One in five college students in a new peer-reviewed study reported extreme binge drinking. That rate is nearly double the national average. Researchers say it demands urgent attention from universities, public health bodies and families alike.

The study was published on 10 March 2026 in PLOS One. It surveyed 116 students aged 18 to 23 at two US universities. A striking 20.69% fell into the extreme binge drinking category. This compares starkly with the 12% recorded in a US national survey in 2020, raising serious questions about campus drinking culture and what universities are doing to address it.

Extreme binge drinking means consuming ten or more standard drinks in a single sitting for men, and eight or more for women. The risks stretch far beyond a bad morning after. Prior research found that drinking at two to three times the standard binge threshold raises the odds of an alcohol-related emergency department visit by roughly 70 times. At three times or more, those odds rise to around 93 times. These are not minor risks. They represent a serious public health crisis hiding in plain sight on university campuses.

Extreme Binge Drinking and Empathy: Scientists Expected a Link. There Was None.

The study’s main goal was to explore whether empathy explains why some young people drink at such dangerous levels. Researchers from Virginia Tech and the University of Vienna predicted that students with lower emotional empathy would be more likely to engage in hazardous alcohol use. The logic: fewer emotional connections mean fewer social brakes on harmful behaviour.

The results told a different story.

Neither cognitive empathy nor emotional empathy showed any significant link to how heavily students drank. The researchers used the well-validated Questionnaire of Cognitive and Affective Empathy (QCAE). They found no meaningful differences in empathy scores across non-binge drinkers, binge drinkers and extreme binge drinkers.

“The relationship between drinking behaviour and empathy may be more nuanced than expected,” the authors noted. Their null findings may partly reflect differences in how studies measure empathy. Earlier research that found a connection used different psychological instruments. Those tools may not be directly comparable to the QCAE.

This does not make empathy irrelevant to alcohol misuse. It makes the picture more complicated. Researchers may need to examine both personality traits and social environments together, rather than either alone.

The Numbers Behind Hazardous Alcohol Use in Young People

Several patterns in the data were both clear and concerning.

Men were far more likely than women to fall into the extreme binge drinking group. Among extreme binge drinkers, 45.83% were men, despite men making up only 26.72% of the total sample. That is a significant overrepresentation. On average, both men and women in the study exceeded the gender-specific thresholds for hazardous drinking on the AUDIT-C, a widely used alcohol screening tool.

Age also played a role. Within the 18 to 23 range studied, older participants reported higher hazardous drinking scores. Risky drinking does not appear to ease as students progress through their university years. According to the 2021 SAMHSA National Survey, 29.2% of young adults aged 18 to 25, around 9.8 million people, reported past-month binge drinking. This age group drinks more heavily than both older adults and younger adolescents.

Women scored significantly higher on emotional empathy than men. This aligns with well-established findings in psychological research.

Why Campus Culture Drives Dangerous Alcohol Consumption

The elevated extreme binge drinking rate in this study is not a statistical oddity. Researchers suggest local campus culture and university-specific social norms play a substantial role in shaping how much young people drink.

College students respond strongly to perceived peer norms around drinking. When heavy alcohol consumption becomes normalised or even celebrated on campus, those norms shape behaviour in ways national averages cannot capture. A student who might drink moderately elsewhere can drink far more when surrounded by a culture that treats excess as normal.

Late adolescence, roughly ages 18 to 24, is also a period of active brain development. The social brain keeps maturing well into the early twenties. Young people become more susceptible to peer influence at precisely the moment many leave home and enter an unsupervised social world for the first time.

This developmental window makes the prevalence of extreme binge drinking especially worrying. Adult consequences of heavy adolescent drinking are well-documented. They include lasting effects on cognition, mental health and social functioning. Early intervention during this period is far more effective than trying to address entrenched habits later in life.

An Alarm Worth Heeding for Extreme Binge Drinking Prevention

The study has real limitations. The sample is small, predominantly white and drawn from just two universities. Participants self-reported their drinking and empathy. This opens the door to underreporting or bias. College students often misjudge standard drink volumes and tend to pour more than they think. This means actual drinking levels may be even higher than what the data shows.

The cross-sectional design also limits what researchers can conclude. It is not possible to say whether heavy drinking reduces empathy over time, or whether lower empathy comes first. Both might be shaped by a third factor entirely. Future studies need larger, more diverse samples and a longitudinal design to answer these questions.

What this study does establish is important. Extreme binge drinking in young people is not a problem that resolves itself through increased emotional awareness alone. Dangerous alcohol consumption in this age group is embedded in social norms, campus environments and adolescent brain development. Tackling it requires a layered, community-wide response.

For anyone working in education, health or community settings, the message is clear. The scale of hazardous alcohol use on some campuses may far exceed what national figures suggest. Universities cannot afford to treat this as someone else’s problem.

References

1. Lester BA, Bislimi N, Lamm C, Pronizius E (2026). Cognitive and affective empathy in binge drinking during late adolescence. PLOS One 21(3): e0341842. https://doi.org/10.1371/journal.pone.0341842
2. Substance Abuse and Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2021 National Survey on Drug Use and Health. SAMHSA, 2021.
3. Hingson RW, Zha W, White AM. Drinking beyond the binge threshold: predictors, consequences, and changes in the US. American Journal of Preventive Medicine. 2017;52(6):717-727.
4. Schulenberg JE, Patrick ME, Johnston LD, et al. Monitoring the Future National Survey Results on Drug Use, 1975-2020. Institute for Social Research, 2021.
5. Patrick ME. A call for research on high-intensity alcohol use. Alcoholism: Clinical and Experimental Research. 2016;40(2):256-259.
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Source: dbrecoveryresources