Addressing Alcohol Use Among College Students: A National

Perspective on a Growing EpidemicPresented by: Stacie M. Schroeder

Fayette County SPF SIG CoordinatorHelping Services for Northeast Iowa

High-risk college student drinking includes the following: Underage drinking

Drinking and driving or other activities where the use of alcohol is dangerous

Drinking when health conditions or medications make use dangerous

Binge drinking; that is, 5 drinks in a row per occasion for males and 4 for females*

*Moderate drinking by persons of legal age is defined as no more than 2 standard drinks per day for men and 1 drink per day for women.

High-Risk Drinking

Death:  1,825 college students between the ages of 18 and 24 die from alcohol-related unintentional injuries, including motor vehicle crashes (Hingson et al., 2009).

Injury:  599,000 students between the ages of 18 and 24 are unintentionally injured under the influence of alcohol (Hingson et al., 2009).

Assault:  696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking (Hingson et al., 2009).

Sexual Abuse:  97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape (Hingson et al., 2009).

Unsafe Sex: 400,000 students between the ages of 18 and 24 had unprotected sex and more than 100,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex (Hingson et al., 2002).

Academic Problems: About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall (Engs et al., 1996; Presley et al., 1996a, 1996b; Wechsler et al., 2002).

Consequences

Health Problems/Suicide Attempts: More than 150,000 students develop an alcohol-related health problem (Hingson et al., 2002), and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use (Presley et al., 1998).

Drunk Driving: 3,360,000 students between the ages of 18 and 24 drive under the influence of alcohol (Hingson et al., 2009).

Vandalism: About 11 percent of college student drinkers report that they have damaged property while under the influence of alcohol (Wechsler et al., 2002).

Property Damage: More than 25 percent of administrators from schools with relatively low drinking levels and over 50 percent from schools with high drinking levels say their campuses have a "moderate" or "major" problem with alcohol-related property damage (Wechsler et al., 1995).

Police Involvement: About 5 percent of 4-year college students are involved with the police or campus security as a result of their drinking (Wechsler et al., 2002), and  110,000 students between the ages of 18 and 24 are arrested for an alcohol-related violation such as public drunkenness or driving under the influence (Hingson et al., 2002).

Alcohol Abuse and Dependence: 31 percent of college students met criteria for a diagnosis of alcohol abuse and 6 percent for a diagnosis of alcohol dependence in the past 12 months, according to questionnaire-based self-reports about their drinking (Knight et al., 2002).

Consequences

Educational Programming Policy Development Individual Intervention Peer Education Assessment/surveys of student drinking

behaviors Sanction classes, then online education Changed “ladies night” in the bars Incentive grants Social norms marketing Late-night programming

Past Education and Prevention Efforts

Did it work? College Drinking Patterns, 1980 - 2003

'80

'81

'82

'83

'84

'85

'86

'87

'88

'89

'90

'91

'92

'93

'94

'95

'96

'97

'98

'99

'00

'01

'02

'03

0

10

20

30

40

50

60

70

80

90

100

Annual

30-day

Heavy

Daily

Pre

vale

nce

Johnston, et al., 2004

Did it work? Daily & Heavy Episodic Drinking, Ages 18-40

18 19-20 21-22 23-24 25-26 27-28 29-30 35 400

5

10

15

20

25

30

35

40

45

Daily and heavy episodic drinking, ages 18-40

5+ Drinks in a Row in Last Two Weeks

Daily in Past 30 Days

Age at Administration

Per

cen

t U

sin

g

Monitoring the Future, 2002

Tendency to “bunch” drinks in heavy episodes.

Tendency to drink around known (and especially social) events.

Environmental, individual and developmental factors interact to determine drinking.

Most students change drinking after graduating. College drinking, for most, does not cause later problems.

How is college student drinking different?

The first 6 weeks of enrollment are critical to first-year student success.  Because many students initiate heavy drinking during these early days of college, the potential exists for excessive alcohol consumption to interfere with successful adaptation to campus life.  The transition to college is often so difficult to negotiate that about one-third of first-year students fail to enroll for their second year.

www.collegedrinkingprevention.gov

First-year students

The proportion of college students who drink varies depending on where they live. Drinking rates are highest in fraternities and sororities, followed by on-campus housing (e.g., dormitories, residence halls). Students who live independently off-site (e.g., in apartments) drink less, while commuting students who live with their families drink the least.

www.collegedrinkingprevention.gov

Living Arrangements

A number of environmental influences working in concert with other factors may affect students’ alcohol consumption. Schools where excessive alcohol use is more likely to occur include:◦ Schools where Greek systems dominate (i.e.,

fraternities, sororities)

◦ Schools where athletic teams are prominent

◦ Schools located in the Northeastwww.collegedrinkingprevention.gov

College Characteristics

Although some drinking problems begin during the college years, many students entering college bring established drinking practices with them. Thirty percent of 12th-graders, for example, report binge drinking in high school, slightly more report having “been drunk,” and almost three-quarters report drinking in the past year. Colleges and universities “inherit” a substantial number of drinking problems that developed earlier in adolescence.

www.collegedrinkingprevention.gov

Established Drinking Patterns

Students who do not drink or do not abuse alcohol experience secondhand consequences from others’ excessive use. In addition to physical and sexual assault and damaged property, these consequences include unwanted sexual advances and disrupted sleep and study. The problems produced by high-risk drinking are neither victimless nor cost-free. All students—whether they misuse alcohol or not—and their parents, faculty, and members of the surrounding community experience the negative consequences wrought by the culture of drinking on U.S. campuses.

www.collegedrinkingprevention.gov

Secondhand Consequences

Biological and genetic predisposition to use

Belief system and personality

Expectations about the effects of alcohol

Availability of alcohol in the area surrounding a campus

www.collegedrinkingprevention.gov

Other Factors Affecting Binge Drinking

As the numbers show, the consequences of college drinking are more significant, more destructive, and more costly than many Americans realize. 

In addition to the damage done to student lives, these consequences affect:◦ The reputation of the institution

◦ The ability to attract and retain outstanding students

◦ The college’s academic ranking

◦ The institution’s operating costs

◦ Legal ramifications

◦ The relationship of the campus with the communitywww.collegedrinkingprevention.gov

How does this affect UIU?

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends a 3-in-1 framework to address high-risk drinking.

The research strongly supports the use of programs:◦ Comprehensive and integrated◦ Multiple complimentary components◦ Targeting:

Individuals, including at-risk or alcohol-dependent drinkers The student population as a whole, and The college and surrounding community

(Hingson and Howland, 2002; DeJong, et al., 1998, Institute of Medicine, 1989; NIAAA, 2007)

High-Risk Drinking Prevention Efforts Now and into the Future

Student Body

Individual

The 3-in-1 Framework

Non-dependent, high-risk drinkers account for the majority of alcohol-related problems on college campuses (Lemmens, 1995; Kreitman, 1986).

Individual Strategies: Judicial Sanctions Intervention E-Chug Brief Counseling Referral

◦ Treatment◦ Long-term Counseling◦ Support Groups

Screening for dependence or high-risk use

3-in-1 Framework: Individuals

Campus and Surrounding Community

Student Body

Individual

The key to affecting the behavior of the general student population is to address the factors that encourage high-risk drinking.DeJong and Langenbahn, 1996; DeJong and Linkenbach, 1999; DeJong and Langford, 2002; Perkins, 2002; Toomey and Wagenar, 2002; Toomey et al., 1993)

Student Body Strategies Substance Abuse Prevention Task Force Clear Alcohol Policies Policy Enforcement Universal Prevention

◦ Online education◦ Outreach presentations◦ Peer education◦ Social marketing

Counseling Skilled Prevention Staff

3-in-1 Framework: Student Body

Campus and Surrounding Community

Campus and Surrounding Community

Student Body

Individual

Mutually Reinforcing Interventions:◦ Change the broader environment◦ Help reduce alcohol abuse and problems over the long

term. When college drinking is reframed as a community

strategy as well as a college problem:◦ It is addressed comprehensively.◦ The total drinking environment is affected.

Campus and Community alliances also:◦ Improve relationships overall◦ Enable key University and community entities to work

cooperatively in resolving issues involving students.

(Hingson and Howland, 2002; Holder et al., 2000; Perry and Kelder, 1992)

3-in-1 Framework: Campus and the Surrounding Community

Strategies Campus-Community Coalition Environmental Strategies

◦ Social Host Ordinance◦ Restricted Promotion of Alcoholic Beverages◦ Server Training◦ ID Checks◦ Alcohol-Free Events

Local Law Enforcement Media Advocacy Awareness and Information

3-in-1 Framework: Campus and the Surrounding Community

Campus and Surrounding Community

Student Body

Individual

1. What type of problem needs to be addressed (e.g., high rates of heavy drinking, fights during sporting events, underage drinking)?

2. What strategy is most likely to address each problem? 3. At what level should the strategy be implemented (e.g., at sports stadiums, campus-

wide, communitywide, Statewide)? 4. Who should participate in developing strategies? Who should participate at the start

and who should be brought in only after a supportive base for action is established? 5. What strategies are currently being implemented? 6. How well are existing policies being enforced? 7. Would enforcement of existing policies be more effective than implementing new

policies? 8. How can environmental and individually focused approaches complement each other? 9. What resources are needed to implement new strategies? Are resources available? 10. How will new strategies be evaluated and fine-tuned to maximize their effect? 11. Are the students who need help most actually getting it? That is, are your

interventions reaching the students who need them the most? 12. Are your strategies founded on solid, research-based findings? And are those

strategies reaching the vast majority of your student population?

SOURCE: Material for this checklist originally appeared in Toomey, T.L., and Wagenaar, A.C. Environmental policies to reduce college drinking: Options and research findings. Journal of Studies on Alcohol (Suppl.14):193–205, 2005, Updated January 2005 for NIAAA.

Questions to Ask in Determining Next Steps…

Wartburg College, Waverly Luther College, Decorah University of Dubuque, Dubuque Buena Vista University, Storm Lake Coe College, Cedar Rapids

Comparison of Like-size Universities in Iowa

Comparison of like-sized college alcohol and drug policies - as of April 24, 2013

Policy and/or Sanction Buena VistaUniversity

Coe College

LutherCollege

WartburgCollege

Universityof

Dubuque

Upper Iowa

University

Overview of the expectations of a responsible studentyes yes yes yes ** pp. 16-19,

p. 61

Reference to State of Iowa law regarding age of consumptionyes yes yes yes yes pg. 21, 35

prohibits possession or consumption of alcohol by a minoryes yes yes yes yes pg. 26

prohibits misrepresentation of age to acquire or consume alcohol

yes yes yes yes yes pg. 26, 35, 61

prohibits providing alcohol to a minoryes yes yes yes yes pg. 26, 35

prohibits minor in a room where legal-aged students are possessing alcohol

** ** yes yes ** pg. 27?

prohibits possession or consumption of alcohol from a common source (keg, punch bowl)

yes yes yes yes ** pg. 26

prohibits intoxication as a minoryes yes yes yes yes **

prohibits participating or being in the presence of activities that promote and encourage the consumption of alcohol regardless of the age of the participants (e.g. drinking games including but not limited to beer pong, water pong, flip cup, kings cup, spades, quarters).

yes yes ** ** ** **

prohibits open container by a person of legal-age on campus outside of University-sponsored event or legal-aged students room

yes yes yes yes yes pg. 35, 44, 61

Comparison of like-sized college alcohol and drug policies - as of April 24, 2013

Policy and/or SanctionBuena Vista

UniversityCoe

CollegeLutherCollege

WartburgCollege

Universityof

Dubuque

Upper Iowa

University

Amount of beer allowed in room of legal-aged person

30 cans ** not in excess of personal use ** ** 24 cans

Amount of alcohol allowed in room of legal-aged person

1 gallon less than 1 gallon

not in excess of personal use ** ** 64 oz.

bans consumption of caffeinated alcoholic drinks by person of any age

yes ** ** ** ** **

bans possession, consumption, or distribution of alcohol by any age person at any sporting events

yes yes yes ** yes pg. 44, 61

bans advertising of alcoholic beverages or their consumption on campus materials or in facilities

yes yes ** yes yes pp. 17, 18, 19, 61

Apartment/Suite parties (10 or more people) are required to be registered with Coordinator and host must review risk management guidelines

** yes ** ** ** **

Has on-campus food service liquor licenseyes ** yes ** ** yes

Requires that legal-aged servers must be used to serve alcoholic beverages

** yes ** ** ** pg. 61

Comparison of like-sized college alcohol and drug policies - as of April 24, 2013

Policy and/or SanctionBuena Vista

UniversityCoe

CollegeLutherCollege

WartburgCollege

Universityof

Dubuque

Upper Iowa

University

Tobacco Policies - prohibited use** ** yes ** yes pg. 27

Drug-free campus** yes yes ** yes pg. 61

Requires that non-alcoholic drinks and food be served at any University-sponsored event that offers alcohol

** yes ** ** ** pg. 61

Attendance at alcohol education class

yes ** ** yes - off campus yes pg. 26

parental notification and/or parental conference with subsequent violations

yes ** ** yes ** pg. 53

Disciplinary probation1 year yes yes yes ** pg. 26

Fines and/or restitution

**yes - amt.

notspecified

yes $50 - $300 ** $50 - $300

Educational fee

$75- 1st$125 - 2nd ** yes ** ** **

Assessment/Evaluationyes yes yes ** ** p. 25

Comparison of like-sized college alcohol and drug policies - as of April 24, 2013

Policy and/or SanctionBuena Vista

UniversityCoe

CollegeLutherCollege

WartburgCollege

Universityof

Dubuque

Upper Iowa

University

Campus/community service restitution

20 hours ** yesmay be done

in place of fine

** **

Removal from University housingyes ** yes yes ** p. 25

Suspension from University and/or reduction in institutional scholarship

1 semester yes yes yes ** pg. 26, 62

Successful completion of off campus substance abuse treatment program

yes yes ** yes ** pg. 26

Referrals for substance abuse counseling and treatment services

yes yes yes yes yes pg. 26

Provides expectations of off-campus student events (traveling and staying off campus)

** ** yes ** ** pg. 61

What are the next steps?

What additional policies and information should be considered?

When is the next meeting?

Next steps….