'Borg' is the dangerous alcohol trend physicians need to know about

By Claire Wolters | Fact-checked by Jessica Wrubel
Published February 17, 2023

Key Takeaways

  • Borgs, or “Black Out Rage Gallons” are a new alcoholic drink trending on TikTok.

  • The drink can include as much as half a gallon of vodka, mixed with water and flavoring in a gallon jug.

  • It is unclear whether or not the trend has spiked emergency room visits, but it highlights a need to educate young people on alcohol serving sizes.

TikTok’s viral mixed drink isn’t something a bar or restaurant serves. But enthusiastic Gen Z drinkers are still consuming them.

Known online as the “borg,” the drink is a colossal, self-curated cocktail that consists of three simple ingredients: vodka, water, and flavored powder.

Its infamy lies in the quantity of these mix-ins, which can amount to half a gallon of vodka, half a gallon of water, and a full packet of flavored energy powder. The acronym stands for "Black Out Rage Gallon."

Is Gen Z really drinking entire handles of vodka?

Borgs made their TikTok debut in 2020, and have been making secondary appearances in videos and party pictures since. 

George F. Koob, PhD, director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), says it’s unclear exactly how many young people engage in the trend, how much alcohol they actually put in it, or how much of the concoction they consume in one sitting. What is clear, he adds, is that heavy drinking can increase risks of injuries, emergency room visits, and death.

“There are about 43 standard servings of alcohol in a half gallon of 40 percent or 80 proof vodka,” Koob told MDlinx. “Consuming this much alcohol would be fatal for the vast majority of people, even if spread out over a day.”

Some young people have made videos warning of the dangers of the trend, where they discuss first-hand experiences with blacking out after consuming a borg.

Borg or no borg, emergency treatments for alcohol poisoning remain the same

Research shows that heavy alcohol drinking increases the risk of injuries, fights, sexual assaults, emergency department visits, blackouts, car crashes and other harms—regardless of if a person is consuming a borg or multiple beers.[]

"In the end, it’s the alcohol that matters with regard to harm, not how the person consumed it."

George F. Koob, PhD

If a patient shows up at the ER with a borg-related injury, follow the same protocols you would have if they sustained their injury from another kind of alcoholic drink.

For alcohol poisoning, you can start by assessing the patient for signs of alcohol poisoning by looking for symptoms like: slow breathing, vomiting, seizures, blue skin, low body temperature, unconsciousness, choking, or slurred speech. If necessary, you may need to administer emergency treatments like oxygen, IV hydration, IV thiamine and glucose to maintain blood sugar levels, or a procedure like a stomach pump to purge the body of the alcohol.[] 

Because young people are not immune to alcohol use disorder (AUD) either, you may want to offer some patients referrals to rehabs or detox centers, too.[]

In 2019, The National Institute on Alcohol Abuse and Alcoholism estimated that about 9 percent of full-time college students ages 18 to 22 met the criteria AUD.[]

Do borgs have any benefits?

According to Koob, there is no evidence that borgs reduce how much alcohol a person drinks. Drinking from a borg could decrease or increase alcohol risks depending on what a person mixes in their gallon and the pace at which they consume it, and therefore cannot be scientifically defined as harm reduction, he says.

“While this could be safer than drinking from a punchbowl at parties or having someone else make one’s drinks, it is up to the individual to make wise choices regarding what and how much to add to their gallon jug,” says Koob.

"In an effort to minimize risks by maintaining control of what’s in the borg, a person could inadvertently increase their risk of harm."

George F. Koob, PhD

Educating before an emergency

Emergency response to borg-related injuries may look the same as other alcohol-induced problems, but interventional education may look a little different—or perhaps, more intense.

Koob stresses the importance of correcting misconceptions about alcohol, like the idea that one way of drinking is safer than another, and hounding down on the importance of knowing what a serving size of alcohol looks like in different beverages.

“The delivery system for alcohol has little impact on the risks. What matters most is how much alcohol a person consumes and how quickly they consume it,” says Koob. “Every student should know how a serving is defined and that trying to consume half a gallon of vodka could easily turn deadly,” 

For vodka, one serving is 1.5 ounces.

He adds that there is no known safe quantity of alcohol, and NIAAA does not recommend alcohol consumption for people under the legal drinking age of 21.

What This Means For You

Some young people are engaging in a new drinking trend called “borg” drinking, where they mix large amounts of vodka, water, and sports powder in a gallon.

While it is unclear if the trend has spiked numbers of recent alcohol-related ER visits, doctors should follow the same protocols when treating all patients with alcohol poisoning regardless of the form of alcohol they consumed.

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