Alcohol Consumption, Related Problems Among High-Risk College-Age Drinkers Can Be Slashed Using Brief Intervention

April 08, 1999

Alcohol consumption and alcohol-related problems were significantly slashed among a group of high-risk college-age drinkers using a brief, non-confrontational intervention treatment. Students identified as high-risk drinkers during their senior year in high school who were given the intervention when they entered college reduced the amount of alcohol consumed each time they drank by 23 percent two years later. A control group of high-risk drinkers who did not receive the program cut their drinking by only 5 percent.

In addition, students who were exposed to the intervention reported that their alcohol-related problems such as fighting, vandalism, driving under the influence, having blackouts, missing classes or having unprotected sex fell by 56 percent, according to researchers at the University of Washington's Addictive Behaviors Research Center. The control group showed a decrease of 38 percent in alcohol-related problem behaviors.

The results come from a study of the drinking habits of more than 450 students throughout their college years. The study, conducted by a team of UW researchers headed by psychology professor Alan Marlatt, was published in the Journal of Consulting and Clinical Psychology and was funded by the National Institute on Alcohol Abuse and Alcoholism.

Alcohol-related accidents and injuries are a leading cause of death among young people 15 to 24 years of age, accounting for an estimated 12,000 lives annually.

"There is a window of risk surrounding alcohol use for teenagers and young adults," said Marlatt. "Most people learn by experience, so they gradually learn the effects of alcohol by drinking. The majority of them mature out of their risky behavior over time. What we are doing with our intervention is to provide training to get them through the school of hard knocks without quite as many hard knocks."

"The transition from high school to college is a critical time," added Mary Larimer, a research assistant psychology professor and co-author of the study. "A lot of negative things begin in this period. Students may be leaving home for the first time and are beginning to experiment with adult behaviors such as drinking and sexual intimacy. They also are exposed to a barrage of alcohol messages through advertising.

"If you ask graduating high school students to estimate if their drinking will increase, they say, 'Yes.' But the data shows it increases way more than they think it will, both in the amount and the frequency. Drinking increases rapidly in the transition to college and in the freshman year. Then it gradually decreases. There also is a brief upward blip when they turn 21 and start going to bars."

Students in the study were recruited from among freshman younger than 19 who had been accepted for admission to the University of Washington. A total of 348 high-risk drinkers and 115 other students were recruited for the study. The high-risk drinkers were identified through questionnaires. Students were considered high-risk drinkers if they reported drinking at least once per month and had consumed five or six drinks on one occasion in the last month, or if they had experienced three alcohol-related problems three to five times over the past three years. This amount of drinking is often called binge drinking, and other studies have shown that about 40 percent of American college students engage in it.

All of the students filled out a variety of questionnaires at the start of the study that measured such things as their attitudes about alcohol and drinking, their personal alcohol use and a family history of alcohol use. Similar data was collected again one and two years later. Half of the high-risk drinkers were given the intervention program, which consisted of follow-up interviews at six months and mailed feedback at one and two years. Each interview lasted about 45 minutes. The interviews were non-confrontational and motivational discussions, providing the students with information about drinking and its consequences. Students also had the opportunity to examine their own alcohol use and beliefs about drinking, according to Larimer. The other high-risk drinkers and the students recruited from the general incoming freshman class were not given the intervention.

"The usual approach in alcohol programs is confrontational. This doesn't work with adolescents. Instead we ally with them in a supportive way and assess if they are ready to make changes, such as cutting down on their drinking," she said.

"Our approach uses harm reduction. Instead of teaching defensive driving we are doing something like teaching defensive drinking. We teach that whether you are behind the wheel or the glass, you are responsible and that there are serious consequences for your behavior."

The average alcohol consumption and related problems of the high-risk intervention group dropped at the end of two years to levels nearly matching those of students who are not high-risk drinkers. However a small number of those in the high-risk group were found to have serious drinking problems. These students were referred to additional resources for help

Co-authors of the study also included John Baer, UW research associate psychology professor; Daniel Kivlahan, associate professor of psychiatry and behavioral science; Linda Dimeff, a research scientist in the psychology department; Lori Quigley, a UW psychology graduate who is now a post-doctoral researcher at The University of California, San Francisco; Julian Somers, another UW graduate post-doctoral researcher at the University of British Columbia; and Ellen Williams, a former UW research coordinator.

The brief intervention program developed by the UW researchers is called BASICS and was published this year under the title "Brief Alcohol Screening and Intervention for College Students: A Harm Reduction Approach." Dimeff was the lead author of the book.
For more information, contact
Larimer at 206-543-3513 or
Baer at 206-768-5224 or
Dimeff at 206-543-3512 or

University of Washington

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