College Drinking
Gail M. Basch M.D
Department of Psychiatry
Rush University Medical Center
© AMSP 2013
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College Heavy Drinking
Transitional time
Heaviest drinking epoch
Believe heavy drinking = norm
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Morbidity & Mortality
~2,000 student deaths/yr
~700,000 assaults/yr
~80,000 sexual assaults/yr
~2.8 million drove while intox
$62 billion /yr underage drinking
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College Heavy Drinking
→ Drinking problems
Clues for prevention
Clues for Rx
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This Lecture Reviews:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
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Standard Drink
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Standard Drink in Solo Cup
Beer (12 oz)
Wine (5 oz)
Spirits (1 oz)
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Heavy Episodic Drinking
/
4+
♀
5+ ♂
≥5 occas/month
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Blood Alcohol Concentration
Standard drink ~12 grams alcohol
1 drink → BAC 0.015 g/dl (~15 mg%)
↑ BAC with:
♀
↓ Weight
Drink w/out food
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BAC’s Effects
Effects
BAC (mg%)
> 300
↓Vital signs, coma, death
≤ 300
Difficulty waking
≤ 200
Anger, moody, confusion
≤ 100
Sleepiness, ↓ coordination
≤ 50 (1-3 drinks)
Well-being, ↓ inhib
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Blackout
Intox →forget events
Remain consciousness
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DSM IV Alcohol Use Disorders
Abuse
Dependence
≥1
Role failure
Risk of harm
Legal problems
Use despite problems
 Dependence
≥3
Tolerance
Withdrawal
Larger/longer
Unable to cut down
↓ Time elsewhere
Use despite problems
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DSM 5 Alcohol Use Disorders
Abuse
Dependence
2-3 mild, 4-5 mod, ≥6 severe
Legal problems
Cravings
Role failure
Risk of harm
Use despite problems
Tolerance
Withdrawal
Larger/longer
Unable to cut down
↓ Time elsewhere
© AMSP 2013
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This Lecture Reviews:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
© AMSP 2013
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Heavy Drinking Episodes
~45% heavy drinking/2 wks
~20% ♂ drink 10 drinks/occas
~10% ♀ drink 8 drinks/occas
~50% 1+ blackout/college
~40 % 1+ alcohol problem prior yr
~20% students drink 72% of alcohol
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College vs Non-College
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Risk Higher For:
Single event/game day/holiday
21st birthday
Fraternity/sorority
Student athletes
↑Impulsivity
AUD relative
Low LR to alcohol
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BAC ↑Drink Days
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st
21
Birthday
~83% drink to celebrate
~25% >21 b-day drinks
~40% blackouts
~50% highest ever drinks
~72% ↑ DWI risk
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Game Day Drinking
~60% drink
~7 drinks/game
↑ Impulsive
↑ Expect drunk
→↑ Drink
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Fraternity/Sorority
~ 60% prior heavy drinkers
~ 80% heavy episodic drinkers
Greek peers = heavier drinkers
Believe ↑ drink norms
→↑ Drink
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Fraternity/Sorority
Blackouts/Past 2 Weeks
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Student Athletes
~50% heavy episodic drinkers
Leaders ↑ drink and set norms
Athlete peers = heavier drinkers
Athlete + Greek →↑ Drink
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Family History
4x ↑ AUD risk
Even if adopted out
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Impulsivity
↓Postpone reward
↑Risk taking
↑Urgency
→↑ Drink
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Level of Response
↑↑ Drinks/occas for effects
→Join peers ↑↑ drinks/occas
→Think everyone drinks ↑↑
→↑ Stress
Use ↑ drinks to cope
→↑ Drink
© AMSP 2013
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This Lecture Reviews:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
© AMSP 2013
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Peer Influence
Students fear rejection
~40% afraid to refuse
Overest. peer/campus drink
↑ Drinking to match
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Inaccurate Beliefs
False beliefs:
~65% more fun
~55% better sex
↓Muscle tension
Better sleep
Other myths
Underinformed:
Alcohol OD
Predict BAC
Alcohol + Drugs
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Alcohol to Cope
Low doses → ↓ mild anxiety
2 or 3 drinks → ↑ anxiety
Drink to Rx anxiety
→ ↑ Drink
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Prevention Programs
Orientation
Student health
Campus Life
Dorm counselors
Prevention campaigns
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Prevention Videos
Peer influence
Accurate alcohol beliefs
Actual campus drinking
Healthy coping
Can’t guess BAC
Alcohol + drugs dangerous
→ ↓ Drink
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This Lecture Reviewed:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
© AMSP 2013
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Acknowledgements
Marc A. Schuckit, M.D.
Department of Psychiatry
University of California, San Diego
Marcy Gregg
AMSP Scholars
www.alcoholmedicalscholars.org
© AMSP 2013
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