Different Thinking about Drinking on College Campuses

There is an interesting article by Brandon Busteed in the Chronicle of Higher Ed about college drinking. Busteed argues that the problem is not the population that addiction specialists tend to focus on: the really heavy drinkers. Rather the problem is in the much more numerous group of moderate drinkers with infrequent binges:

Despite conventional wisdom, the alcohol problem colleges face is not mainly about high-risk drinkers, and the solution is not about intervening with them alone. If it were, we'd have declared success long ago because we have invested so much time, money, and resources doing just that. Yet our studies show that, despite a handful of solid efforts in the realm of primary prevention, most colleges take a group-think approach to identifying and intervening with high-risk drinkers. The solution lies instead in a counterintuitive approach: working with the 80 percent of students who are not frequent heavy drinkers, and changing their ideas about what constitutes normal college drinking habits.

My company, Outside the Classroom, develops programs to counter alcohol abuse in higher education. Working with more than 500 colleges and universities across the country last year, we surveyed 450,000 freshmen about their drinking habits. We found that comparatively few students are problematic drinkers, and, in fact, other studies have found that the majority of negative consequences from drinking on our campuses come from the population of students who are light-to-moderate drinkers and infrequent bingers. There are three times more such drinkers than frequent heavy drinkers -- the two groups account for about 60 and 20 percent, respectively, of college students. Thus, while we need to make major changes in the frequent heavy-drinker category to reduce their risk to a reasonable level, we need only make modest changes among the light-to-moderate drinkers to yield far fewer negative consequences.

The Harvard School of Public Health's College Alcohol Study has produced data that correlate specific levels of consumption (by number of drinks consumed) with relative risk for negative consequences. For example, a moderate drinker who typically has four drinks has a risk factor of 14, while a heavy drinker who typically drinks nine or more has a risk factor of 33. The heavy drinker has more than double the risk of injury than the moderate one, but because the moderate drinker has three times more friends who drink like him, the moderates incurred more injuries over all than the heavy drinkers.

He goes on to recommend strategies to address this group such as focusing on negative effects of drinking in the first couple weeks of the freshman year and creating a more permissive culture for non-drinkers.

I like the way this guy is thinking about the problem, but I have a couple things to add. My experience in alcohol abatement in college has been informed in two ways.

First, I was an RA my senior year at Stanford. The Stanford Residential Education policy (at least at the time...it may have changed) was relatively progressive with respect to drinking. They actually encouraged the RAs to drink in moderation with their younger residents. You weren't allowed to buy it for them or drive them to purchase it, but otherwise pretty much everything was permitted. This RA policy was combined with some forward thinking on behalf of the Stanford Police Department. With respect to student drinking, they generally would not break up parties provided the participants were drinking indoors and weren't being disruptively loud. You wouldn't get a minor-in-possession unless you were outside or doing something truly egregious.

The purpose of this policy was to guarantee that if individuals were drinking, they were doing so under the supervision of older and more experienced peers. It reflected a recognition that it is very difficult to penalize underage drinking out of existence. Recognizing that underage drinking is likely to be prevalent no matter what you do, it is best to arrange policies that limit the serious negative consequences such as alcohol toxicity. Someone is always there to watch you if you had too much. At least when I was there, this policy was mostly successful. There hasn't been an alcohol fatality at Stanford, and most of the alcohol related injuries were minor.

The second experience I have had dealing with alcohol policy is through my father. My father works at CU-Boulder and is involved in setting up an organization there called the Student Emergency Medical Services Foundation or SEMS. A little background: several years ago there were several student deaths due to alcohol toxicity at CU and CSU. In some cases, the people involved were left in their rooms unattended. My Dad is an ER doc in the area and has considerable experience dealing with inebriated minors. The idea with SEMS is that they would train and place student EMTs in parties of various sorts. If you felt one of your friends had too much to drink, you would get the local representative to come take a look at them. If they indeed had too much, they would then call EMS. No harm, no foul. The party doesn't get busted, and everybody lives.

From everything I have been told, this program has also been quite successful. But it has required a degree of cultural change on behalf of the CU administrators. From discussion I have had with friends who went to CU, much of CU alcohol policy was based on the principle that if you made the penalties harsh enough, people wouldn't drink. Both the RA program at Stanford and the SEMS program are predicated on the idea of limiting the negative consequences of drinking, rather than preventing it outright. I think this difference in emphasis accounts for their success.

My experience and the piece in Chronicles of Higher Ed both suggest that the key to alcohol abatement on college campuses is a cultural change on behalf of both administrators and students. On the side of administrators, it requires a concerted effort to address excess alcohol consumption as a public health issue rather than a legal issue. When something is a public health issue, you try and limit its prevalence and its worst negative results. But you recognize that you can't just raise the penalties and expect it to go away. On the side of the students, good policy requires informing them of the negative consequences. There needs to be special emphasis put on those consequences that still result from level of consumption less than outright addiction. Student cultural change also requires creating a more permissive culture for non-drinkers and encouraging non-drinking social alternatives.

I think this is an issue that we can solve, but it does require a cultural change. I am curious to hear about other people's experience with alcohol policy on their campus. What works, and what doesn't?

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If these people really want to test out their ideas then they should head to East Lansing, MI. If they can help Michigan State's drinking problem then they can help ANY campus with their alcohol problems. I know, I was one of the problems...

Well, the easy fix is gene transplants of that East Asian glow allele.

For real, though, we need a tougher attitude toward disciplining kids. We have it backwards: we indulge kids and the younger adolescents, so they don't learn boundaries and rules of behavior early on. When they become adults, they fuck shit up and we have to clamp down on them for their own good.

Pinching the ear of some bratty kid who isn't related to you goes a long way -- it shows that the little shit won't get away with anything. Even if his parents don't slap him into line, the larger community will police his behavior. Then when they grow up, they behave themselves a lot better, and you could lower the drinking age back to 18.

One thing, though -- the whole concern about drinking on college campuses is really missing the big picture. Most people who screw the world up by drinking aren't smart enough to get into college in the first place.

I'm not saying we shouldn't pay attention to college students, but let's get real: most of the problems of society, on a personal scale (not foreign policy disasters), are caused by the left half of the bell curve. Heather McDonald did a recent exposee of the fact that rape on college campuses pretty much doesn't happen, yet tons of funding goes into preventing it. That funding should be spent on preventing rape where it is more likely to happen, off of college campuses in bad neighborhoods.

In our culture, it is considered sensible policy to expel middle and high school students for giving aspirin to a friend with a headache. Politicians promise to "get tough", not "get sensible" because the former gets them elected and the latter gets them labeled "elitist."

Your plan is too sensible to ever be implemented.

Do you ever wonder what US drinking-age laws, and the attendant drinking problems, look like to nations which have no 'drinking age'?

By Gilipollas Caraculo (not verified) on 07 May 2008 #permalink

I agree with Jake. The real measure of an intervention program is whether the culture changes for the majority of drinkers. The college population is isolated from consequences, has a herd mentally in regard to flaunting the rules of society (Gerhard Casper, the former president of Stanford University, once called them "anarchists and talented ones at that")and have NO education in the dangers of alcohol, and the techniques to fit in while not killing themselves and others. That is as much the fault of our failure to educate as it is the fault of our continued Puritan parenting.
We have had success at CU because the kids teach the kids, and occasionally save them from themselves as well. Parental and administrative rules are viewed as unreasonable and the ONLY way to get the message across is from the mouths and the actions of their peers. Peer-to-peer education and culture change works. SEMS was recently voted the "best student organization" on CU's campus. The reason are the best is that we provide practical information and reasonable help to students without judging and without reproach.
The problem is not a small one. The graduates of our colleges will be the leaders of the future. We need their creativity, drive and focus to be maximized. With too much alcohol, we (and they) cannot reach our full potential.

By J T Young (not verified) on 07 May 2008 #permalink

As a teenager in the '70s, I was actually encouraged to drink alcohol by my parents. It started as a little bit of watered-down wine with dinner, and progressed to a light bourbon-and-water on the night of my high school graduation. They held the notion that alcohol was a drug best consumed with full prior knowledge of its effects. Both of them considered it highly improper to get drunk, and my mother had had a couple of dicey experiences as a young woman, when manipulated into drinking more than she should have. They did not want that -- or worse -- to happen to their daughter!

As a result, I drank lightly, watched what I drank, understood the combined affects of alcohol and exhaustion, and profited thereby.

Nowadays that sort of parenting would result in someone calling Child Protective Services, and ultimate punishment. Yet the younger undergrads at my school, raised in this "zero-tolerance" environment, don't seem to handle their booze nearly as well as I did.

I also started drinking with my parents early - sips of drinks from about 3, a glass of wine or cider with a meal from 10. I now don't bother drinking much, am well aware of my limits, and don't see getting drunk as grown-up or exciting. Alcohol becomes like chocolate cake - pleasant, but harmful in large quantities and not actually that special.
The UK law supports this sort of attitude. There are three legal drinking ages: 5 to drink at home, 14 to order a drink with a meal in a restaurant and 18 to buy a drink on its own or drink spirits. Done properly, this gives a more mature attitude, where people can enjoy alcohol without feeling the need to get slaughtered. After all, it's hardly news that banning something makes it more appealing to teenagers. If they've never been able to drink, they're going to overdo it the moment they get out of their parent's control.

@Karen - my parents also let me drink in very moderate amounts when I was young (starting from the age of about 10). I do like that approach (but you're right, it probably isn't something I'll be able to do with my own son, or risk losing custody of him, which is totally stupid). In my case, though, I don't think my parents were really trying to teach me to drink responsibly; most of the people in my family are alcoholics, and I guess they thought there was nothing wrong with alcohol, in general, so they thought it was only fair to share.

I don't think this is just a college issue; here in the U.S. our relationship with alcohol is unhealthy, period. On campus and off, in pretty much all walks of life. We desperately need a culture change. In my experience (purely anecdotal, and see comment above about alcoholism in my family; I am not unbiased, and alcohol use by people I know has directly, and negatively, impacted my life), I believe a large percentage of Americans of all ages simply have no idea how to drink responsibly. A great many of the people I know who drink do it in ways that are harmful - drinking too much or too often (or both), habitually drinking to escape troubling life situations that would be better dealt with in some other way, drinking and driving. Trouble is, until the culture changes, people are going to continue with these harmful behaviors, because most people believe that drinking is no big deal. Which, it wouldn't be if people did it responsibly, but a great many of them don't. Obviously, not all these people learned to drink like this in college. Some of them did, some of them learned it elsewhere. It's a far-reaching problem.

I love the idea of the peer-to-peer influence (especially older students interacting with younger ones). This does seem like a good place to start fixing the problem, but it needs to be addressed elsewhere, too, in order for the culture to shift in a better direction.