Drunk and Vomiting? Don't Try a Backpack

College students’ drinking habits -- taking a shot through the eyeball or an alcohol enema, the crudely named “butt-chugging” -- have generally inspired incredulity and some head shaking among their elders.

After a fraternity pledge at Pennsylvania State University, Timothy Piazza, died in February, however, one detail that emerged was Piazza’s fellow fraternity members’ decision not to call an ambulance after he tumbled 15 feet down a fight of steps -- instead they strapped a backpack to him to (theoretically) ensure he wouldn’t recline and choke on his own vomit.

It’s a fad that has taken on many names -- “turtling,” “backpacking” or “Jansporting,” after the popular backpack brand. Students fill the bag with heavy objects and place it on the back of the intoxicated person, which supposedly will prevent them from lying flat -- presumably allowing the person to be left unattended while the partying continues.

Health experts warn that so-called Jansporting is actually quite irresponsible. Though it appears to relate to the advice professionals give to not lie down to avoid death by vomit aspiration, people who are drunk can die in many other ways, and they should be supervised at all times. Above all, students should call 911 in a tenuous situation and colleges and universities should reinforce proper drinking habits through continual education, experts say.

“Jansporting” has captured some headlines since Piazza’s death and subsequent legal action against the fraternity members, but the internet has long been tuned into it. The humor blog Total Frat Move wrote about it in January 2016, with a post containing explicit instructions how to stuff a backpack full of “books, jackets, empty bottles of booze” before tightening it around a person -- “kinda like a mom would do as she’s gearing up her little tyke for their first day of kindergarten” -- though the website warns to never leave the drunk person alone.

Several Reddit threads, some as old as four years, in the “life hacks” section of the site, are devoted to the practice, though some users express skepticism -- “[maybe] read up on some first-aid techniques.”

“It’s a very interesting development,” said Aaron White, senior scientific adviser to the director of the National Institute on Alcohol Abuse and Alcoholism. “I’m really surprised about all the work we’ve done around college drinking -- somehow college students think it’s a good idea to put a backpack on their friend’s back as a lifesaving strategy.”

Other drinking trends -- some of them myths -- have emerged and evaporated: sobering up a with a mug of strong coffee or a freezing shower, White said, or inserting a tampon soaked in vodka to get drunk quickly. He said Jansporting will likely be a brief flash, too.

This method isn’t even foolproof. White said he knew of a student who went out to a bar with his friends, drank too many shots, came back to his dormitory and eventually went to bed, throwing up in his sleep. He inhaled just a bit of vomit and died a week later. White said a person doesn’t have to “drown” from vomit -- they can just inhale a bit into their lungs, where the bacteria thrives in the moist, warm environment, resulting in a slower death.

A person’s blood alcohol concentration (BAC) can continue to rise even after they have stopped drinking if alcohol remains in the stomach and hasn’t yet been absorbed into the bloodstream, White said. Moderate drinking will result in a 0.03 to 0.05 BAC, while 50 percent of alcohol-related deaths occur at a 0.35 or above -- so “about 10 times the effective dose.”

Once the alcohol in the blood reaches a certain point, it can start to switch off the body’s vital functions -- gag reflex, breathing and heart rates -- so a backpack wouldn’t make a difference, White said.

Students may have mixed the alcohol with something else or taken another drug, increasing the danger of leaving them alone, said Beth DeRicco, one of the chairs of the American College Health Association’s Alcohol, Tobacco and Other Drugs Coalition. Left alone, the person could also be vulnerable to sexual assault.

DeRicco and the other chairwoman, Delynne Wilcox, both said that students are all looking for a “quick fix” -- something to sober them quickly. Drinks have gotten sweeter, fruitier and more palatable, they said, citing the rise of hard lemonades and cinnamon-flavored whiskies such as Fireball. These liquors that have taken the “alcohol flavor” out of the drink can more easily lead to poisoning.

DeRicco recalled reading about IV services -- some of which can cost hundreds of dollars -- that will come to someone’s door after a night of heavy drinking and directly replenish the body’s fluids so the person can avoid a hangover.

But the only way to possibly avoid the worst outcome is for students to dial 911, said Kimberley Timpf, senior director of prevention at EverFi, which developed AlcoholEdu, the popular digital program that many colleges rely on to teach their incoming students about drinking.

When students are asked why they didn’t want to contact a medical professional or an authority figure about a dangerously intoxicated friend, they’ll say it was to avoid punishment by the college, Timpf said. But surveys reveal a different reason, she said -- many students are ignorant of the symptoms of alcohol poisoning entirely. Many institutions have created amnesty policies, too, that immunize students who seek help for themselves or their drunken friends.

The more that these trends -- such as backpacking -- are discussed, the more attention they’ll receive, and the publicity may ultimately result in students trying them, Timpf said. When she was at a training at the University of Delaware, she was pleasantly surprised to learn students hadn’t heard of filling up a backpack and strapping to someone.

More and repeated education will help students learn -- not just a single webinar at the start of their college careers, but in-person sessions to teach them, said Timpf. She said fewer and fewer students will enter college now with experience in drinking, and some may not drink at all before arriving on campus. Campuses should be obligated to create a culture that offers students alternatives to drinking so they aren’t “caught up” at a party and feel like abusing alcohol is something necessary for them to experience in college.

“The underlying message here is that we don’t want to [have to] take care of the person,” Timpf said of backpacking. “It’s ‘we’ll cross our fingers and hope that it works,’ and go about our partying while this person is passed out but sitting up. That’s a really … that’s the thing that’s most disturbing -- you’re trying to put a Band-Aid on something.”