The Wednesday before Thanksgiving is one of the heaviest drinking days of the year, rivaling even New Year’s Eve. Black Friday is part of the Thanksgiving weekend and is synonymous with shopping, and “Blackout Wednesday, ” or “Drinksgiving,” is known as a big day for drinking, as almost everyone has the next day off.

Binge drinking in the U.S. causes an estimated tens of thousands of deaths every year, and adds billions of dollars in health care costs. The Centers for Disease Control and Prevention (CDC) defines binge drinking as five or more drinks for men, four or more drinks for women, and blood alcohol levels of 0.08 percent or higher.

Last year, police in Detroit arrested 20 percent more people for drunk driving on the Wednesday before Thanksgiving than they did on New Year’s Eve. Officers around the country will be stepping up patrols on Wednesday night and throughout the holiday break.

The CDC has identified the Midwest and Northeast as the homes of heavier drinkers. Wisconsin tops the list with nearly a quarter of their adult population reporting binge drinking on an average of five times per month. The national average for binge drinking is about 17 percent. Other states reporting binge drinking by over 20 percent of adults include Alaska, Washington DC, Iowa, Illinois, Minnesota, Massachusetts, Montana, North Dakota, Nebraska and Vermont. Arkansas, West Virginia and Utah report the lowest rates of binge drinkers.

Men consistently do the most binge drinking according to the CDC, but women are catching up. Higher percentages of women are reporting both regular and more frequent drinking. It may not be surprising to find that young people are the biggest binge drinkers, with 28.2 percent of 18 to 34-year-old adults reporting binge drinking.

Alcohol is a frequent accompaniment to parties and family get-togethers, but the practice can set the stage for alcohol-related problems such as binge drinking. The risks of heavy drinking include alcohol poisoning, injuries, liver disease, diabetes complications, high blood pressure, sexual dysfunction and cardiovascular disease. Binge drinkers are 14 times more likely than non-binge drinkers to report driving while impaired.

According to Levi Stone, chief nursing officer at Odessa Regional Medical Center, the criteria for a binge drinker has been met if the motivation for drinking is to get drunk.

Wednesday before Thanksgiving is considered the single day of the year most heavily traveled by road. The combination of travel and Blackout Wednesday leads to particular dangers, both for binge drinkers and sober drivers.