for respondents to remember the number of drinks consumed at these high levels. Of course, this limitation comes with the benefits of large national samples. Future research should document the contexts of drinking, duration of the drinking occasion, and consequences experienced. Additional work is needed to assess extreme binge drinking in other populations, including young adults, and may consider a broader range of risk factors such as genetic, community, school, family, and mental health indicators to describe more clearly the etiology of the different levels of binge drinking. The documented rates of extreme binge drinking, and the fact that they have not changed across recent historical time, support the need for additional research to develop effective prevention and intervention strategies to reduce high-risk alcohol behaviors of adolescents.
