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Toll of Binge Drinking Far More Destructive than Realized

2002; Lippincott Williams & Wilkins; Volume: 24; Issue: 6 Linguagem: Inglês

10.1097/01.eem.0000334153.38128.fd

1552-3624

Peggy Eastman,

Substance Abuse Treatment and Outcomes

Binge drinking in college is a far more serious public health problem and causes more harm, including deaths and emergency visits for alcohol poisoning, car crashes, sexual assaults, and injuries in fights, than has been recognized up until now, according to a comprehensive new study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The institute, part of the National Institutes of Health (NIH), released the new study along with a call-to-action report and supporting research-based documents from its Task Force on College Drinking at an April news briefing at the National Press Club in Washington, D.C. The task force was created in 1998. Thirty percent of 12th graders report binge drinking in high school About 40 percent of college students binge drink, defined as five or more drinks in a row for men and four or more for women. If they are under age 21, they are drinking illegally. Many bingeing college students whose behavior is affected by heavy alcohol use don't make it to the ED in time. Each year, 1,400 college students aged 18 to 24 die from alcohol-related unintentional injuries, according to the study's lead author and NIAAA task force member Ralph W. Hingson, ScD, a professor of social and behavioral Sciences and the associate dean for research at Boston University's School of Public Health. While the deaths of college students due to excessive drinking receive the most publicity nationwide, the toll of injuries affects many more thousands of college students, according to Dr. Hingson's study, which was published in the March 2002 issue of the Journal of Studies on Alcohol (see box). “What we found should be of great concern” to college presidents and administrators and U.S. society, said Dr. Hingson. “It's time for the nation to look squarely, and say, ‘We can do something about this problem; it's been around too long.’” “These numbers paint a picture of a deeply entrenched threat to the health and well-being of our young people,” said NIAAA Acting Director Raynard S. Kington, MD, PhD. The problem, he said, “is greater than we had anticipated.” The NIAAA task force found that drinking tends to be heavier in northeastern colleges, at schools with fraternities and sororities, and at schools where athletic teams are prominent. Some high school students bring underage bingeing behavior with them to college; 30 percent of 12th graders report binge drinking in high school. Putting the Numbers Together The NIAAA is sending its call-to-action report to every college and university president in the nation, and has posted its action report and supporting research documents on the web at www.collegedrinkingprevention.gov. NIAAA Task Force Co-Chairman Rev. Edward A. Malloy, CSC, the president of the University of Notre Dame, said he knows firsthand the anguish a college president feels when he is called on to deal with a student near death from binge drinking. “You're the home away from home; you are entrusted with these students,” he said. “Each one is someone you know. When you put all these numbers together, you see the magnitude of the number of lives affected for ill.” Father Malloy said he has conducted the funeral liturgy for a person killed by a drunken driver. Recently, he said, two of his students ended up in the ED due to alcohol. The first was a young man, a freshman who was described as “blind drunk.” Father Malloy said the emergency physician caring for the student had remarked, “If this had happened to me, I would have been dead.” It was a “terrible incident” that happened to “a wonderful young man,” said Father Malloy. “He could have died.” The second incident involved an undernourished young woman found in the basement of a Notre Dame building after consuming 11 vodkas in a row on an empty stomach. Nearly dead, she stayed alive until she was rushed to the ED. “Each child is irreplaceable to every parent,” said Jeff Levy, whose son Jonathan died on Halloween in 1997 in a head-on car crash that also claimed the life of the student who was driving and Prof. Margaret Moore, who was driving the other car. Jonathan, a passenger in the student car, was a popular athlete at Radford University in Virginia who planned to major in business and join his father's company. Dr. Moore was on the faculty at Radford. Jon and two other students had consumed alcohol at a party on campus, and had decided to drive to a fraternity party in a nearby town. “Students don't have the message,” said Mr. Levy. “They believe getting drunk is equivalent to having fun.” They need to know, he said, that “if you're underage, drinking is unacceptable behavior. And getting drunk is unacceptable at any age.” Widespread Support Millie I. Webb, the president of Mothers Against Drunk Driving (MADD), welcomed the NIAAA task force efforts. She said in a statement that the new study “shows the nation, in staggering numbers, the enormous extent and consequences of the drinking problem on college campuses.… These deadly consequences clearly demonstrate that drinking on college campuses cannot be tolerated.” MADD released its own action plan to reduce drinking on college campuses in October 2000. The group was instrumental in enacting the federal minimum age 21 drinking law. U.S. Secretary of Education Rod Paige agreed, noting in a statement, “The statistics are sobering, and we must work to change the culture of acceptance of high-risk behavior as a rite of passage.” While getting drunk is part of the college culture for many students, especially freshmen and especially at parties, it doesn't have to be that way, said NIAAA Task Force Co-Chairman Mark S. Goldman, PhD, a distinguished research professor of psychology at the University of South Florida. “We can, in fact, make a change,” he said. “It's not intractable if we work together. Part of the problem in the past is that we've always used a narrow lens. This is an effort to get all of us…on the same page at the same time to make a difference.” He said skills to help students resist peer pressure to binge drink can be learned. The action report cited the value of personalized motivational enhancement training sessions to give students those skills. Drinking tends to be heavier in northeastern colleges, at schools with fraternities and sororities, and at schools where athletic teams are prominent The NIAAA's action report calls for changing the campus culture to one in which excessive drinking is the exception rather than the norm, and is considered unacceptable behavior. The institute said there is scientific evidence to support the following strategies among others to reduce binge drinking among college students: ▪ Formation of a campus and community coalition involving all major stakeholders, including students and the police, with incentives to reduce the destruction caused by binge drinking. ▪ Informing new students and their parents about alcohol policies and penalties before arrival on campus and during orientation periods. ▪ Increased prices and excise taxes on alcoholic beverages. ▪ Increased enforcement of minimum legal drinking age laws. ▪ Restrictions on alcohol retail outlet density, especially near college campuses. ▪ More emphasis on refusing liquor sales to minors, and enforcing penalties for noncompliance when underage drinkers are served. ▪ Increased enforcement of underage drinking laws at campus-based events that promote excessive drinking. ▪ Increasing publicity about the enforcement of underage drinking laws on campus. ▪ Provision of “safe rides” programs via free or low-cost rides to students who have been drinking and cannot drive safely. ▪ Regulation of happy hours and sales, such as two drinks for the price of one. The Human Costs of Heavy Drinking in College There are eight million U.S. college students. In addition to the annual toll of 1,400 deaths among them due to drinking, the NIAAA released the following statistics on the magnitude of harm from excessive drinking by college students ages 18 to 24 every year. ▪ Injury: Some 500,000 college students are unintentionally injured under the influence of alcohol. ▪ Assault: More than 600,000 college students are assaulted by another student who has been drinking. ▪ Sexual assault: More than 70,000 college students are victims of alcohol-related sexual assault or date rape. ▪ Unprotected sex: Some 400,000 students have unprotected sex, and more than 100,000 were too drunk to know whether they had consented to having sex. ▪ Driving under the influence: More than two million college students drive a car while under the influence of alcohol. ▪ Health problems/suicide attempts: More than 150,000 college students develop an alcohol-related health problem, and between about 1.5 percent of student drinkers tried to commit suicide within the past year due to drinking or drug use. ▪ Alcohol abuse and dependence: More than 30 percent of college students met the criteria for a diagnosis of alcohol abuse and six percent for a diagnosis of alcohol dependence in the past year.