College Alcohol Abuse Sparks Drinking Prevention Debate

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Hollywood's fantasy version of college life, represented in movies such as "National Lampoon's Animal House" and "Old School," paints the campus experience as a non-stop tour de farce of beer, binges and, last and somewhat least, books.

Unfortunately, on many campuses, that big-screen depiction might not be far from reality.

Mental health and substance abuse professionals are growing increasingly concerned that today's college students have pushed partying to the point of dangerous alcohol abuse, or worse.

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The National Institute on Alcohol Abuse and Alcoholism reports that about 1,700 college students die each year due to alcohol related injuries. Other studies put the number of students who drive under the influence of alcohol at more than two million a year. More telling, a study in the Archives of General Psychiatry found that 18 percent — nearly one out of five — of U.S. college students suffered clinically significant alcohol-related problems.

"Binge drinking brings noise, assaults, vomit and rapes, all occurring within and near the dormitories," said Henry Wechsler, the Harvard University social psychologist who is at the forefront of the movement to wage an all-out war against alcohol on college campuses and their environs. "Students who don't drink are losing sleep, unable to study. And the same goes for those living adjoining to college campuses, who suffer from everything from litter to violence."

Wechsler, director of College Alcohol Studies at the Harvard School of Public Health, did not exactly coin the term "binge drinking," but redefined the term in his 1993 study of alcohol use on American universities. Wechsler's study used the term to mean five drinks at a single sitting for a man, or four for a woman — a definition that's taken hold among researchers.

Using Wechsler's definition, the 1993 study found that 44.1 percent — nearly half — of students in the 116 colleges surveyed were binge drinkers, that 19.5 percent were frequent binge drinkers. Only 15.6 percent said they abstained from alcohol use.

Subsequent studies found the percentage of binge drinkers remaining about the same, with the number of frequent binge drinkers increasing (up to 23 percent in 1999). About four out of five fraternity or sorority members were binge drinkers, a number that remained fairly constant.

This June, however, Duke University researchers, working from data collected in a 2003 survey of 10,424 freshman at 14 U.S. colleges, published a study that branded the drinking habits of college students "extreme drinking," an upgrade of two or three times the alcohol consumption of binge drinking.

Still, there are those who think alcohol use among college students is not the urgent crisis it is so often depicted to be.

Bill Arck, director of alcohol and drug-education services at Kansas State University, said that drinking levels on campus have been pretty stable the last 20 years despite the recent media furor, adding that the alcohol consumption habits used to define binge drinking inaccurately brands many students as problem imbibers who are actually modest or low risk drinkers.

A College Tradition

Drinking and higher education have long gone hand in hand in Western civilization, leading to more than a few notorious incidents. In 1355, Oxford University students drinking at a local tavern sparked the legendary St. Scholastica riots when one of them threw a tankard at the head of the tavern owner (and mayor of the town), who had the audacity to defend the quality of the wine he was serving.

The ensuing clash between townsfolk and academics lasted two days, involved thousands armed with bows and arrows and other weapons, and left 63 students and academics and an uncertain number of townspeople dead.

That and countless other booze-spiked tragedies did little to curb the long association between higher education and the consumption of vast quantities of alcohol.

Hollywood-created college stereotypes, such as John Belushi's "Bluto," were not only cast as reckless alcoholics but were assigned the added value of scruffy, anti-establishment heroes who performed such feats as chugging an entire bottle of Jack Daniels (though, the film's director substituted iced tea). Recent movies like "Old School" and "National Lampoon's Van Wilder" have updated the "Animal House" model by portraying comedic bouts of drunkenness with ultimately harmless and often admirable results (the character Van Wilder, a professional student, is portrayed as a party-throwing anti-establishment entrepreneur).

It was within this rich tradition that "Rob," now a doctoral candidate in economics at a Big 10 university, slid into the depths of alcohol abuse during his freshman year at a Pennsylvania college.

"Rob," who asked that his real name not be used, arrived on campus with a history of high school drinking that wouldn't sound too unfamiliar to most young people today.

"I was drinking when I got to college, but not like a profession, which it was like in college," he said.

"In high school, I'd go to parties on weekends and drink a 40 (ounce can), or someone would get a keg. It was mostly beer one day a week."

Within weeks of starting college, Rob was finding trouble at the bottom of a bottle.

"My first night there, I went to a keg party, a fraternity party, and we drank all week," he said.

"Everclear, Bacardi, we drank pretty much all the time. It's all we did. There was nothing to do except drink at college. If we didn't have class, we'd start around 3 o'clock. During that first semester, I got my first DUI," he said.

The statistics suggest that Rob's experience is not unusual, but what is changing is the public awareness and understanding of the problems alcohol can cause among young people: addiction and alcoholism; a high incident of driving under the influence; and, hazing injuries and deaths.

A recent Duke University study found that alcohol use by teens leads to lifelong medical problems, including neurological damage and a dramatically increased chance of suffering from outright alcoholism at some point in life.

Now, university administrators, sociologists and concerned parents are not just paying attention, but debating the best way to reduce college drinking or end it entirely.

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The Best Approach

Wechsler said his research has shown that what's successful in cutting down college drinking is a slow but steady approach that proponents call "environmental prevention," a comprehensive attack on alcohol use on campus that targets not just the drinkers but every possible aspect of college life that might encourage them to take to the bottle — nearby bars, liquor stores, liquor advertisers.

Schools using the program provide more alcohol-free dormitories and activities, work with local government to go after businesses that break liquor laws, and encourage nearby restaurants and bars to fully train their staff about serving young drinkers.

"You don't rely on just the alcohol and drug-abuse office on campus," said Tom Workman, assistant director of student involvement at the University of Nebraska-Lincoln. "We looked at what worked and what didn't work, and the bottom line was that the only answer was everything. It took 360-degree coverage by the full community to impact that."

The all-out approach has its critics. They claim that Wechsler relies on false assumptions, including his original definition of binge drinking. Some say he demonizes alcohol, making the administration lose credibility when, probably inevitably, the students nonetheless begin experimenting with drinking.

"He says binge drinking is off the wall," said Arck. "Unfortunately, what he has done is mislabeled a lot of college students as binge drinkers who for all intents and purposes are fairly moderate- or low-risk drinkers.

"The average K-State male weighs about 180, and with four to five drinks in him in a typical four- to five-hour party, his BAC (blood alcohol content) would be about 0.035. I'd be hard-pressed to call him a binge drinker." (The general standard for intoxication is a BAC of 0.10)

Many who dismiss Wechsler's approach as "scare tactics" instead tout the "social norms" method. It posits that a more effective way is to inform students that their peers drink and abuse drugs much less than the media would have them believe, making incoming students feel less socially pressured to drink.

Social norms also target advertising and local bars, seeking to make the image of college-age drinking less ubiquitous, while providing alcohol-abuse services for those students who do end up drinking to excess.

"The typical college student comes to college already having made the decision whether or not they will drink," Arck said. "At Kansas State, generally one in six, or one in five students don't drink, and they aren't ostracized or shunned. But the majority of students drinks alcohol, and most of them do all right most of the time — most students are more responsible than people give them credit for. Three percent of students here in the age range may be actively drinking alcoholics, but that's a very small percentage of the population."

In fact, a study published this June by the National Social Norms Resource Center found that college students may have actually become more responsible in their drinking habits. The survey of 28,000 students at 44 colleges did find that 80 percent of students drink. But it also found that 73 percent of student drinkers have widely adopted practices such as using designated drivers, setting spending limits at bars, counting their drinks, and listening to friends who tell them they've drank too much.

Wechsler said approaches like social-norms programs — that don't explicitly advise students to abstain from alcohol — implicitly endorse drinking.

"It sends a message to incoming students: 'Welcome to college, alcohol is available here,'" he said. Others say only a combination of several approaches will yield the best results.

"Over the years, we have thrown millions at this problem, and I don't think there's any one thing that is going to change the course of experimentation by students. But we can reduce the risk, not by advocating that they don't drink but by telling them the facts," said Rosa B. Ament, director of counseling services at Pace University. "I take a middle approach, primarily I'm not 100-percent convinced that there's any approach out there besides the home-reduction programs that have shown significant impact on students with problem alcohol behavior."

Ament supports the BASICS model, an increasingly popular program that stands for Brief Alcohol Screening and Intervention for College Students, and tries to educate students about alcohol abuse while putting participants in the context of a typical college environment, assuming that those in the program have drunk heavily at some point but aren't necessarily alcoholics. It envisions college drinking as a continuum from complete abstinence to alcohol abuse, and uses group workshops and questionnaires to move students away from the alcohol-abuse end.

"Since '99 we've been surveying incoming freshmen and consistently have found that between 14 and 18 percent of students coming in already have high-risk consumption," she said. "This program doesn't tell them not to drink, but it puts into perspective that if their behavior is high risk, there's a high risk to it."

For "Rob," it took two more DUIs for him to stop drinking and enter a rehabilitation program. He hasn't had a drink for four years.

"In the end, I'm glad it happened," he said. "I was just sort of floating through college before this whole experience. When I went back, I chose a career path, took the extra classes necessary and actually managed to get into a half-decent program, which was a miracle considering my background.

"My family and friends are happy for me. Even the ones I used to party with."

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