There is no question that some college students drink irresponsibly and do great harm to themselves and/or others. Alcohol overdoses have claimed the lives of roughly half a dozen students since the fall of 2004. The videoclip to the right shows just how little understanding some students have about the dangers of pushing things too far. The clip shows a student being filmed by his "friends" while they prod him to drink shot after shot and then give him bottles of beer and a can of sprite that are actually partially filled with liquor. I cut out the portion of the clip that shows this young kid extremely ill and probably in need of medical attention while his friends continue to laugh and take pride in their accomplishments. Here is a link to a videoclip of students using a beer bong to chug straight liquor if you would like another example (must have Windows Media Player V.9 or V.10 to view it -- available here).

       Last year, one of my students told me an interesting story about her spring break experience in Jamaica. She said that she walked out onto a sparsely populated beach and noticed a small group of people crammed into a small area of sand, with TV cameras focused on them. It was MTV and they were clearly trying to capture footage that American consumers want to see -- kids going crazy on their wild spring break trip to Jamaica. Few advertisers would pay to push their products in between footage of an empty beach in Jamaica, so they were apparently trying to create the illusion of craziness as best they could. This is certainly not to suggest that spring break trips are zen-like experiences for most students -- the point is often to go to some far off place and get drunk repeatedly over a period of a week. However, the public do not see episodes of MTV Spring Break in which students volunteer to build homes for the homeless, deliver food aid in foreign countries, etc, they simply see craziness, even if it has to be manufactured by the media to give the public what they want. A little digging quickly turns up plenty of alternatives to stereotypical spring break trips.
       Have you ever seen a movie about college life in which heavy drinking was not a central theme? I haven't. If you ask college students how much they think other students drink, the numbers that they provide are often way beyond the reality of the situation. For some reason, we as a society have convinced ourselves that drinking on college campuses has reached an unheard of level and that the situation is quite dire. Is this true?  Let's take a look at the data.
        According to Henry Wechsler and colleagues at the Harvard School of Public Health, roughly 23% of students qualify as frequent binge drinkers or frequent heavy episodic drinkers. Binge drinking is defined as having four (females) or five (males) drinks during a single evening, and frequent binge drinking means doing this three or more times during a two week period (Wechlser and Nelson, 2001).  Frequent binge drinkers consume roughly 68% of all of the alcohol on college campuses and do most of the damage, including the damage to the reputations of college students as a whole.
        Dr. Wechsler's data suggest that the number of students that fall into the frequent binge drinking category has increased significantly during the past decade, from roughly 20% to 23%. However, it is almost always overlooked that the number of students that abstain from drinking has also increased significantly, 16% to 19%.  As a result, the data could be spun in two different ways - either raising alarm by suggesting that an epidemic is brewing or praising the growing number of abstainers for making healthy choices. Indeed, if one looks at the magnitude of shift in drinking habits, the proportionate change in abstention rates outpaced the rise in heavy drinking rates. Clearly, the media have chosen to focus on the increase in heavy episodic drinking and the public have responded with both concern and great interest. The concern and interest combine to increase viewership, which helps media outlets sell advertising. The cycle then simply continues to feed on itself.  I am well aware of this fact, having had my own research twisted by reporters to confirm the myth that college drinking is completely out of control. 
         On a side note, one ironic and unfortunate aspect of this entire process is that, during the same commercial break in which a reporter might foreshadow an evening news report about the dangers of college drinking, one might see several commercials for alcoholic beverages.  Scary news about drinking draws viewers close while beer commercials attempt to sell them the same product that they are supposed to be worried about!  
        The public should be aware that researchers have essentially no control over how the media spin their research findings. In the end, simply because a reporter refers to a published study does not mean that they are accurately reporting on the outcomes or the implications.
        The truth about college drinking is far more complicated than it is made out to be in the media. Alcohol misuse on American college campuses is certainly a problem, in some ways a big problem, and we need to find a way to deal with it. The number of students suffering from alcohol misuse, their own or someone else's, has increased over the years, and Emergency Room visits seem to be on the rise. However, such data DO NOT necessarily indicate that there is true epidemic of alcohol abuse at colleges across the country. The majority of the alcohol-related problems seem to be caused by a minority of students. Not all college drinkers get out of hand, drink to get drunk, require treatment for alcohol poisoning, etc. Indeed, if one looks at trend data from nationwide surveys that assess college alcohol use, levels of alcohol use, even levels of heavy episodic alcohol use (e.g., 5+ drinks per occasion at least once in a two week period), have either remained relatively stable or decreased in the past 20 years. The chart below illustrates this fact.  It is from a recent report based on data from the Monitoring the Future Survey (Johnston et al., 2002). 
      

Reconciling stable binge rates with increases in consequences

As indicated above, the number of alcohol-related consequences on college campuses has apparently been on the rise. Several universities, including Harvard (see table at right) have reported increases in the number of students arriving at Emergency Rooms for alcohol poisoning. How can this be if the percentage of students that binge-drink has remained relatively stable?  Wechsler and colleagues suggest that the rise in consequences is directly tied to an increase in the number of frequent binge drinkers (i.e., three or more binges or more in two week period). On the surface, this hypothesis seems to make sense,
and is backed up by data showing a relationship between frequency of binge drinking and likelihood of suffering consequences.  Frequency of binge drinking could certainly increase the chances of getting in arguments or fights, being a victim of sexual assault, being injured in accidents, etc. However, there doesn't seem to be any logical reason why binge drinking often would, by itself, increase the odds of suffering an overdose requiring medical assistance. If four or five drinks doesn't cause a person to overdose and die during a single night (which it shouldn't), then why would drinking at that threshold three or more times per two week period increase your risk of such consequences?        The most logical explanation is really quite simple. Binge drinking is a threshold. Those that have the requisite number of drinks are classified as binge drinkers while those that fall under the threshold are classified as non-binge drinkers. The percentage of students that are binge drinkers has remained relatively unchanged. HOWEVER, sorting students into just two categories tells us virtually nothing about how heavily the students actually drink. A female student would qualify as a binge drinker if she had four drinks or forty drinks. Thus, it is entirely possible that peak levels of consumption beyond the binge threshold have been skyrocketing over the years, and we have simply missed this fact because of the focus on binge vs. non-binge drinking.        By analogy, according to CDC data regarding how much Americans weigh, the percentage of Americans meeting the criteria for being overweight increased from roughly 45% to 65% between 1960-2000. That represents roughly a 50% increase the number of people that are overweight. At the same time, obesity increased from 13% to 31%, a change of roughly 250%! Just looking at the number of people that surpass the overweight threshold tells us little to about how far beyond the threshold they actually go. It is quite possible that a similar situation has occurred with drinking levels on college campuses.