Prevention programs
       As discussed in earlier sections, although the media frenzy surrounding "binge" drinking among college students is a relatively new development, heavy drinking among America's youth is not a new phenomenon. It is a problem that those in the prevention field have been contending with for decades now. A tremendous amount of effort has been put forth over the years to develop effective programs for minimizing hazardous alcohol use among adolescents and young adults, including college students. The majority of these programs have not worked as planned, but each failure provides an opportunity to improve existing strategies and develop new ones.  What follows is a very cursary overview of some of the many prevention strategies currently being explored.  This section will be expanded as time allows. 
       I have had the sincere pleasure of being part of several promising initiatives, including an online alcohol prevention course for college students called AlcoholEdu.  It is a highly interactive, very comprehensive course delivered through the web.  It has been taken by more than 100,000 students in 300+ schools, and the data collected thus far are very encouraging.  Because the course is offered at a fee and my involvement in its development prevents me from being completely objective, I have decided not discuss the program in detail on this site.  However, I would be happy to provide more information if you are interested. Alternatively, please visit Outside The Classroom for more detail.     

What works?
      The common denominator of successful programs appears to be, in a broad sense, that they are capable of altering the way that students view their own alcohol use, thus altering the decisions that they make regarding such use. Recent research indicates that there are a number of brief intervention techniques that appear to be effective at reducing hazardous alcohol use. One common theme of these techniques is that they use objective, personalized feedback regarding an individual's alcohol use in order to increase the individual's awareness of the potential risks caused by his/her alcohol use and to motivate changes in behavior.  Even brief (i.e., one session) interviews in which such feedback is provided to students have been shown to produce significant decreases in levels of consumption six-weeks following the intervention (Borsari and Carey, 2000) and to diminish the likelihood of experiencing negative alcohol-related consequences for at least four years (Baer et al., 2001).
       One promising approach involving brief interactions aimed at gently leading a person to alter their behavior is known as Motivational Interviewing (MI).  This strategy was developed by Miller (1981) based in his work in the alcohol treatment field.  Miller conceptualized motivation as a state of readiness to change.  He viewed it as a fluid state highly influenced by interpersonal interactions rather than a static personality characteristic.  While this might seem intuitive, it was somewhat of a leap at the time.  The goal of the treatment provider or prevention specialist, according to Miller, should be to help nudge the individual closer to change rather than trying to force them to change.  In contrast to the traditional practitioner/patient relationship, in which the practitioner tells the patient what is wrong and then gives advice or direction for how to fix the problem, the focus of MI is on helping the individual recognize the need to change on their own.  Indeed, employing MI effectively requires giving as little direct advice as possible, unless the individual asks for it.  Common strategies used during the interview include asking the individual questions about the quality of their life, their plans for the future, and how the behavior in question, in this case drinking, fits in with those plans.  The hope is that the individual will recognize that there is dissonance, or discrepancy, between what they want out of life and the state they are currently in, or heading toward, as a result of drinking.  It is easy to see how this approach could easily be extended beyond issues related to alcohol use and into a wide array of health-related behaviors, like diet, exercise, compliance with therapy, etc.  
       It has been known for more than two decades that a person's expectations regarding what alcohol will do to them, or for them, correlate positively with drinking levels (Brown et al., 1980). Those who think that alcohol will have a positive impact on their sexual experiences, enhance their social skills, enhance their cognitive skills, reduce their stress level, etc., drink more heavily than those who do not share these expectations. Alcohol expectancies assessed in freshmen during the first week of college predict drinking levels during the following year (Kidorf et al., 1995). In fact, research even suggests that expectations assessed prior to the onset of drinking can predict the likelihood that an individual will become a problem drinker (Christiansen et al., 1989). 
       Research suggests that challenging students' expectations about alcohol use can alter their drinking behaviors. Some expectancy challenges can be quite costly and labor intensive. For instance, one approach involves bringing a group of students into a simulated bar and giving some of them alcohol and others placebo (e.g., Darkes and Goldman, 1998). The students are then asked to indicate the behaviors that they or the other person engaged in that they expected were indicative of alcohol consumption. In this way, they are shown that many of the apparent effects of alcohol can actually be attributed to their expectations and not to the actual pharmacological effects of alcohol.
       Another approach to reducing alcohol use among college students, related to the concept of challenging expectancies, is known as social norming. The basic tenet of social norming is that college students overestimate how much alcohol other students drink, leading them to drink more in order to fit their concept of normal.  Social norming campaigns seek to replace students' faulty concepts of normal drinking levels with accurate information about how much other students' actually drink.  The hope is that students will then recognize the discrepancy between their perceptions and reality and then reduce their levels of consumption accordingly.  In many cases, these approaches appear to be successful at reducing consumption (Perkins, 2002), though their general utility is currently a topic of debate (Wechsler et al., 2003).
       Alcohol manufacturers and distributors spend more than $1 billion each year promoting their products through advertisements. While it is unlikely that such ads increase alcohol use in general, the evidence suggests that the ads are capable of influencing the buying behavior of existing drinkers, thus increasing market share. Recent research indicates that alcohol-specific media literacy approaches, in which students are asked to critically evaluate the content and purpose of alcohol advertisements, can have a significant influence on students' attitudes regarding alcohol advertisements, can alter their expectations regarding the use of the products being advertised, and can increase resistance to alcohol advertisements for months or years after the intervention (Austin and Johnson, 1997).
      Clearly, this review is currently limited and far from complete.  However, what should be clear from the information provided above is that there are promising programs for reducing alcohol misuse on college campuses.  The common thread of these approaches seems to involve causing students to reflect on their drinking and question the role that it plays in their lives. While the importance of establishing and enforcing campus alcohol policies cannot be understated, the trick seems to be helping a student find the motivation to change from within.