See also: Alcohol and Carcinogens
See also: Alcohol and crime
See also: Safety tips for college drinkers
See also: Teens and Alcohol
See also: Women and Alcohol
See also: Your Health and Alcohol

See also: Clery Act Report on crimes: this report requires all colleges and universities who receive federal funding to share information about crime on campus and their efforts to improve campus safety as well as inform the pulic of crime in or around campus.

See also: "Vital Signs" newsletter from the CDC - centers for Disease Control and Prevention article on "Binge Drinking : nationwide problem, local solutions"

Changing the culture of campus drinking, Alcohol Alert (2002), 58.
Binge Drinking
Most research on drinking among college students focuses on the widespread pattern of binge drinking. Many researchers define binge drinking for men and women as drinking five or more drinks at one sitting (1-3). In 1994, by this definition, 40 percent of college students reported binge drinking at least once within 2 weeks of being surveyed(1). Thirty-one percent of college women binge drank compared with 52 percent of college men (1). However, a strong argument has been made that a more equivalent bingeing criterion for women is four drinks per occasion (3,4) and that the five-drink level may underestimate binge drinking among women (4). Developmentally, the ages 18 through 21 is the period of heaviest alcohol consumption for most drinkers in the United States (5). However, within this heavy-drinking age group, binge drinking is more prevalent among college students than non students (1).

Students who binge drink are more likely to damage property, have trouble with authorities, miss classes, have hangovers, and experience injuries than those who do not (3,9). Alcohol-related problems of this nature increased between the early and late 1980's (10,11). Interestingly, frequent binge drinkers and those who report experiencing specific alcohol-related problems do not perceive themselves as problem drinkers (3).

Among men, research indicates that greater alcohol use is related to greater sexual aggression (12). Sixty-seven percent of the male sexual aggressors at one university, as well as about 50 percent of female victims, had been drinking at the time of the sexual assault or other incident of victimization (13). Binge drinkers appear to engage in more unplanned sexual activity and to abandon safe sex techniques more often than students who do not binge drink (3).

Students living on campuses with higher proportions of binge drinkers experience more incidents of assault and unwanted sexual advances as a result of their peers' drinking than do students residing on campuses with lower proportions of binge drinkers (3,14). The former also more often report having their studies disturbed or having to take care of a drunken student (3,14). Students who consume alcohol but do not binge drink seem to have a lower frequency of drinking and getting drunk than do binge drinkers (3). The former also experience fewer of the alcohol-related problems cited above than their binge drinking peers (3).

Drinking and driving has been reported by more than 60 percent of college men and almost 50 percent of college women who binge drink at least three times in a 2-week period (3). By comparison, drinking and driving has been reported by 20 percent of college men and 13 percent of college women who do not binge drink (3). College students reported a decrease in drinking and driving incidents between 1982 and 1991 (9).

Heavy drinking or alcohol-related problems during college may be associated with personality characteristics, such as being impulsive (15); psychological problems, such as depression or anxiety (15-17); or early deviant behavior (18). As in the general population (19), a positive family history of alcohol abuse appears to be a risk factor for problem drinking in college students (17,20,21), although not all studies report this relationship (22,23).

Several studies indicate that students generally perceive their peers' drinking levels to be higher than their own (24-26) and higher than they actually are (24). Some studies further indicate that exaggerated perceptions of others' drinking are associated with greater individual consumption (24,26,27) but not with more alcohol problems (25,27).

College binge drinking
College binge drinking is more widespread and much more dangerous than anyone realized. The NIAAA Task Force on College Drinking says the answer is to change the entire college drinking culture. The number of college students who participate in "binge drinking" -- or drinking for the purpose of getting drunk -- remains at 44 percent of all students despite increased efforts by colleges to curb the trend, according to the Harvard School of Public Health College Alcohol Study released in March. The study revealed that drinking by college students contributes to an astonishing 1,400 student deaths, 500,000 injuries, and 70,000 cases of sexual assault or date rape each year.

Therefore, the NIAAA Task Force recommends that efforts aimed at preventing college drinking be aimed at changing the entire "college drinking culture" by simultaneously targeting three audiences: the student population as a whole; the college and its surrounding environment; and the individual at-risk or alcohol-dependent drinker.(from

Arria, A. M, et al. "Energy drink consumption and increased risk of alcohol dependence." ALCOHOLISM: CLINICAL & EXPERIMENTAL RESEARCH, November 12, 2010. Researches surveyed 1,000 college students, asking about their use of energy drinks and their consumption of alcohol in the past 12 months. Even after controlling for other risk-taking characteristics of the students, the link between energy drink consumption and alcohol dependence persisted, researchers found. Frequent use of energy drinks were defined as those who drank 52 energy drinks or more in the past 12 months (one per week).

Compared to non-users of energy drinks, frequent energy-drinker users were morel likely:
-- to get drunk at an earlier age
-- drink more per drinking session
-- more likely to develop alcohol dependence.

Amelia M. Arria, the lead author of this study, Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health, believes the use of energy drinks may be linked to other forms of substance abuse and plans to conduct further research to confirm the association.

Benton, Stephen L., et al., "College protective strategies and drinking consequences," JOURNAL OF STUDIES ON ALCOHOL (2004), 65: 115-121. (3,851 males and 4,151 females) This study explored the relationship between college student gender, alcohol use, protective strategies (drinking in an environment that provides food, drinking with friends, drinking only when a bartender is serving, and drinking with a meal, planning a response for refusing to drink, using a designated driver, and employing time management and organizational skills) and harmful drinking consequences. Although women drank less than men and were less likely to experience harmful consequences, they ere more likely to use protective strategies. Hierarchical regression analysis revealed that students who consumed at least six drinks when they partied--especially men--were less likely to experience more common consequences (e.g., poor academic performance, property damage, unconsciousness, riding in a vehicle with others who have been drinking) if they engaged in self protective strategies. Such strategies also helped students who exceeded the median number of drinks to moderate the effects of drinking on less common consequences (e.g., vehicular accidents, class failure, conflicts with authorities). Conclusions: These findings add to the growing literature to contextual events that protect students from harm while drinking.

Benton, Stephen, "Safety tips for college drinkers," May 14, 2006, Professors at Kansas State University have found that males ten to be greater risk takers when it comes to alcohol, while women tend to use more protective strategies. They recommend the following steps to all college student who drink as a way to avoid dangerous drinking episodes: limit the number of drinks consumed; use self-protective strategies, limit money spent on alcohol, drink with friends, pour your own drinks; and develop low-risk attitudes.

Researchers at Kansas State University found that 'The more you drink, the more you get into trouble. We found that the protective strategies are especially beneficial to male students, because they drink more than females, as well as to students who have six or more drinks.

Bingham, C Raymond; Shope, Jean T.; Tang, Xianli ; "Drinking behavior from high school to young adulthood: differences by college education", ALCOHOLISM: CLINICAL & EXPERIMENTAL RESEARCH (2005), 29(12):2170-2180. "To better understand patterns of at-risk alcohol use and its association with education, this study compared at-risk alcohol use from 12th grade to young adulthood (age 24) in a sample of never-married young adults. Three groups were formed based on completed education when the survey was administered in young adulthood: high school or less, postsecondary education without a four-year college degree, and completed college. Men who completed college experienced the greatest increase in at-risk drinking from grade 12 to young adulthood; however, their at-risk alcohol use did not differ markedly from men in the other education groups in young adulthood. Men who did not complete college had high levels of alcohol risk in 12th grade and maintained or increased those levels in young adulthood, demonstrating a pattern of prolonged risk. Women whose completed education was high school or less experienced the fewest increases in at-risk alcohol use. Education group differences were not explained by place of residence or employment status. Conclusions: These results emphasize the need to intervene early to prevent at-risk alcohol use, and emphasize that at-risk alcohol use is neither unique, nor necessarily the highest among individuals who complete college."

Clap, John D.; Min, Jon Won; Shillington, Audrey M.; Reed, mark B.; Croft, Julie Ketchie; "Person and environment predictors of blood alcohol concentrations: a multi-level study of college parties", ALCOHOLISM: CLINICAL & EXPERIMENTAL RESEARCH (2007), 32(1):2100-107. This study build upon previous research by assessing the relationship of breath alcohol concentrations (BrAC) to environmental and individual characteristics. A multi-level study of college parties was conducted. The design included observational measures of party environments, a brief self-administered questionnaire, and the collection of breath samples from partygoers. A total of 1,304 individuals attending 68 parties participated in the study. Analyses revealed significant variation at the part and individual levels. At the individual level, motivations to socialize were significantly associated with lower BrAC, while drinking games providing the sample after 11:00 pm were associated with higher BrACs. At the party level, large parties were significantly associated with lower BrACs while reports of many intoxicated partygoers were associated with higher BrACs. Finally, the authors identified a significant gender by theme party interaction indicating that women had higher BrACs at theme parties relative to nontheme parties; however BrACs for men were similar regardless of the type of part attended.

Clayton, Mark; "Websites use waistline factor to cut down on student drinking", THE CHRISTIAN SCIENCE MONITOR (2002), October 15. Scott Walters and William Miller surveyed students at the University of New Mexico about their drinking habits. Dr. Walters and colleagues responded with personalized data. Students found out how much alcohol is in their blood when they drink, how much money they spend on drinking, and how many calories their drinks contain. They were also given information about genetic risk factors and how their drinking habits compared with the average student on campus. The authors came up with the idea of a website on alcohol use called e-CHUG. Most materials is written from a student's point of view, to crate the feeling that peers are giving the information about drinking's impact on grades, its, secondhand effects, and ways to manage money and control anger. The website's core is a multilevel questionnaire soliciting information about student's beliefs about drinking, the risks they typically run, and lifestyle concerns, and so on.

College Drinking--Changing the Culture

Crego, A.; Holguin, S. R., Parada, M.; Mota, N., Corral, M.; Cadaverira, E.; "Binge drinking affects attentional visual working memory processing in young university students", ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH (2009), 33 (11): 1870-9. Binge drinking (BD) typically involves heavy drinking over a short time, followed by a period of abstinence, and is common among young people, especially university students. Animal studies have demonstrated that this type of alcohol consumption causes brain damage, especially int nonmature brain. The aim of this study was to determine how BD affects brain functioning in male and female university students, during the performance of a visual working memory task. The researchers used event-related electrophysiological brain response (ERP) technique to measure the students' brain response to a visual working memory task. The study found: students who were binge drinkers displayed anomalies during execution of the task, even when they correctly executed the task; binge drinkers required greater attentional processing during the task to finish it correctly; the binge drinking students had difficulties differentiating between relevant and irrelevant stimuli; and binge drinking students displayed less efficiency in distributing attentional and working memory resources between the different information presented during the task. The authors concluded that healthy adolescents and young people who binge drink--even only once or twice a week, and who do not display chronic alcohol consumption or alcohol dependence, "may suffer alterations at the electrophysiological level in attentional and working memory processing. This study is another in the long list of research that shows that binge-type drinking is harmful and can have long-term consequences.

DuRant, Robert, et. al.; "College students who get drunk weekly have higher risk of injuries and sexual victimization than other drinkers", 05/23/2005 Wake Forest University. "College students who get drunk at least once a week are significantly more likely to be hurt or injured than other student drinkers, according to new research from Wake Forest University School of Medicine.

"Each year approximately 1,700 college students die from alcohol-related injuries," said Mary Claire O'Brien, M. D., assistant professor of emergency medicine and public health sciences at Wake Forest's School of Medicine, which is part of Wake Forest University Baptist Medical Center. "Our goal was to develop a simple tool to tell which student drinkers are at highest risk of getting hurt, as a result of their own drinking and the drinking of others."

'The results, part of an ongoing, five-year research project to develop effective strategies for reducing problem drinking on college campuses, were reported today at the annual meeting of the Society for Academic Emergency Medicine in New York City.

"Wake Forest researchers found that students who got drunk at least once weekly were three times more likely to be hurt or injured due to their own drinking than student drinkers who do not report getting drunk at least once a week. They were twice as likely to fall from a height and need medical care, and 75 percent more likely to be sexually victimized. Getting drunk was defined as being unsteady, dizzy or sick to your stomach.

According to the NIAAA, about four out of five students drink and about half of the drinkers engage in heaving episodic consumption. It is estimated that that 97,000 students each year are victims of alcohol-related sexual assault or date rape, that almost a third (31 percent) of college students meet the criteria for a diagnosis of alcohol abuse and that 2.8 million college students drove under the influence of alcohol last year."

"Heavy drinking by college students poses many serious dangers", NEWS-MEDICAL in Miscellaneous News, August 3, 2004.
"People commonly think of drinking in college, in particular heavy drinking, as a rite of passage--implying that it's common and those who don't do it are missing out on something", says Robert Zucker, Ph.D., head of the U-M HEALTH SYSTEM's Addiction Research Center. "But the research data we now have paints a picture that there are all sorts of negative experiences that are associated with binge drinking, ranging from loss of life to being involved in something you will never be able to live down."

This level of heavy alcohol consumption, which corresponds to about five drinks in two hours for men and four drinks in two hours for women, is far more common among college-aged young people than among the larger population.

Among full-time college students, Zucker says, about 45 percent binge on alcohol occasionally or often, compared with 25 percent of the general public.

The binge drinking rate is higher for males students that for women --52 percent compared with abut 35 percent-- and the numbers vary from year to year. And even among the percentage of college students who drink has dropped slightly in recent years as colleges and activist groups have carried out education campaigns, heavy alcohol use and is consequences still plague many campuses.

Why is college such a big time for heavy drinking? Researchers think its a combination of factors. First, student are at a stage in life when they're exploring new experiences and new relationships, and developing their adult selves. They're immersed in circumstances where drinking is more commonly accepted and encouraged, including events related to athletics, and fraternities and sororities. They may even hold the incorrect belief that they have to drink to get drunk in order to be accepted. And they then to have more free time and less accountability, and the penalties for missing class or sleeping in because of a hangover aren't high.

High Costs of Excessive Drinking to States

The numbers compiled by the National Institute for Alcoholism and Alcohol
Abuse include: 1,400 college students aged 18 to 24 years die from alcohol-related incidents, including vehicle crashes. Another 500,00 are hurt under the influence of alcohol, and about 600,000 are assaulted by another student who has been drinking.

More than 70,000 students are sexually assaulted or raped in alcohol-related incidents, and 100,000 get too drunk to know afterward if they consented to have sex or not. About 400,000 colleges students have unprotected sex under the influence of alcohol, putting them in risk of unplanned pregnancy and sexually transmitted disease.

No matter when they started, studies have shown that around 6 percent of current college students meet the formal definition for alcoholism, and another 31 percent have an alcohol abuse problem that falls short of addition or dependence but can still lead to problems.

No matter what the reason for drinking, the effect on a student's body and brain will be the same. "The level of intoxication, or blood-alcohol content,that a student will reach in a binge is high enough to impair judgment and decision-making, and to slow reflexes," Zucker explains. "And those effects are what can lead to momentary loss of balance, coordination, emotional control or consciousness that can result in something that last a lifetime, or ends a life."

Harford, Thomas C., Wechsler, Henry, Seibring, Mark; "Attendance and alcohol use at parties and bars in college: a national survey of current drinkers", JOURNAL OF STUDIES ON ALCOHOL (2002), 63: 726-733. Consistent with the literature, fraternity/sorority parties were occasions of heavy drinking (49%) among drinkers those settings, yet they drew upon smaller portions of students (36%) when compared to off-campus parties (75%) and off-campus bars (68%). Off-campus parties (45%) and bars (37%) were also occasions for heavy drinking among drinkers in these settings. College residence was shown to relate to differential exposure to drinking settings, but residence had less impact on the decision to drink and the level of heavy drinking. Attendance at parties decreased with advance in school years, but attendance at off-campus bars increased. Although heavy drinking at off-campus bars decreased with advancing grade year in school, slightly higher proportions of underage students (41%) compared to students of legal drinking age (35%) exhibited heavy drinking at off-campus bars. The identification of high-risk settings and their correlates serves to better understand the development of heavy drinking on college campuses. Off-campus parties, as compared to campus parties and bars, may pose greater difficulties related to successful intervention.

"High-risk drinking on college campuses: white paper", Iowa Alcoholic Beverages Commission, April 30. 2002.
"Dr. Henry Wechsler, Harvard School of Public Health, examined the nature and scope of heavy episodic alcohol use among a national sample of American college students. In a representative sample of 140 colleges and more than 17,000 students, Wechsler found 84% of college students drink alcohol and 44% of those drinkers are high-risk drinkers who consume five or more drinks in a single sitting. Approximately two out of five college students are high-risk drinkers. Drinking patterns established in high school often persist during college. Compared to other students, college students who were high-risk drinkers in high school are almost three times more likely to participate in high-risk drinking in college. Approximately 56% of the students in four-year institutions either abstain or drink in moderation."

"Effects of High-Risk Drinking
Be hurt or injured
Drove a car after drinking
Get in trouble with campus or local police
Engage in unplanned sexual activity
Engage in unprotected sex
Damage property
Fall behind in schoolwork
Miss class.

"High-Risk Drinking and Sexual Assault.
"According to Columbia University's National Center on Addiction and Substance Abuse, alcohol is involved in 90% or campus rapes. A Study on campus rape published in the Journal of American College Health found that 73% of the assailants and 55% of rape victims used alcohol or other drugs prior to the assault.

"High-Risk Drinking and Drunk Driving
There is a positive relationship between high-risk drinking and driving after drinking. Wechsler's national study found that, among frequent high-risk drinkers, 62% of men and 49% of women drive after drinking. Approximately half of these students have ridden with a driver who was drunk.

"Second-Hand Effects of High-Risk Drinking.
Three out of four moderate drinkers and abstainers who lived in dormitories or fraternities and sororities reported experiencing at least one secondhand effect from high-risk drinking, Wechsler's survey found:
23% had experienced unwanted sexual advance.
11% had been pushed, hit or assaulted.
36% had been insulted or humiliated.
16% had property damage.
71% had sleep or study interrupted.

"What are the Costs Associated with High-Risk Drinking?
The costs associated with high-risk drinking are staggering. College students spend approximately $5.5 billion on alcohol each year. This amount is more than they spend on books, soda, coffee, juice, and milk combined. No precise estimates exist for societal costs associated strictly with high-risk drinking. However, according to the U. S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention, annual costs of alcohol use by those under 21, is estimated at more than $58 billion."


Hingson, R.; Heeren, T.; Zakocs, Ronda A.; Kopstein, Andreas; Weschler, Henry; "Magnitude of alcohol-related mortality and morbidity among U. S. college students ages 18-24", JOURNAL OF STUDIES ON ALCOHOL (2002) 63: 136-144. The authors estimate that offer 1,400 students ages 18-24 and enrolled in 2- and 4-year colleges died in 1998 from alcohol-related unintentional injuries, including motor vehicle crashes. According to surveys conducted in 1999, in the preceding year, over 2 million of the 8 million college students in the United States drove under the influence of alcohol and over 3 million rode with a drinking driver. Over 500, 000 full-time 4-year college students were unintentionally injured under the influence of alcohol and over 600,000 were hit or assaulted by another who had been drinking. There is an urgent deem for expanding prevention and treatment programs to reduce alcohol-related harm among U. S. college students and other young adults.

Hingson, R.; Heeren, T.; Winter, M. R..; Wechsler, H.;"Early age of first drunkenness as a factor in college students' unplanned and unprotected sex attributable to drinking", PEDIATRICS (2003), 111 (1), 34-41. Early age of drinking onset has been associated with a greater likelihood among adults of experiencing alcohol dependence, frequent heavy drinking even among nondependent drinkers, and an increased risk of motor vehicle crashes, unintentional injuries, and physical fights after drinking. This study explores whether first getting drunk at a younger age is associated with a greater likelihood of college students reporting that they had unplanned or unprotected sexual intercourse because of their drinking. Results: Among college students who drink, those first drunk before age 13 compared with those who never drank until age 19 or older has a 2.0 times greater odds of having unplanned sex and a 2.2 times greater odds of having unprotected sex reportedly because of drinking, even after controlling for age, race/ethnicity, marital status, parental drinking history and frequency of smoking and marijuana use. After further controlling for history of alcohol dependence and frequency of heavy drinking those first drunk before age 13 had 1.5 times greater odds of unplanned sex and 1.7 times greater odds of unprotected sex reportedly because of drinking. Conclusions: Clinical, educational, legal, and community interventions to delay age of first getting drunk need to be coupled with efforts to prevent unplanned and unprotected sexual intercourse among US college students.

King, Andrea C.; Houle, Tim; de Witt, Harriet; Holdstock, Louis, Schuster, Alyson; "Biphasic alcohol response differs in heavy versus light drinkers," ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH (2002): 26 (6): 827-835. 34 subjects participated in the study consisting of three early-evening testing sessions in which subjects consumed a beverage containing either 0.8 or 0.4 g/kg ethanol or placebo. The results indicate that young adult binge drinkers show a biphasic alcohol response, with heightened sensitivity to stimulant-like alcohol effects and greater tolerance to sedative alcohol effects compared with their light-drinking counterparts.

"The study demonstrated that those drinkers who experience 'euphoria and stimulation' from their first drink are more likely to drink excessively, while those who experience a 'sedative' effect will drink lightly. Within 15 minutes of their first drink--when blood-alcohol level had just begun to rise--the heavy drinking group demonstrated a rapid increase in feelings of euphoria, vigor talkativeness and excitement. The light drinking group did not sow any such changes in stimulation. Over 55 percent of the heavy drinking group said they liked the feeling they had shortly after beginning to drink-- and said they wanted to drink more. Only 30 percent of the light drinkers felt the same way. "Most people in college who binge think they[re doing it at that time, and that they'll grow out of it and it's not a big deal, King said. But certainly there's a percentage that goes on to be alcohol dependent."


Knight, John R.; Wechsler, Henry; Kuo, Meichun; Seibring, Mark; Weitman, Elissa R,; Schuckit, Marc A.; "Alcohol abuse and dependence among U. S. college students", JOURNAL OF STUDIES ON ALCOHOL (2002), 63: 263-270. " Many college students report behaviors and symptoms that meet the diagnostic standard for alcohol abuse or dependence. In addition to strengthening prevention programs, colleges should implement new strategies for screening and early identification of high risk student drinkers, and ensure that treatment is readily available for those with alcohol disorders. Male students are at greater risk than females for dependence. Nearly one in 10 college men under the age of 24 met a 12-month diagnosis of alcohol dependence compared to one in 20 college women under the age of 24.

"Furthermore, unless colleges and their surrounding communities reduce the easy access to cheap alcohol we can expect colleges to produce a continuing stream of alcohol-addicted young people," Wechsler said.

Frequencies of specific abuse criteria were: 27.2% for alcohol use in hazardous situations; 26.7% for alcohol-related school problems; 12.4% for recurrent interpersonal problems; and 3.3% for recurrent legal problems. Frequencies of dependence criteria were: 17% for symptoms of tolerance; 15% for drinking more or longer than initially planned; 8% for drinking despite physical or psychological problems; 7% for spending a lot of time on drinking-related activities; and less than 2% for symptoms of withdrawal.

Kraus, Courtney L.; Salazar, Natasha C.; Mitchell, Jamie R.; Florin Whitney D.; Guenther, Bob; Brady, David; Swartzwelder, Scott H.; White, Aaron M.; "Inconsistencies between actual and estimated blood alcohol concentrations in a field study of college students: do students really know how much they drink?" ALCOHOLISM: CLINICAL AN EXPERIMENTAL RESEARCH (2005), 29 (9): 1672-1676. (Breathalyzer readings for 152 college students) Estimated BAC levels were significantly higher,not lower, than breath BAC measures. The accuracy of estimated BACs decreased as the number of drinks and amount of time spent drinking increased. Being male and drinking only beer predicted greater accuracy of estimated BACs. Conclusions: Although laboratory data suggest that students underestimate how much they drink, the hypothesis was not supported by data collected in the field. It appears that students might actually overestimate rather than underestimate their levels of consumption when surveyed in the midst of a night of drinking. The findings corroborate observations made by other researchers and suggest that the findings of laboratory studies on college drinking do not necessarily extend to real-world situations.

Kuo, Meichun, Wechsler, Henry, Greenberg, Patty, Lee, Hang; "The marketing of alcohol to college students: the role of low prices and special promotions," AMERICAN JOURNAL OF PREVENTIVE MEDICINE (2003), 25 (5): 204-211. Heavy episodic or binge drinking has been recognized as a major problem on American college campuses affecting the health, safety, and education of students. This study examines the alcohol environment surrounding college campuses and assesses the impact on students' drinking. This environment includes alcohol promotions, price specials, and advertising at drinking establishments that serve beer for on-premise consumption as well as retail outlets that sell beer for off-premise consumption.

McCabe, Sean Esteban; Schulenberg, John E.; Johnston, Lloyd D.; O'Malley, Patrick M.; Boatman, Jerald G.; Kiosk, Deborah D.; "Selection and socialization effects of fraternities and sororities on US college student substance use: a multi-cohort national longitudinal study", ADDICTION (2005), 100: 512-524. The study provides strong evidence that higher rates of substance use among US college students who join fraternities and sororities predate their college attendance, and that membership in a fraternity or sorority is associated with considerably grater than average increases in heavy episodic drinking and annual marijuana use during college. These findings have important implications for prevention and intervention efforts aimed toward college students , especially members of fraternities and sororities.

Mallett, Kimberly A.; Lee, Christine M.; Neighbors, Clayton; Larimer, Mary E.; Turrisi, Rob; "Do we learn from our mistakes" An examination of the impact of negative alcohol-related consequences on college students' drinking patterns and perceptions," JOURNAL OF STUDIES ON ALCOHOL (2006), 67: 269-276. "Results suggest that heavier-drinking students do no learn from their mistakes but instead overestimate the amount of alcohol they can consume without experiencing negative consequences. Clinical implication of these findings are discussed in terms of augmenting brief interventions aimed at heavy-drinking college students.)

A Matter of Degree
College students at universities participating in an American Medical Association (AMA) program, "A Matter of Degree" (AMOD), are less likely to miss class, be assaulted by a drunk student or hurt themselves after drinking, according to an evaluation conducted by the Harvard School of Public Health (HSPH) and appearing in the October 2004 issue of the American Journal of Preventive Medicine.

Alcohol specials, promotions, and advertisements were prevalent in the alcohol outlets around college campuses. Almost three quarters of on-premise establishments offered specials on weekends, and almost one half of the on-campus establishments and more than 60% of off-premise establishments provided at least one type of beer promotion. The availability of large volumes of alcohol (24- and 30- can cases of beer, kegs, party balls), low sale prices, and frequent promotions and advertisements at both on- and off-premise establishments were associated with highest binge drinking rates on the college campuses. In addition, an overall measure of on-and off-premise establishments was positively associated with the total number of drinks consumed.

The regulation of marketing practices such as sale prices, promotions, and advertisements may be important strategies to reduce drinking and its accompanying problems.

The study also found a decline in the drinking rates themselves at colleges incorporating the most AMOD policies or "interventions." AMOD, a program funded by The Robert Wood Johnson Foundation and managed by AMA, helps universities collaborate with their students and surrounding communities to reduce the environmental factors that lead to high-risk drinking.

Mattern, Jody L.; Neighbors, Clayton; "Social norms campaigns: examining the relationship between changes in perceived norms and changes in drinking levels." JOURNAL OF STUDIES ON ALCOHOL (2004), 65: 489-493. "Results suggest that social norms marketing in residence halls can effectively reduce overestimates of typical student drinking and that reduction of perceived drinking norms are associated with reduced drinking."

Mohler-Kuo, Meichun; Dowdall, George W.; Koss, Mary P.; and Wechsler, Henry; "Correlates of rape while intoxicated in a national sample of college women," JOURNAL OF STUDIES ON ALCOHOL (2004), 65: 37-48. Heavy alcohol use is widespread among college students, particularly in those social situations where the risk of rape rises. The purpose of this study was to present prevalence data for rape under the condition of intoxication when the victim is unable to consents and to identify college and individual-level risk factors associated with the condition. Results: roughly one in twenty women reported being raped. Nearly three quarters (72%) of the victims experienced rape while intoxicated. Women who were under 21, were white, reside in sorority house, use illicit drugs, drank heavily in high school and attended colleges with high rates of heavy episodic drinking were at higher risk of rape while intoxicated. Conclusions: The high proportion of rapes found to occur when women were intoxicated indicates the need for alcohol prevention programs on campuses that address sexual assault, both to educate men about what constitutes rape and to advise women of risky situations. The findings that some campus environments are associated with higher levels of both drinking and rape will help target rape prevention programs in colleges."

Rutledge, Patricia C., et. al; "21st birthday drinking: extremely extreme", JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY (2008), 76 (3): 511-516. Despite public recognition of the hazards of 21st birthday drinking, there is little empirical information concerning its prevalence, severity, and risk factors. Data from a sample of 2,518 college students suggest that 21st birthday drinking poses an extreme danger (a) 4 or every 5 participants (83%) reported drinking to celebrate, (b) birthday drinkers indicated high levels of consumption, (c) 12% of birthday drinkers (men and women) reported consuming 21 drinks, and (d) about half of birthday drinkers exceeded their prior maximum number of drinks. Current problematic alcohol involvement and its typical correlates strongly predict both the occurrences and severity of 21st birthday drinking. It is imperative that investigators consider a variety of potential interventions to minimize the harm associated with this rite of passage. The study talks about sending 21st birthday cards to college students stressing the dangers of alcohol. Additional findings: This study found that even 36% of students who never drink when they were underaged participated in drinking to celebrate their 21st birthday.

Scribner, Richard; Mason, Karen; Theall, Katherine, Simonsen, Neal; Schneider, Shari, Kessel; Towvim, Laura Gomberg; DeJong, William; "The contextual role of alcohol outlet density in college drinking", JOURNAL OF STUDIES ON ALCOHOL AND OTHER DRUGS(2008): 69: 112-120. Off-campus, on premises outlet density is strongly associated with college-drinking outcomes. Given the limited number of modifiable factors that affect college drinking, on-premise outlet density represents a potential modifiable means of addressing the problem.

Thombs, Dennis L.; Olds, R. Scott; Snyder, Barbara M.; "Field assessment of BAC data to study late-night college drinking", JOURNAL OF STUDIES ON ALCOHOL (2003) 64: 322-330. 1.020 self reported data over 15 weeks in the spring semester between the hours of 10:00 p.m. and 3:00 a.m. and 5 drinks or more for males and 4 drinks or more for females was the standard for binge drinking. Conclusion: Field assessment of student intoxication is an important tool for examining research questions in college drinking. The 5+/4+ measure classifies many college students as heavy episodic drinkers, even though their intoxication level is below conventional thresholds used to define drunkenness. In addition, there is a discernible pattern of BAC estimation in the field that corresponds to intoxication level.

Wechsler, H.; Kuo, M.; "Watering down the drinks: the moderating effect of college demographics on alcohol use of high-risk groups", AMERICAN JOURNAL OF PUBLIC HEALTH (2003) 93 (11):1929-33. The binge drinking rates of White, male, and underage students were significantly lower in schools that had more minority, female, and older students. Students who do not binge drink in high school are more likely to start binge drinking at colleges with fewer minority and older students. Student-body composition and demographic diversity should be examined by colleges wishing to reduce their binge drinking.

Weitzman, E. R.; Nelson, T. F.; "College student binge drinking and the "prevention" paradox: implications for prevention and harm reduction", JOURNAL OF DRUG EDUCATION (2004), 34 (3): 247-266. Considerable attention has been paid to heavy episodic or "binge" drinking among college youth in the United States. Despite widespread use, the binge measure is perceived by some as a low intervention threshold. We use data from the Harvard School of Public Health College Alcohol Study (n = 49,163) to describe patterns of consumption and harms along a continuum including the binge measure to demonstrate the validity of the binge threshold and prevention paradox in college. While the heaviest drinkers are at greatest risk for harm, they are relatively few and generate proportionately small amounts of all drinking-harms. The risk of harms is not zero among lower level drinkers in college. Because they are numerous, they account for the majority of harms. This paradoxical pattern suggests we moderate consumption among the majority using environmental approaches, the efficacy of which are described using case study data from a national prevention demonstration. Implications for prevention policy, programming, and media advocacy are discussed.

Weitzman, E. R.; Nelson, T. F.; Lee, H.; Wechsler, H.; "Reducing drinking and related harms in college: evaluation of the "A Matter of Degree" program", AMERICAN JOURNAL OF PREVENTIVE MEDICINE (2004); 27 (3): 247-265. Between 1997 through 2001 ten colleges with high levels of heavy and problem drinking, along with their surrounding communities, participated in the ongoing program. The evaluation measures patterns of program implementation and effects of the program on frequent, heavy and 'binge' drinking, harms and secondhand effects of alcohol consumption. For this phase of the evaluation, drinking and harm patterns from the ten AMOD schools were compared to patterns at 32 matched colleges from the national Harvard School of Public Health College Alcohol Study. Findings include that an environmental prevention program targeting heavy and harmful drinking such as AMOD can be implemented within college communities and that where program implementation emphasizes changes to alcohol availability and larger cultural factors, college communities experience significant reductions in levels of heavy alcohol consumption including binge drinking and related harms as well as reductions in secondhand effects. Changing the conditions that shape drinking-related choices, opportunities and consequences for drinkers and those that supply them with alcohol, appear to be key ingredients to an effective public health prevention program.

Weitzman, Elissa R.; Nelson, Toben F.; Weschler, Henry; "Taking up binge drinking in college : the influences of person, social group and environment", JOURNAL OF ADOLESCENT HEALTH (2003), 32: 26-35. College students who reported that they were exposed to "wet" environments were more likely to engage in binge drinking than were their peers without similar exposures. Wet environments included social, residential, and market surroundings in which drinking is prevalent and alcohol cheap and easily accessed. Findings held up in multivariate analyses that included variables describing person and social group characteristics. Students who picked up binge drinking in college also were more likely than their peers to report inflated definitions of binge drinking and more permissive attitudes about appropriate ages for legal consumption. Conclusions: Binge drinking can either be acquired or avoided in college among students who report they did not binge drink in high school. Reducing college binge uptake make require efforts to limit access/availability, control chap prices, and maximize substance free environments and associations.

White, Aaron; Hingson,Ralph; "The burden of alcohol use: excessive alcohol consumption and related consequesnces among college students", ALCOHOL RESEARCH: CURRENT REVIEWS, Volume 35, Issue Number 2.


White, Aaron M.; Kraus, Courtney L.; Flom, Julie D.; Kestenbaum, Lori A.; Mitchell, Jamie R.; Shah, Kunal; Swartzwelder, H. Scott; "College students lack knowledge of standard drink volumes: implications for definitions of risky drinking based on survey data", ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH (2005), 29 (4): 631-638.  Despite the recent focus on alcohol education and prevention at the college level, college students have not been taught how to define standard drinks accurately. They tend to overstate the appropriate volumes, leading them to overpour drinks and underreport levels of consumption. Self-reported consumption levels are altered by feedback regarding the accuracy of students' definitions of standard drinks. The findings raise important questions about the validity of students' responses on alcohol surveys and the definitions of risky drinking that are based on them.

White AM ; Kraus CL ; Swartzwelder H; "Many college freshmen drink at levels far beyond the binge threshold", ALCOHOLISM: CLINICAL AND EXPERIMENTAL RESEARCH (2006), 30(6): 1006-10. "Binge drinking is a dichotomous variable that allows researchers to sort students into categories based upon a specific threshold of consumption, commonly 4 (females) or 5 (males) drinks. Crossing the binge threshold increases the risk of negative alcohol-related consequences. The use of such thresholds has played a vital role in the study of college drinking. While extremely valuable, the dichotomous nature of binge drinking variables removes information about how heavily students actually drink, leaving the characterization of college drinking incomplete. The present study examined patterns of alcohol use beyond the binge threshold. METHODS: The data set consisted of self-reported 2-week drinking histories from 10,424 first-semester freshmen at 14 schools across the United States during the fall of 2003. The number of students who reached the 4+/5+ binge-drinking threshold was calculated, as was the number who reached 2 times (8+/10+ drinks) or 3 times (12+/15+ drinks) the binge threshold. Logistic regression analyses were used to explore gender differences and to assess whether frequent binge drinkers (3+ binges per 2 weeks) were more likely than infrequent binge drinkers (1-2 binges per 2 weeks) to reach high peak levels of consumption. RESULTS: Roughly 1 of 5 males consumed 10+ drinks and 1 of 10 females consumed 8+ drinks, twice the binge threshold, at least once in the previous 2 weeks. Gender differences were observed at every drinking level and were particularly large at higher peak levels. Frequent binge drinkers were more likely than infrequent binge drinkers to consume 2 or 3 times the binge threshold. DISCUSSION: A surprisingly large percentage of students, particularly males, drink at peak levels well beyond the binge threshold. Such findings suggest that schools might make additional progress in the battle against alcohol misuse by focusing on extreme drinking practices in addition to binge drinking per se."

updated 12/15/16