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Binge drinking 101: Learning to curb the college trend

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By CNN Wire Service.
(CNN) -- It was April of his freshman year. Ben Yeager woke up on a couch in a dark basement not sure where he was and how and when he got there, he wrote in a powerful personal essay for The Washington Post.

His face, half of which was covered with dried blood, started to ache. His pockets, which on countless other occasions helped piece parts of blackouts together, were empty and lacking any clues. Yeager would learn that he had broken into a professor's home -- the head of the English department (he was an English major!) -- in the middle of the night, with a nearly deadly blood alcohol level. He wandered through the house, including two young children's bedrooms. Their father heard him and called the police. Officers found him covered in blood, urine and vomit in the family's basement.

It was that experience that made Yeager, who had been blacking out every time he drank since high school, realize he couldn't live his life like this any longer.

"If this kind of thing keeps happening to me, it's going to destroy my life," said Yeager, now a freelance writer in New York, during a phone interview. "It was the first time there had been potentially serious consequences to my body and ... an episode like that jeopardized or basically made it impossible for me to stay at ... school."

Yeager would go on to rehab and now, at 26, has been sober for seven years. His story, even he is quick to point out, is certainly not the norm. The majority of college students who drink do not become alcoholics. However, plenty drink too much, too quickly, with nearly 40% of college students saying they binge drank -- defined as five or more drinks at one time -- in the past 30 days, according to the National Institute on Alcohol Abuse and Awareness. That rate has remained relatively stable for more than a decade.

Those numbers -- combined with the consequences of binge drinking, including an estimated 1,825 deaths, 696,000 injuries and 97,000 sexual assaults and rapes every year, also according to the NIAAA -- have prompted college and universities to ask themselves what more they can do to stop excessive drinking on campus.

"In college, many times students drink in a way that most people don't comprehend. They drink to accomplish a goal called becoming blackout drunk," said Jonathan Gibralter, president of Wells College in New York state and chair of the NIAAA College Presidents Working Group to Address Harmful and Underage Drinking.

"They don't know their own capacity, and oftentimes underage students get into situations where they find themselves in trouble and they don't even know how they got there." (A study conducted at Duke University in 2002 found that of students who consumed alcohol at some point in their lives, 51% reported having at least one alcohol-induced blackout.)

Help for college presidents

Adding to the challenge for colleges and universities, said Gibralter, is the fact that there are numerous programs that exist to stem excessive drinking on campus but administrators don't always have the resources to comb through the research to determine what works best, particularly for their school.

"It's not easy just to find what is the best research evidence, what are the best tried and true strategies. Of all of those strategies, if I were to take the time and research them myself, how do I know how valid they are? How do I know how effective they are? How do I know which one I would employ above any other?" said Gibralter.

Enter the NIAAA, which asked college presidents what they needed. The result? What the NIAAA calls the CollegeAIM, a matrix of 60 alcohol interventions -- everything from alcohol education to restricting happy hours and other drinking promotions, to requiring Friday morning classes -- along with ratings based on their effectiveness, costs and barriers to implement.

"We're hoping that you can use it like a menu at a restaurant," said George Koob, director of the NIAAA. "This isn't for students. This is for administrators who have skills in this area and want to do something about underage drinking to go into this matrix and look at what would fit their campus in particular, what might be the most effective, what might be the cost that they can afford in that effectiveness range, what barriers might exist because of their unique situation and how much research has actually been done to validate or show the effectiveness of it."

One of the easiest and most cost-effective strategies on the list, believes Gibralter, is requiring all first-year students to take a 90-minute interactive online course called AlcoholEdu, which covers all aspects of alcohol's impact on the brain, signs of a problem drinker and safety and security, such as advising students to never leave their glass alone at a bar.

"There has been substantive evidence that it really does change students' knowledge and behavior," he said. And yet, a lot of schools don't make it a mandatory requirement during freshmen orientation, he added. Instead, they require it only for students who end up with a disciplinary issue and who are required to take the course to stay in school.

"So it becomes a disciplinary sanction. It doesn't become an educational tool."

Changing the social norms

Another approach, given the highest rating for effectiveness by the NIAAA, are so-called social norming programs, which communicate to students how much drinking is really taking place on campus.

"Sometimes young people will drink an enormous amount of alcohol because they believe it's really cool and everybody's doing it, and so if you present them with real data that you've collected from the students on your campus, many times students find out, 'Hey you know what, they're really not drinking that much and I don't have to consume that much alcohol to be cool,' " said Gibralter.

"It just helps to normalize it a little bit so that they come to understand that the social norm is not dangerous and destructive behavior," he said.

Restricting happy hours and other drinking promotions at campus area bars can also be a highly effective strategy, according to the NIAAA.

"Bars will be the first one to tell you we don't make money off of those things. But why do they keep doing it? Because everyone else is doing it, and it draws the kids into their bar," said Gibralter. "Well, that's great, but if nobody was doing it, they wouldn't have a need to."

Another strategy, still more the exception than the norm, especially at Division I schools with large sports arenas, is prohibiting alcohol use at sporting events on campus.

"It's all about money," said Gibralter. "I think that a lot of schools just don't have the courage to take the hit. Remember when in some states, they were talking about prohibiting cigarette smoking in bars and restaurants, and bar owners and restaurant owners were freaking out. They were saying we're going to go out of business. Well, what they found out was that business actually got better."

"We're so used to a culture that accepts alcohol in every aspect of it that I don't know that we even take the time to ever step back and say, 'What if?' What might happen if we weren't so accepting and if we were just trying to look at life a little bit differently?"

Banning alcohol from campus sports events received a rating of "moderate effectiveness" from the NIAAA in terms of its impact on student drinking.

When it comes to other programs -- such as prohibiting beer kegs, establishing substance-free residence halls and requiring Friday morning classes -- the agency found there were too few studies or mixed results to determine the effectiveness of those approaches. (The University of Michigan is just one school reportedly considering adding more Friday morning classes as a way to limit excessive drinking and the very common Thursday night start to the weekend on campus.)

Removing the stigma

I asked Yeager, the former college binge drinker, what he thinks schools and universities can and should do. He said he is not an expert and doesn't claim to be one on the best alcohol reduction policies on campus.

In his view, students have always been drinking a lot at college. He thinks, if anything, perhaps more could be done on the social side, providing more students with education about alcoholism, helping to dispel myths and communicate what might be the warning signs.

"That way when they're like, 'Hey I have this friend. I'm kind of worried about him or worried about her,' they have something of a framework to think maybe we should talk to that person,", he said.

"I just think it's a matter of removing the stigma of having a 'problem,' which is sort of already happening," said Yeager, who said he didn't write his essay as part of a mission to spread the word about drinking and young people but is thrilled if his story helps raise awareness. "I think it would be cool now that it's published that if people were a little more forthcoming with their stories and weren't as uncomfortable or embarrassed ... when drinking comes up."

Discomfort on the part of college and university presidents is also part of the problem, said Gibralter. He believes too many don't think it's their problem or are too unwilling to take on the alumni and board members who may be against any dramatic changes when it comes to alcohol policies on campus.

"One of the things that has been my struggle for the last 15 or more years in this area is that there just aren't enough college presidents out there who are willing to stand up and take a stand on this issue, to be role models, to set a level of expectation for their students, to stand up to their alumni, to just do the right thing to save lives, and I struggle to know why. I've struggled with that for a long time," he said.

"Believe me, I'm not against alcohol. I'm not a prohibitionist. I just have seen too many instances where alcohol consumption amongst young people has caused terrible tragedy."

What do you think is the best way to stop binge drinking on college campuses? Share your thoughts with Kelly Wallace on Twitter @kellywallacetv or CNN Parents on Facebook.

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