College & Alcohol

Introduction

For adolescents who go away to college, campus drinking is often a fact of life. Although many who drink are above the legal drinking age of 21, younger undergraduates often fi nd themselves in settings where others are drinking. Many are away from home and independent for the fi rst time, and will use their newfound freedom to experiment and engage in behavior that was considered off-limits while in high school. Unfortunately, drinking — and sometimes heavy drinking — is common on many college campuses.

A) Why is college drinking a problem?

Surveys on college campuses reveal that most college students drink alcohol, and many of them drink to excess (1,2). Although moderate or infrequent drinking may be the norm in many settings, college students often drink to get drunk. This kind of drinking can have harmful and serious consequences.

Teens and young adults under the infl uence of alcohol are more likely to be involved in unplanned and unprotected sexual activity, physical and sexual assaults, vandalism and property damage, and motor vehicle accidents (3). Intoxicated college students are more likely to be injured in falls or as a result of participating in risky activities while their judgment is impaired (3,4). Other negative consequences of college drinking include missing classes, poor school performance, social problems, and being subject to disciplinary and legal actions.

B) How are colleges noting and responding to the problem?

Colleges are using a variety of approaches to address and minimize underage drinking, both prior to college entry and during the undergraduate years. Most college handbooks for entering students and parents discuss that it is illegal to purchase, possess or drink alcohol, and clearly delineate the consequences.

As underage drinking is against the law, many college administrations will punish underage students severely if they are caught purchasing or drinking alcohol, using false identification cards to obtain entry into bars, or serving alcohol to minors while on campus. Punishments have included mandatory counseling, suspensions, expulsion, and often calling local police. Many colleges also work with the local communities, neighborhood bars, and law enforcement agencies to minimize opportunities for underage drinking.

Many colleges also work with the local communities, neighborhood bars, and law enforcement agencies to minimize opportunities for underage drinking.

C) What is the role of parents in preventing underage drinking?

Parents who express their views on underage drinking can be powerful positive influences on their college-age children. The literature supports this: parental expectations that their children not drink alcohol has been associated with less alcohol use, better refusal skills, and stronger resistance to peer influences to drink to excess (5). Parents are in a key position to discuss safety prior to a teen’s departure for college, and to monitor safety during the college years. Although older teens can be particularly challenging when parents try to initiate conversations about risky behaviors, they do tend to be receptive to guidance if delivered discreetly and in a non-judgmental manner.

The Facts

A) Epidemiology — what are the statistics?

Most college students have tried alcohol. A national survey reports that 86% of college students have tried alcohol, and more than one third admit to at least one episode of heavy drinking in the two weeks prior to being surveyed. And although drinking by high school seniors and young adults who are not in college is now less than it was ten years ago, the prevalence of college drinking has remained relatively steady over the past ten years (1,2).

Sadly, every year college students die in accidents related to alcohol. In 2001, alcohol was thought to be involved in the accidental deaths of 1,700 United States college students aged 18?24. Over two million college students each year drive under the infl uence of alcohol and more than half a million college students each year are injured in accidents related to drinking (3,6).

Alcohol use among college students is also associated with risky sexual behavior with unintended and dangerous consequences. About 400,000 college students each year report having had unsafe sex, with one quarter admitting that they were too intoxicated to know if they gave consent. In addition, more than 97,000 students between the ages of 18 and 24 are victims of an alcohol-related sexual assault or date rape each year (7).

Excessive alcohol use by college students is also strongly associated with academic problems. Young people who drink to excess often have trouble completing assignments, concentrating on their reading, and waking up in time to attend early classes.

Surveys of college students also indicate that among those who drink excessively, alcohol-induced blackouts are not uncommon. During these blackouts, some students have later learned they were involved in a variety of risky behaviors, including vandalism, unsafe sex, and driving while intoxicated (8).

B) Is drinking a part of college life?

Although most college administrations are trying to prevent underage and excessive drinking, alcohol is a part of college life for many. Often, where a student chooses to live infl uences his/her drinking behavior. Some college living situations may be associated with parties involving alcohol. More than half of the undergraduates surveyed at a major U.S. university admitted to an episode of heavy drinking two weeks prior, with 82% who lived in fraternity or sorority housing reporting such drinking (2). Although living in fraternity and sorority houses has been depicted in the media as being associated with heavy drinking, many school-sponsored organizations are striving to counter that stereotype. In fact, it may be that students who drink alcohol in high school are more likely to choose to live in that type of housing, perpetuating the stereotype.

Because students over the age of 21 are legally able to purchase alcohol, many social settings will have alcohol readily available...

Participation in athletic associations or sports teams has also been associated in some reports with binge drinking (9). Although athletes may try to maintain a healthy lifestyle, it is often the case that once a big game or the season is over, many may drink excessively.

Alcohol may be available at college parties, both on and off campus. Because students over the age of 21 are legally able to purchase alcohol, many social settings will have alcohol readily available, including for the underage student who wants to drink.

C) What is binge drinking?

This term means drinking a large amount of alcohol in a relatively short amount of time. Some experts define binge drinking as drinking five or more drinks in a two?hour time period for males, and four or more drinks in the same time period for females (10).

According to the National Institute on Alcohol Abuse and Alcoholism, binge drinking is defined as a pattern of alcohol consumption that brings the blood alcohol concentration (BAC) level to 0.08% or above. This pattern of drinking usually corresponds to more than four drinks on a single occasion for men, or more than three drinks on a single occasion for women — generally within about two hours (11).

Research indicates that binge drinkers are more likely to experience alcohol-related problems, and that frequent binge drinkers can be more than 20 times more likely to experience a problem (ranging from missing classes to having an accident to having a regrettable sexual experience) compared to non-binge drinkers (12).

D) What are the effects of heavy alcohol use on the brain?

Studies on rats given alcohol in large quantities suggest that binge drinking may cause neurodevelopmental and learning dysfunction (13). Adolescents who abused alcohol were found in one study to have smaller hippocampi (parts of the brain that control memory and learning) than teens who did not drink (14). It also seems that adolescent and young adult brains may be more vulnerable to the toxic effects of heavy drinking than adult brains. Learning and memory problems have been associated with heavy alcohol use among young people (15).

E) What are the legal issues with respect to underage drinking on campus?

Colleges are subject to the state and local laws in their communities. As all states in the United States generally prohibit the provision of alcohol to anyone younger than 21, colleges have policies supporting this, with varying types of consequences outlined for both the occasional and repeat offender.

The passage of the Drug Free Schools and Communities Act Amendments of 1989 impacts all institutions of higher education that receive federal financial assistance. This law mandates that colleges implement alcohol and drug prevention programs that clearly outline expected standards of student conduct, the health risks associated with illegal substances and alcohol, a description of the counseling programs available to those who fi nd themselves in trouble, the local, state and federal laws and punishments, and a clear statement of the penalties that the institution will impose for violations by first-time and repeat offenders.

Several colleges utilize a concept called “First Year Experience.” This program helps freshmen navigate the college experience.

F) How are colleges trying to prevent underage drinking on campus?

Almost all four-year colleges provide some form of alcohol education to their students (16). Most address underage drinking in their freshmen orientation manuals and seminars, and on their Web sites. Many also request that students fi ll out online surveys to assess their alcohol use, and require students to take online tests to make them aware of the consequences. Several colleges utilize a concept called “First Year Experience.” This program helps freshman navigate the college experience, offering assistance with studying, social issues, and alcohol and drug awareness. Many colleges tailor special alcohol education programs to high-risk students, such as those living in fraternities and sororities. Some universities conduct special anti-drinking campaigns for students who may have problems with alcohol. Often students incorrectly believe that more of their peers are drinking heavily than are actually doing so. Many programs try to correct this misperception and emphasize that most students drink moderately or not at all (17).

In addition to conducting education and alcohol awareness programs, many colleges have developed early-intervention strategies. These include offering health services, counseling and support groups which can help identify students with substance abuse problems and refer them to services. Many also use enforcement strategies. Some colleges will handle alcohol violations internally, asking resident advisors and faculty to supervise parties and check identifiations, then report violators to the college administration for punishment. However, some colleges will refer those who are caught drinking while underage or serving alcohol to minors to the police for criminal prosecution (18).

Conversations

A) Discussions with your younger teen

Often the media can provide opportunities to initiate a discussion with your child about underage drinking, even before the subject of college comes up. When watching a television show or movie in which teens or young adults are depicted drinking alcohol, you may ask your child:

  • Do you think that the kids on the television show got into any trouble because of their drinking?
  • Do you know any kids who drink like this?

Try to help your child make the connection between drinking and getting into trouble. These connections will be much stronger if your child fi gures out on his own (rather than if he hears it from you) that alcohol can lead to trouble. Also try to find out more about your child’s friends, as we know young teens are greatly affected by their peer group. Ask what your child expects to do about drinking when he/she enters college and peers are getting drunk. What are some strategies you both can come up with to resist peer pressure?

When a newspaper or the television news runs a story on local youth who either were injured or killed in alcohol-related accidents, you may choose to discuss with your child what happened. These terrible occurrences can often provide a lesson that will make a far more indelible impression on your child?s future behavior than anything you can preach yourself.

B) Discussions with your pre-college high school senior

  • What do you know about how kids are drinking on campus?
  • Does the college have rules about underage drinking?
  • What do you think you will do at parties where there is alcohol?
  • Have you spoken to any of your friends who are in college now about what the drinking is like on campus?

Older teens can be particularly challenging when parents try to initiate conversations about safety. They may feel that they know more than their parents. Yet in spite of their physical maturity, they often have large gaps in their emotional intelligence and judgment.

Older teens can be particularly challenging when parents try to initiate conversations about safety.

During college visits with your child, ask about alcohol-related policies. How do they enforce the prevention of underage drinking? How are social events monitored? Are non-alcoholic drinks (and food) always available at college-sponsored events? Is there a bar on campus? How does the college handle those students caught with false identifi cation cards while trying to obtain liquor? Who monitors and reports violations of the school’s alcohol policy? What are the consequences for violations? Are there alcohol-free dorms available for on-campus living? Are there campus transportation vehicles available (buses, vans, etc.) for students in order to minimize driving while intoxicated? Often colleges provide a forum exclusively for parents to ask questions about college policies and safety issues during the orientation period.

Afterwards, discuss with your child what the college offi cials said. Make it clear that these are college policies with consequences, and that you support these policies. Brainstorm with them how they will react to situations where alcohol is available.

Although it’s illegal to drink underage, it is still appropriate to talk to your children about moderation — if your child chooses to drink, how will he/she know if it is too much? What are the signs of intoxication? When does drinking become dangerous? (See Facts & Conversations: Talking to Teens — Underage Drinking at www.HealthAllianceonAlcohol.com for signs and symptoms of intoxication.) What happens to judgment after several drinks? Remind your child not only to avoid driving if he/she has had one or more drinks, but also to never get into a car with anyone else who has been drinking. Discuss when it is appropriate to call for help if your child thinks a friend is drinking too much and may be in danger. Who can your child call when a friend appears to be critically intoxicated — someone on campus, the emergency room, 911? What are the resources? Again, talk about safety around cars, water (swimming pools and beaches), etc.

C) Discussions with your college student

  • What have you been doing during your first few weeks of school?
  • What are the courses like?
  • Are there a lot of parties?

Many experts emphasize that the first six weeks of a freshman’s college experience are crucial in determining how he/she will respond to the new freedom of college life. Those who drink heavily during orientation week and the first few weeks of classes will often have a harder time adapting to college life later on, as the work gets harder (19). Call or e-mail relatively frequently during the first few months to see how your child is adjusting. If the college has a family-visit weekend, usually in the first two months of the semester, try to visit. Here are some things you can ask while visiting:

  • What kind of parties do they have on campus?
  • Is there a lot of drinking?
  • Have any of your friends become very drunk and done irresponsible or unsafe things?
  • What do you think about that?

Later, when your child returns for breaks or summer vacation, you may also ask about the alcohol scene at college. However, bring up the subject delicately; you may initiate the conversation by asking about friends and peers, rather than about your child’s behavior directly. Check grades if you can; students who drink to excess often will fall behind on their academic performance. Ask about any experiences your child may have had with a friend who drank too much. Make sure your child understands who and when to call for help if someone is dangerously intoxicated (symptoms of severe intoxication include poor responsiveness or slow, shallow breathing). Does the college have resources for problem drinking, where students can get help? Be sure to emphasize safety and responsibility.

  • Are you planning on joining a fraternity or sorority?
  • Are you trying out for a sport this year?
  • Are there any special clubs you want to join?

Depending on his/her plans, you may need to have a special conversation with your child about drinking and initiation practices. Although the practice of hazing has been banned in many states, many college clubs, teams, and housing groups participate in initiation “rites of passage” that involve risky behaviors, and which may include pressure to drink alcohol and even drink heavily. Again, this is an important time to discuss peer pressure, moderation, and safety with your child.

Depending on his/her plans, you may need to have a special conversation with your child about drinking and initiation practices.

D) Talking to your child who is about to turn 21 (and legally able to drink alcohol)

  • How do you think your life is going to change once you are 21?
  • Do you feel you can drink in moderation and be responsible?

Talking about, and modeling, responsible drinking behavior is key at this time. Emphasize how much drunker and sicker one can get when drinking on an empty stomach. Talk about the negative effects of mixing different types of alcohol. Warn against drinking games, which push young adults to drink more than they should, and can even result in life-threatening alcohol intoxication. For example, a popular drinking ritual in which young adults drink 21 shots of liquor on their twenty-first birthday has resulted in many cases of severe intoxication and death. Encourage your child to keep track of how much he/she is drinking, and to avoid binge drinking. Hopefully, your child has enough of a sense of self-esteem and responsibility at this time to avoid being pressured by peers to drink to excess. Additionally, it is important to also remind your child after turning 21, not to purchase alcohol for those who are underage.

Final Thoughts

Parents of older teens and young adults still have the power to influence their children’s thoughts and actions. However, talking to your child respectfully and in a non-condescending manner is crucial — especially at this time when your child has almost completed the separation process and is becoming independent. And for the conversation to be effective, it needs to feel natural; try to integrate it into your own routines and interactions with your child, and adapt it to your own type of relationship.

And remember, even though your child may have graduated high school and/or be in college, you should make it clear that if he/she is ever in trouble — even if he/she has been drinking (i.e. has drunk too much and is stranded at a closed bar and has no way home, or is too drunk to drive safely) — your child should be comfortable calling you for help, for a pick-up, or to arrange a safe ride home. Don’t let him/her be too embarrassed or afraid to call for help. Let them know that you will be there for them — no questions asked!

Parenting older teens and young adults is certainly tricky. Any conversation about risky behavior needs to be negotiated carefully so that the subject is addressed, safety is emphasized, and your child is still empowered to make his/her own decisions as an emerging adult.

About

Health Alliance on Alcohol

A national education initiative on underage consumption of alcohol through parent/child communications.

NewYork-Presbyterian Healthcare System

The NewYork-Presbyterian Healthcare System, the largest secular not-for-profit non-governmental health care system in the U.S., is committed to providing high-quality, cost-effective and accessible care to communities throughout the greater New York Metropolitan region. The System, made up of 38 acute care hospitals, 100 ambulatory sites, 16 residential health care facilities, three specialty institutions, and more than 15,000 affiliated physicians, serves one in four patients in the Greater New York Metropolitan Area. The System is also the largest not-for-profit employer in New York City. System members are affiliates of the Joan and Sanford I. Weill Medical College of Cornell University or Columbia University College of Physicians and Surgeons. During 2003, System institutions discharged more than 560,000 inpatient cases and saw more than 5,700,000 cases on an outpatient basis. For additional information, visit www.nyp.org.

White Plains Hospital Center

White Plains Hospital Center is a voluntary, not-for-profit health care organization with the primary mission of offering high-quality, acute health care and preventative medical care in a compassionate manner to all people who live in, work in or visit Westchester County and its surrounding areas. The Hospital has the busiest Emergency Department in Westchester County, treating approximately 24,000 patients in 2004. Its “Centers of Excellence” include cardiology, emergency medicine, endoscopy, minimally invasive surgery, oncology, orthopedics, neonatal and maternity, and radiology. The Hospital has won the National Research Corporation “Consumer Choice Award” for Westchester County four times, most recently in 2004. WPHC is an affiliate of the NewYork-Presbyterian Healthcare System and a member of Stellaris Health Network, Inc. and Voluntary Hospitals of America, Inc. For additional information, visit www.wphospital.org.

Morgan Stanley Children’s Hospital of NewYork-Presbyterian

Ranked by U.S. News & World Reports as one of the top five children’s hospitals in the country, Morgan Stanley Children’s Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics — including the most complex neonatal and critical care, and all areas of pediatric subspecialties — in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation’s premier children’s hospitals, Morgan Stanley Children’s Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City’s only hospital dedicated solely to the care of children and the largest provider of children’s health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children’s Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide.

Heineken USA

Heineken USA Inc., the nation’s largest beer importer, is a subsidiary of Heineken International (Netherlands), which is the world’s most international brewer. The Company and its affiliates are firmly committed to promoting responsible consumption of beverage alcohol. Among other distinctions, Heineken was the first brewer in the world to place a responsible consumption message on all of its bottles and cans. Heineken USA was also the first alcohol company to place a responsibility message on all of its television, radio and print advertising. Please visit www.EnjoyHeinekenResponsibly.com.

Author


Karen Soren, MD
Associate Clinical Professor of Pediatrics and Public Health,
Columbia University Medical Center
Director of Adolescent Health Care,
Morgan Stanley Children’s Hospital of NewYork-Presbyterian

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