Failing Grade on Alcohol

New data showing nationwide increases in drinking-related deaths among college students call into question the strategies being used to promote moderation.

June 16, 2009

Amidst the hubbub surrounding colleges' attempts to curb excessive drinking on college campuses, one surprising finding has come to light: drinking-related deaths have actually increased. The number of alcohol-related unintentional injury deaths among college-age students between 18 and 24 rose from 1,440 in 1998 to 1,825 in 2005, according to a study released Monday.

Researchers from the National Institute on Alcohol Abuse and Alcoholism multiplied the number of 18- to 24-year-olds in the United States, as reported by the Census Bureau, by the estimated percentage of deaths among 18- to 24-year-olds that were alcohol-related, as provided by 331 medical examiner studies. That number was multiplied by 30 percent, since three-tenths of 18- to 24-year-olds are in college. Analysis of drinking habits and driving habits of college students versus non-college students found that those in college drank more and drove under the influence just as much, which led the researchers to conclude that college students suffered alcohol-related deaths as often as non-college students.

The overall lack of progress -- despite years of highly public campaigns by colleges to discourage excessive drinking -- led to some self-reflection Monday as campus officials and substance abuse experts considered the findings. Some experts see the data as evidence of the failure of existing efforts, especially the 21-year-old drinking law, while others question the wisdom of some campus campaigns and wonder whether those campaigns ever received enough money and support.

"I'm sure there are some universities where they can say, 'We are making progress,' but if you look at the nation as a whole, the proportion of college students who said they engage in binge drinking increased," said Ralph Hingson, author of the study and director of the division of epidemiology and prevention research at the National Institute on Alcohol Abuse and Alcoholism. "It looks like there have been increases, not decreases."

However, James Turner, executive director of the National Social Norms Institute and dean of the department of student health at the University of Virginia, has raised concerns with the methodology used in the survey. He questions the report's assumption that the causes of death are "proportional to populations," saying that college students are unlikely to die at the same rate as the rest of the population because they live closer to one another.

Turner maintains that colleges have been making considerable progress in curbing binge drinking over the past few years, especially at his home institution, the University of Virginia. A 2008 study there showed that a campaign that corrected misperceptions about drinking helped reduce the number of alcohol-related negative consequences, such as missing class and having unprotected sex.

Hingson agrees that it would have been better to have data on every injury death, but maintains that from the information he used, the results were a conservative estimate of the number of deaths.

Last fall, a former Middlebury College president, John McCardell, drafted and began circulating the Amethyst Initiative, a pact to discuss lowering the national drinking age of 21. The document has gathered more than 130 college officials' signatures to date. McCardell says the new study's findings reflect the need for the debate to continue on a state level rather than a national one.

"It's very hard to celebrate success when one sees binge drinking increasing from 41.7 to 44.7 percent of the population in the near term," he said, "and it's hard for me to say that a law that says you may not drink until you're 21 can be deemed successful."

The study also charted the rate of "heavy episodic drinking" among 21- to 24 year-olds was significantly higher than 18- to 20 year-olds. This could throw a damper on the Amethyst Initiative, which claims that lowering the legal age, along with education regarding safety, will decrease the rate of binge drinking. Hingson said that there is a "preponderance of evidence" to suggest that binge drinking declined among underage students when the national drinking age rose to 21 in 1984.

At the University of Florida -- which last year was named the Princeton Review's No. 1 party school and was the subject of an in-depth report on binge drinking by The New York Times -- administrators claim that, contrary to the trends in the report, they have made progress in reducing binge drinking. However, with limited resources to serve the 50,000-student institution and generally loose liquor laws dictated by the state, solving the problem of binge drinking is nearly impossible, said Jeanna Mastrodicasa, assistant vice president for student affairs at the university.

University President Bernie Machen has refused to sign the Amethyst Initiative, instead co-authoring an opinion piece in The St. Petersburg Times outlining his stance that the drinking age of 21 has saved lives. The university prefers to take "preventive strategies" by carrying out an alcohol education program; using a late-night bus system to minimize any temptation to drive drunk; and promotion of healthy drinking strategies. Machen has also long called for a shift in the campus culture of drinking.

Some campuses that have tried to change campus culture have faced a backlash. In 1999, Dartmouth College President James Wright attempted to overhaul the campus's long-standing Greek system, in part to curb excessive drinking. His proposed initiative sparked a student outcry and eventually evolved into a more moderate alcohol-management policy.

A 2009 Dartmouth graduate who wished to remain anonymous said the campus's lively party scene primarily stems from its rural New Hampshire location. The neuroscience major and sorority member said the administration's efforts to manage the drinking culture -- ranging from alcohol-free events to a hotline that allows students to anonymously report a friend suffering from alcohol poisoning -- have generally been effective. Still, she said there is no shortage of alcohol on campus, even for those who are not 21, and that's unlikely to change.

"I think policies like that [which] the college is doing do help -- 'Let's make sure they're not actually really hurting themselves,' " she said, adding that she views a "zero-tolerance" policy as unrealistic.

Drew Hunter, president of the BACCHUS Network, a nationwide health and safety organization, said the increased number of drinking-related injury deaths may have resulted from a decrease in campus funding and staffing needed to address alcohol abuse issues.

"Campuses make different progress at different times," he said. "If we're going to get serious about combating this, we need to create a national strategy to make sure the funds and resources to address this problem broadly are in place. Unfortunately, it just has not been a budget priority nationally in some time."

Hingson believes that curbing underage drinking is not impossible -- universities just need to carry out programs properly.

"Twenty-five years ago, people thought we would never be able to reduce drinking and driving, but population deaths have been cut in half," Hingson said. "It can be done on alcohol-related topics if they work with communities where they are located, if they implement tested interventions and if they make sure they do rigorous evaluations of implemented programs."

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