. Specifically, neural systems like frontosubcortical and prefrontal circuits, closely linked to reward processing and executive control, may be impacted by early alcohol consumption, which can impair inhibitory control, worsen decision-making, and increase risky intake behaviors. A large number of neuropsychological and neuroimaging studies have shown several detrimental neuroanatomical, neurofunctional, and neuropsychological consequences associated with BD practice. Nevertheless, causal relationship remains unclear. A growing body of literature highlights the importance of longitudinal studies to understand potential predisposition profiles, where neurological and neuropsychological conditions would make some individuals prone to initiate risky behaviors, such as BD. Throughout this chapter, an overview of the state of the art of BD during adolescence will be described. To this end, the consequences of consumption will be approached from different disciplines covering neuropsychology, neuroanatomy, and neurophysiology, building a global framework for this problem.