Gail M. Basch M.DDepartment of Psychiatry

Rush University Medical Center

College Drinking

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College Heavy Drinking

Transitional time

Heaviest drinking epoch

Believe heavy drinking = norm

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~2,000

~700,000

~80,000

~2.8 million

$62 billion

Morbidity & Mortality

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student deaths/yr

assaults/yr

sexual assaults/yr

drove while intox

/yr underage drinking

→ Drinking problems

Clues for prevention

Clues for Rx

College Heavy Drinking

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This Lecture Reviews:

• Definitions

• Campus drinking & problems

• Risk factors for heavy drinking

• Prevention efforts

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Standard Drink

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Standard Drink in Solo Cup

Beer (12 oz)

Wine (5 oz)

Spirits (1 oz)

/ 4+ ♀  

≥5 occas/month

Heavy Episodic Drinking

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5+ ♂

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Blood Alcohol Concentration

Standard drink ~12 grams alcohol

1 drink → BAC 0.015 g/dl (~15 mg%)

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BAC’s Effects

≤ 50 (1-3 drinks)

BAC (mg%)

Well-being, ↓ inhib

≤ 100 Sleepiness, ↓ coordination

≤ 200 Anger, moody, confusion

≤ 300 Difficulty waking

> 300 ↓Vital signs, coma, death

Effects

Intox →forget events

Remain consciousness

Blackout

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≥ 1

Role failure

Risk of harm

Legal problems

Use despite problems

Dependence

DSM IV Alcohol Use Disorders

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≥3

Tolerance

Withdrawal

Larger/longer

Unable to cut down

↓ Time elsewhere

Use despite problems

Abuse Dependence

Legal problems

Cravings

DSM 5 Alcohol Use Disorders

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Tolerance

Withdrawal

Larger/longer

Unable to cut down

↓ Time elsewhere

Abuse Dependence2-3 mild, 4-5 mod, ≥6 severe

Role failureRisk of harmUse despite problems

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This Lecture Reviews:

• Definitions

• Campus drinking & problems

• Risk factors for heavy drinking

• Prevention efforts

heavy drinking/2 wks

♂ drink 10 drinks/occas

♀ drink 8 drinks/occas

1+ blackout/college

1+ alcohol problem prior yr 

students drink 72% of alcohol

~45%

~20%

~10%

~50%

~40 %  

~20%

Heavy Drinking Episodes

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College vs Non-College

Single event/game day/holiday

21st birthday

Fraternity/sorority

Student athletes

↑Impulsivity

AUD relative

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Risk Higher For:

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BAC ↑Drink Days

~83%

~25%

~40%

~50%

~72%

drink to celebrate

>21 b-day drinks

blackouts

highest ever drinks

↑ DWI risk

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21st Birthday

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Game Day Drinking

~60% drink

~7 drinks/game

↑ Impulsive

↑ Expect drunk

→↑ Drink

~ 60% prior heavy drinkers

~ 80% heavy episodic drinkers

Greek peers = heavier drinkers

Believe ↑ drink norms

→↑ Drink

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Fraternity/Sorority

Fraternity/Sorority

Blackouts/Past 2 Weeks

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~50% heavy episodic drinkers

Leaders ↑ drink and set norms

Athlete peers = heavier drinkers

Athlete + Greek →↑ Drink

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Student Athletes

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Family History

4x ↑ AUD risk

Even if adopted out

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Impulsivity

↓Postpone reward↑Risk taking↑Urgency→↑ Drink

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Level of Response

↑↑ Drinks/occas for effects

→Join peers ↑↑ drinks/occas

→Think everyone drinks ↑↑

→↑ Stress

Use ↑ drinks to cope

→↑ Drink

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This Lecture Reviews:

• Definitions

• Campus drinking & problems

• Risk factors for heavy drinking

• Prevention efforts

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Peer Influence

Students fear rejection

~40% afraid to refuse

Overest. peer/campus drink

↑ Drinking to match

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Inaccurate Beliefs

~65% more fun~55% better sex↓Muscle tensionBetter sleepOther myths

Alcohol ODPredict BACAlcohol + Drugs

False beliefs: Underinformed:

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Alcohol to Cope

Low doses → ↓ mild anxiety

2 or 3 drinks → ↑ anxiety

Drink to Rx anxiety

→ ↑ Drink

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Prevention Programs

OrientationStudent healthCampus LifeDorm counselorsPrevention campaigns

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Prevention VideosPeer influence Accurate alcohol beliefsActual campus drinkingHealthy copingCan’t guess BACAlcohol + drugs dangerous→ ↓ Drink

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This Lecture Reviewed:

• Definitions

• Campus drinking & problems

• Risk factors for heavy drinking

• Prevention efforts

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Acknowledgements

Marc A. Schuckit, M.D.Department of Psychiatry

University of California, San Diego

Marcy Gregg

AMSP Scholarswww.alcoholmedicalscholars.org