Extreme drinking

May 24, 2006

Binge drinking - consuming large amounts of alcohol in a relatively short period of time - is generally defined as four+ drinks per occasion for females and five+ drinks for males. Although using this definition or threshold has provided invaluable insight into college drinking, new research has found that a considerable number of students, particularly males, drink well beyond the "standard" binge-drinking threshold. Results are published in the June issue of Alcoholism: Clinical & Experimental Research.

"During the past decade, binge-drinking has been the primary focus of most research and public discourse about college alcohol use," said Aaron White, assistant professor in the department of psychiatry at Duke University Medical Center and first author of the study. "We know that when students cross the binge-drinking threshold, the risk of consequences goes up significantly ... things like accidents, fights, sexual assaults, blackouts, dying from an overdose, etc. However, one of the unfortunate consequences of this focus on binge drinking is that it sends the unintended message that drinking at any level below the threshold is safe and that all people are at equal risk once they cross the threshold. Clearly this is not the case. There is a huge difference between having four or 40 drinks, although both are defined as binge drinking."

"Previous research from this group has further suggested that college students may underestimate the numbers of drinks they have consumed," added Susan F. Tapert, associate professor of psychiatry at the University of California, San Diego and program director of Substance Abuse/Mental Illness in the VA San Diego Healthcare System," particularly if drinking freely poured beverages such as beer from kegs or home-made mixed drinks. It appears that highly excessive drinking among this age group is more common in American colleges than colleges in other countries, but other countries - Denmark, Great Britain, Australia, New Zealand, South Africa, and Russia - also have high rates of drinking among youth."

For this report, researchers analyzed a dataset consisting of self-reported drinking histories gathered from 10,424 first-semester freshmen at 14 schools across the U.S. during the fall of 2003. Numbers of students that reached the 4+/5+ binge-drinking threshold were calculated, as were those who drank at two (8+/10+) and three (12+/15+) times the binge-drinking threshold.

"College students drink at levels far higher than we expected," said White. "We found that roughly 20 percent of all freshmen males had 10 or more drinks at least once during the two-week period. This is twice the binge threshold. Approximately eight percent drank 15 or more drinks, or three times the binge threshold. Clearly, simply dividing students into two categories, binge-drinkers and non-binge drinkers, oversimplifies the problem."

Both White and Tapert were alarmed by the potential consequences of such heavy drinking.

"Fifteen drinks is enough to create a very dangerous level of intoxication, yet nearly one out of 10 freshmen males surpassed this threshold in the two weeks before the survey," said White. "In my opinion, we could make additional progress toward reducing the harm that alcohol brings to our campuses by shifting some of our focus away from students drinking at or near the binge threshold, and toward the significant number of students that drink at levels well beyond the binge threshold. My hope is that we could recruit the help of students themselves in this pursuit. It is doubtful that students who drink wisely appreciate the antics of a minority of students that turn into drunken idiots when they go out. Unfortunately, it's the obnoxious students that make for newsworthy stories, thus perpetuating the stereotype that all college students get drunk and act irresponsibly."

Tapert said that a key future issue for university as well as health officials will be to figure out how to encourage young people to reduce the harm caused by consuming such very heavy levels of alcohol. "I also hope this research will help encourage investigators to utilize quantitative measures of alcohol intake to capture the full range of drinking behaviors," she said. "Given the tendency of students to underestimate drinking quantities, biological indicators of drinking - such as transdermal sensors - and adequate participant information about how to define and quantify drinks are also very important."

"For most students, college is about exploring themselves, the world around them, and their intellectual topics of interest," said White. "It is unfortunate that problems related to alcohol have drawn attention and resources away from the main business of universities - providing safe environments that foster life-enhancing educational experiences - toward dealing with the irresponsible behaviors of a minority of students. These kids are doing a disservice to the throngs of students that just want to get a good education and move on."

White called for greater accountability on the part of the alcohol industry and closer scrutiny of industry marketing tactics. "For example," he said, "the alcohol industry freely suggests in their advertisements that alcohol will enhance the quality of one's life. These ads not only make misleading promises, they also fail to carry the disclaimers that companies hocking other drugs must provide. What about the side effects of the drug - like nausea, vomiting, sedation, poor decision making, problems with vision, and death? Alcohol is more dangerous than many street drugs yet it is advertised like candy. It is time for us to finally start taking this drug seriously."

White added that the alcohol industry brings in an estimated $20 billion in revenue from underage drinkers each year. "In my opinion, if the industry keeps this money, they are knowingly supporting dangerous and illegal drug use by our kids and should be held partially responsible for all of the consequences that follow from it. At the very least, they should extract their costs and reinvest the profit in the fight against underage drinking."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Many College Freshmen Drink at Levels Far Beyond the Binge Threshold," were Courtney L. Kraus and H. Scott Swartzelder of the Department of Psychiatry at Duke University Medical Center in Durham, North Carolina. The study was funded by the National Institute on Alcohol Abuse and Alcoholism, Veterans Affairs, and Duke Undergraduate Research.

Alcoholism: Clinical & Experimental Research

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