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In addressing the moral consequences of classification, Bowker and Star have remarked that “each category valorizes some point of view and silences another”.1 Unusually in medicine, such valorisation has silently entered the Read Codes with the announcement by the NHS Centre for Coding and Classification in January 2004 of the addition of “136R. Binge drinker”. Medical terms usually qualify a condition or disease rather than label the person who has it. The reason is that personal labels may carry negative connotations, arousing resistance or defensiveness, whereas terms for behaviours (such as “high risk drinking”, “alcohol dependence”, and even “binge drinking”) are more likely to be seen as a necessary and acceptable part of therapeutic discourse. The World Health Organisation’s lexicon of alcohol terms includes “binge drinking” (“a pattern of heavy drinking that occurs in an extended period set aside for the purpose”) and also offers “bout drinking” and “spree drinking” for the activity.2 The Health Development Agency additionally references “risky single occasional drinking” and “heavy episodic drinking”.3 Definitions of binge drinking vary, too. It was defined in a report of the Royal College of Physicians as “a man who regularly drinks 10 or more units in a single session, or a woman who regularly drinks 7 or more units in a single session”.4 The new national alcohol harm reduction strategy uses the definition of eight or more units in a single session for men and six or more for women.5
Quotidian practice has tied “binge drinker” strongly to negative stereotypical images of the young (and frequently female, although statistically more likely to be male). The attachment of this category to a person is not a neutral process: it entails assignment rather than self ascription, a degree of visibility to others, and the likelihood of durability. Furthermore, the coupling is under the control of the medical establishment with respect to reversibility. There must be better terms in the drinking repertoire for describing this behaviour that avoid labelling people.