FY01-01
THE NATION’S NEWSPAPER
Collegiate
Case
Study
www.usatodaycollege.com
Inside:
Schools urged to serve the
facts about booze
Students experience is tapped to
teach differences in social and
binge drinking
Choosing Wisely (or Not)
Summary: College students are making decisions about lifestyles that may have a
long-term impact on the quality and length of their lives. The newly found
freedom and peer pressure add to the challenge of making logical decisions. The
four articles in this case study offer information and research that can help
college students make more informed and healthy choices.
By Kathleen Fackelman
Binge drinkers may be
trying to consume their
‘fair share’
By Mary Beth Marklein
College’s party atmosphere
inflates number of
smokers
By Sherice L. Shields
Two 20-year-old
women take a
memory test. One
of them abused
alcohol. The MRI
scan on the left is
her brain, the lack
of color indicating
a sluggish mind.
In contrast, the
scan on the right
is of the woman
who doesn’t have
a drinking problem. The colors
show lots of brain
activity. Not surprisingly, she does
better on the test.
By Sandra A. Brown and Susan F. Tapert, University of California, San Diego
Cover story
Teen drinking, thinking don’t mix
Case Study Expert:
Sally Deters
Alcohol appears to damage young brains, early research finds
Residence Life Coordinator
Iowa State University
Ames, Iowa
USA TODAY Snapshots®
College students who binge-drink
Men 50%
Women 39%
Source: Harvard School of Public Health Study
By Kathleen Fackelman
USA TODAY
portrait of alcohol's impact on the
young brain:
Teens who drink heavily face a slew
of hazards, ranging from accidental
injuries to death by alcohol poisoning.
If early research is verified, scientists
might add another danger to that list
soon: brain damage.
u Brain scans of teenagers who have
abused alcohol suggest damage to the
hippocampus, the region involved in
learning and memory. On average, the
young drinkers had a 10% smaller
hippocampus than their peers, one
study shows.
Preliminary studies indicate that
heavy, regular drinking can damage
the developing brains of teens and
young adults and perhaps destroy
brain cells involved in learning and
memory.
Recent scientific findings represent
the first brush strokes of an emerging
u A separate study shows that teens
who are heavy drinkers perform
poorly on memory tests.
u Brain scans of young women who
drank heavily as teens showed regions
of sluggish activity in the brain.
By Karen Sloan and Keith Simmons, USA TODAY
Reprinted with permission. All rights reser ved.
AS SEEN IN USA TODAY LIFE SECTION, WEDNESDAY, OCTOBER 18, 1-2D
At risk: at least 3 million American teens who abuse
alcohol regularly.
People joke about the fact that alcohol kills brain cells,
says Duncan Clark, a
researcher at the University of
Pittsburgh Medical Center.
''Well, in this case, the
implications are quite serious.''
especially vulnerable target for alcohol.
The team injected young rats with a high dose of alcohol - the human equivalent of drinking a 12-pack in a single
night. The rats got a day off,
then got another shot the next
day. The team continued that
bingeing pattern for 20 days.
The team let the rats mature
into adults, then challenged
them with a memory maze.
Initially, the rats did fine. But
researcher
H.
Scott
Swar tzwelder wondered
whether the rats had sustained
a subtle brain injury, one that
would show up under duress.
To find out, the rats were given
a single injection of alcohol and
placed in the maze.
Clark and other scientists
fear that teens and young
adults who regularly get drunk
will sustain lasting damage to
the brain, which could make it
more difficult for them to do
well in school or at work.
Critics say it's too early to
blame brain damage on alcohol
abuse. They say that many
teens who drink heavily also
abuse other drugs and have
other risk factors that could
hurt the brain.
But researchers say that
though the work is in the early
stages, the evidence leans
toward a link between alcohol
and damage to young brains.
By Robert Willett for USA TODAY
Caught in a maze: H. Scott Swartzwelder says rats injected with alcohol when young suffer memory loss as adults.
Sur veys show that many
young Americans favor the particularly dangerous binge
drinking — downing four or five drinks in a row.
That slight impairment didn't
mar the performance of rats
that had never been given
alcohol. Nor did it slow down
rats that had been given
alcohol as adults. But rats given
shots of alcohol as adolescents
faltered. Again and again, those
rats made mistakes.
''They were doing twice as
bad as everyone else,'' Swartzwelder says.
Hippocampus may be hurt
A recent survey by the Harvard School of Public Health in
Boston found that 44% of college students are binge
drinkers, and nearly 74% said they binged in high school.
''We have a massive alcohol problem among youth,'' says
Enoch Gordis, the director of the National Institute on
Alcohol Abuse and Alcoholism (NIAAA), a part of the
National Institutes of Health in Bethesda, Md. Gordis and
other experts say the new studies, although far from
complete, represent a warning that alcohol may target the
young brain. ''Teens who drink heavily may not realize their
maximum potential,'' Gordis says.
Until recently, researchers thought the teen brain had
completed its development. Now scientists realize that the
brain makes important strides until age 20 or 21.
Aaron White, a researcher at Duke University Medical
Center in Durham, N.C., and his colleagues wondered
whether that meant the young brain presented an
The team thinks that the alcohol inj ured the
hippocampus, a brain region involved in memory and
learning. The findings are in the August issue of Alcoholism:
Clinical and Experimental Research.
Other research suggests that binge drinking overloads a
protein receptor on cells in the hippocampus, White says.
When working properly, the receptors help the brain
encode recent events. The proteins help lay down a
memory so that it can be recalled.
Researchers think that binge drinking may lead to the
death of cells in the hippocampus. The loss of those brain
cells may underlie the rats' poor performance on the
memory maze, Swartzwelder says.
There's also human research suggesting that teens and
young adults who binge are hammering the hippocampus.
Reprinted with permission. All rights reser ved.
Case Study: Teen Drinking
Adults who drink heavily for 20 or 30 years are known to
damage that brain region. But the injury was thought to be
inflicted over decades of bathing the brain in toxic alcohol,
says Michael De Bellis, a researcher at the University of
Pittsburgh Medical Center. De Bellis and his colleagues
recruited 12 teens and young adults with serious drinking
problems. They took scans of their brains and compared
them with those of 24 kids who did not have an alcohol
problem.
On average, the drinkers had a 10% smaller hippocampus
than their peers, a ''substantial difference,'' co-author Clark
says. The longer a youth had been drinking, the smaller the
hippocampus.
The small study, which appears in the May issue of The
American Journal of Psychiatry, does not prove that alcohol,
rather than some other factor, damages the hippocampus,
De Bellis cautions.
But those findings fit with another MRI study, this one of
10 young women who had abused alcohol as teens. All 10
had stopped drinking before the study.
The researchers used a type of MRI that snapped pictures
of the brain while the women took a test -- in this case, they
had to remember the location of objects on a computer
screen. Compared with 10 healthy young women, the
women with a drinking history had trouble remembering
the locations of objects, says Susan Tapert, a co-author who
is at the University of California, San Diego.
The scans of the 10 former drinkers show sluggish brain
regions. The worry is that alcohol damaged parts of the
brain involved in spatial memory. In the real world, such
damage could lead to trouble doing math or even reading a
map, Tapert says.
And the study suggests that the brain damage, if it exists, is
long-lasting. Some of the women in the study, who were in
their late teens and early 20s, had been alcohol-free for
months. Yet they still showed impairment in brain function,
co-author Sandra Brown says.
The San Diego team has uncovered additional signs of
thinking problems in a study of 33 teens, 15 and 16, who
had been drinking heavily for several years.
The researchers gave the teens a list of names and 20
minutes later asked them to repeat it. The 24 members of
the control group, who had no histor y of drinking,
remembered 95% of the names. Those who had abused
alcohol got 85%, Tapert says.
That's like getting a B instead of an A on a test, she says.
The researchers described their results in the February issue
of Alcoholism: Clinical and Experimental Research.
Again, the implication is that alcohol harmed regions of
the brain involved in memory. The drinking teens had
trouble remembering names — a problem that could
translate to forgetting facts during a school test and might
set the stage for spiraling underachievement, Brown says.
Those findings suggest that alcohol attacks the brain,
although all three research teams say their results fall short
of an indictment. It's almost impossible to find alcohol
abusers who haven't used other drugs such as marijuana,
they say. It could be marijuana, and not the alcohol, causing
the memory difficulties, says Linda Spear, an alcohol and
drug researcher at the State University of New York,
Binghamton. And the MRI studies are far too small to offer
any proof of brain damage, she says.
Don't give up on youths
There has been a ''rush to judgment'' on the part of the
research community, Spear says.
She worries that people will write off young alcohol
abusers as hopelessly damaged.
''We have to be cautious,'' says Kenneth Sher, an alcohol
researcher at the University of Missouri in Columbia. The
studies to date have not conclusively proved that alcohol
causes damage in the young brain. ''Yet the findings are
extremely provocative,'' he says.
His research suggests that teens who drink heavily have
trouble on cognitive tests. His findings suggest that the brain
is most vulnerable to alcohol's toxic assault in the teen years,
not during college.
Swartzwelder says he would bet on the theory that
alcohol harms the brain throughout young adulthood. ''The
converging lines of evidence provide a very compelling
argument,'' he says.
At the very least, the findings should raise a red flag for
parents, teachers and others, Brown says. Kids with alcohol
problems should get into treatment as quickly as possible,
she says. If further research does prove brain damage from
heavy drinking, the injury might be reversed, she says.
Even if research rules out brain damage, there is concern
that heavy drinking can lead to short-term memor y
impairment, Swartzwelder says. Alcohol is thought to
disrupt brain receptors that form memories, he says. So
even if brain cells don't die, a heavy dose of alcohol will
garble the ability to encode recent facts and events.
Therefore, kids who study all day and drink at night might
have trouble getting their facts right on a test the next day.
Swartzwelder has a simple message for students: ''Alcohol
is bad for your memory.''
Reprinted with permission. All rights reser ved.
AS SEEN IN USA TODAY LIFE SECTION, WEDNESDAY, OCTOBER 18, 2000, 8D
Health and behavior
Schools urged to serve
the facts about booze
Student experience is tapped to teach
differences in social and binge drinking
By Kathleen Fackelman
USA TODAY
booze for them, Abbate says.
Teens and college-age youths often are not versed in the
convention of ''social drinking,'' instead favoring a drinking
style in which they consume lots of drinks quickly.
A 1999 Harvard School of Public Health survey of 119
U.S. colleges found that almost one-fourth of college
students drink heavily and frequently. ''Binge drinking is on
the rise,'' says alcohol researcher Sandra Brown of the
University of California, San Diego.
He participated in a teen panel at a recent Washington,
D.C., meeting of Leadership to Keep Children Alcohol Free,
an initiative formed to educate the public about the
dangers of underage drinking.
In light of recent studies that suggest a link between
heavy drinking and brain damage among teens and young
adults, parents could find themselves in a tough spot when
dealing with the issue.
That's what 23-year-old Brandon Busteed recalls about
college life at Duke University in Durham, N.C.
''Nobody thinks we should go out and tell teenagers to
drink,'' says Robert Butterworth, a psychologist to children
and adolescents in Los Angeles.
Busteed, who graduated last year, says students who
drink often do so with the sole purpose of ''getting
trashed.''
''But we just have to be so careful when we talk about
these studies,'' he says. ''A while back we had one study
that said if you drink a little bit every day, you'll live longer.''
For many teens, the drinking begins in high school or
even in middle school. Another survey, this one conducted
by the Centers for Disease Control and Prevention, found
that one out of four ninth-graders reported binge drinking
in the month before the survey.
The back-and-forth nature of the scientific method can
be confusing, Butterworth says, adding that future studies
could reverse or modify current findings.
Alcohol flows freely at underage parties, says 17-year-old
Andrew Abbate of Burrillville, R.I.
''It's all around you,'' says Abbate, noting that at many
parties alcohol is the only drink that is served. Most of the
kids he knows drink, and some of them drink heavily, he
says.
Kids bring their own liquor bottle or six-pack to a party.
In some cases, legal-age siblings or other adults buy the
''I do a lot of evaluations of kids,'' Butterworth says. ''We
know that the youngsters who have the worst time are
those who have been strictly forbidden to have even a sip
at home, and when they get some freedom, they rebel.''
Busteed thinks schools should do more to include alcohol
education in the curriculum. His company, Outside the
Classroom (www.outsidetheclassroom .com), is developing
an online course that presents the facts on alcohol
consumption to college students.
Contributing: Karen S. Peterson
Reprinted with permission. All rights reser ved.
Case Study: Teen Drinking
AS SEEN IN USA TODAY LIFE SECTION, WEDNESDAY, OCTOBER 18, 2000, 8D
How to keep your kids
from abusing alcohol
u Make it easy for your child to talk honestly with
you about alcohol and other issues.
u Talk to your child about the risks of alcohol use,
reasons not to drink and ways to avoid drinking.
Where to get help
For kids and young adults who have a drinking
problem, experts advise getting help right away.
For more information:
u The National Institute on Alcohol Abuse and
Alcoholism at 301-443-3860 or www.niaaa.nih.gov.
u The National Council on Alcoholism and Drug
Dependence at 800-622-2255 or www.ncadd.org.
u Keep tabs on your child's activities.
u Encourage healthy friendships and participation
in activities that don't involve drinking.
u Develop family rules about drinking, and
establish consequences.
u Set a good example regarding your own alcohol
use.
u Know the warning signs of a drinking problem,
and get help quickly for your child.
Parents of college kids can take these additional
steps:
u Ask the college about its alcohol policies and
sanctions.
u Find out whether the school has a reputation as a
party school.
u Call the campus health clinic and find out
whether the school has lots of alcohol-related
incidents during the year.
u If your child wants to join a fraternity or sorority,
ask about the group's alcohol use and ask your child
how he or she will handle situations involving alcohol.
u Stay in touch with college students, and don't be
afraid to ask them directly about their alcohol use.
Reprinted with permission. All rights reser ved.
AS SEEN IN USA TODAY LIFE SECTION, MONDAY, SEPTEMBER 11, 2000, 7D
Health and behavior
Binge drinkers may be trying
to consume their 'fair share'
By Mary Beth Marklein
USA TODAY
similar drops.
One of the most popular approaches to curbing binge drinking
on college campuses may not be effective for most students and
could even backfire on some students, a new study suggests.
The survey of 14,000 students, conducted in 1999 at 119
colleges in 40 states, centers on how student perceptions about
drinking levels affect student behavior.
About one college in nine has in recent years adopted a
strategy, called the ''social norms approach,'' that aims to correct
misperceptions about alcohol use with education and publicity
campaigns.
The premise is that students will adjust their drinking levels to
whatever level of consumption they perceive the norm to be.
But the strategy is based on an assumption that most students
overestimate drinking levels, Harvard researcher Henry
Wechsler says. His study, published in the September Journal of
American College Health, finds the assumption inaccurate:
Nearly half (47%) of college students underestimated binge
drinking levels at their schools, whereas 29% overestimated the
level, 13% were accurate within 10%, and 12% said they did not
know. Binge drinking is defined as five or more drinks in a row for
men, four or more for women.
Also, just 13% of college students surveyed are binge drinkers
who overestimate the amount of drinking — the population
most likely to benefit from a social norms approach, Wechsler
says.
''If you have a campus where a lot of students are
overestimating the amount of drinking, that's certainly fertile
ground for this approach, but the approach isn't going to work for
all students,'' he says. It's also possible that students who
underestimate drinking levels might increase their drinking if
they conclude they're not consuming their ''fair share,'' he says.
Michael Haines, director of the National Social Norms
Resource Center at Northern Illinois University (NIU) in DeKalb,
says he is not persuaded by Wechsler's research. He says a
campuswide campaign stressing that most college students
drink moderately has contributed to a 44% decline in heavy
drinking at NIU since 1990, and other campuses have seen
''The central theme of the social norms approach is that you
get more good behavior if you pay more attention to good
behavior rather than (using) scare tactics and threats of
punishment, which has been the more common approach,'' he
says.
Even so, smaller studies by other researchers published in the
journal appear to support Wechsler's findings.
One study involving first-year residential students at a
medium-size public university in the South found that a social
norms campaign did not reduce drinking levels for students
overall, and that risky behavior worsened somewhat among
students who showed signs of being in the early stages of binge
drinking behavior.
How big a problem?
College students' perceptions of the
alcohol problem on their campuses
seems to depend on how much they
drink, according to a Harvard School of
Public Health study. The research definition of binge drinking is five or more
drinks at one sitting for men, four or
more for women. A frequent binge
drinker had binged three or more times
in the two weeks prior to the survey. A
non-binge drinker had consumed alcohol in the prior year but had not binged
in the two weeks before the survey.
Frequent
Non-binge
drinker binge drinker
Major problem
Problem
Minor problem
Not a problem
12.5%
39.0%
33.5%
5.6%
29.3%
42.9%
14.9%
22.2%
Source: Journal of American College Health
Reprinted with permission. All rights reser ved.
Behind the Story: A Reporter’s Notebook
Stories on college drinking have taken me all over the map. I've gone into fraternity houses with sticky floors and John Belushi posters and under bleachers to count discarded
liquor bottles during a football game. I've spoken with parents who lost a son or daughter
because of alcohol, with hospital emergency room workers who are tired of pumping
stomachs (or worse) at midnight, and with college and fraternity leaders who are trying to
figure out how to address binge drinking as a legal, social and health issue -- while also
downplaying the problem, sometimes, to fend off negative publicity.
Mary Beth Marklein
Reporter, Life
It's a complex issue with lots of questions. Do you ban alcohol or teach students to use it
responsibly? Do you notify parents or work out problems with a student confidentially?
Should problem drinkers be punished or offered therapy? The list goes on.
My favorite stories are those about college students trying to change the campus culture.
At one school, members of the senior class vowed to stop participating in a longtime drinking ritual after a classmate fell down the stairs and died after chugging alcohol. One fall, I went through fraternity rush with a chapter
that had banned alcohol in their house -- and had a great time. Those examples suggest to me that students can
make a difference. And on a selfish level, those stories are a lot more fun to do!
Higher education reporter Mary Beth Marklein earned a bachelor's degree from the University of Wisconsin at
Madison and a master's in journalism and public affairs from American University in Washington, DC. She also is
an adjunct on the faculty of American University, and recently returned from a sabbatical offered by USA TODAY
at the University of North Carolina at Chapel Hill. She speaks often to college students and groups.
Teen Drinking Case Study
AS SEEN IN USA TODAY LIFE SECTION, WEDNESDAY, AUGUST 9, 2000. 8D
College's party atmosphere
inflates number of smokers
By Sherice L. Shields
USA TODAY
Almost half the nation's college students have turned to
tobacco in the past year, says a report out today in the
Journal of the American Medical Association.
That finding and others are part of a JAMA issue devoted
to tobacco issues and will be conveyed at this week's 11th
World Conference on Tobacco OR Health in Chicago. Other
studies have focused on college students' cigarette use, but
researchers say this is the first to look into cigar use as well.
Researchers studied the results of the 1999 Harvard
College Alcohol Survey, which focused not only on alcohol,
but on cigarette, cigar, smokeless tobacco and pipe use at
119 colleges.
u 8.5% had smoked a cigar within the past month.
More freshmen and sophomores used tobacco than
juniors and seniors. ''This suggests that the cigar use is a
new phenomenon entering the college population,''
researchers write.
Other findings:
u Michael Thun and colleagues from the American
Cancer Society in Atlanta dispute claims that the estimated
death toll from tobacco — put together by the Centers for
Disease Control and Prevention — was inflated because the
research didn't account for the higher proportion of
smokers who are from lower socioeconomic groups.
''It quantifies and confirms that tobacco is the culprit,''
Thun says.
Of the more than 14,000 students who responded:
u 61% said they had tried a tobacco product at least
once in their lives.
u Florida's ''The Truth'' anti-smoking campaign has
reduced the number of teen smokers in the past two years
— a 40% decrease among middle school students and an
18% decrease for high school students.
u 45.7% said they had used tobacco within the past year.
u 32.9% said they had used a tobacco product within the
past month.
Researchers found that students are more likely to use
tobacco if they value social life more than academics,
religion or athletics or if they engage in risky behavior such
as having multiple sex partners or
binge drinking.
''It's a gross generalization, but students who are
majoring in partying are those most likely to smoke,'' says
lead researcher Nancy Rigotti, the director of Tobacco
Research and Treatment at Massachusetts General Hospital
and associate professor of medicine at Harvard Medical
School in Boston.
The study also found that:
u 37% said they had smoked a cigar at least once in their
lives.
u23% had smoked a cigar within the past year.
USA TODAY Snapshots®
Cigarette smoking drops
The average annual number of cigarettes smoked by
an American adult:
Year
1991
2,727
1992
2,647
1993
2,543
1994
2,524
1995
2,505
1996
2,482
1997
2,423
1998
2,320
1999
2,1361
2000
2,1031
1 - preliminary
Source: USDA Economic Research Service Agricultural Outlook
By Keith Simmons, USA TODAY
Additional
Resourcs
CDC Tobacco Information Source
Information, publications and tips
on smoking cessation
www.cdc,gov/tobacco
Entertainment Industries
Council, Inc. (EIC)
Information referral, scrip
consultation
800-783-3421
www.eiconline.org
National Clearinghouse for
Alcohol and Drug Information
Posters, brochures and videos
800-729-6686
www.health.org
American Public Health
Association (APHA)
Information, brochures
202-789-5600
www.apha.org
For discussion
1. In era where students typically "live for today,” what alternative
methods of teaching should be implemented to demonstrate the
long term effects of alcohol / tobacco use /abuse?
2. The facts about the long-term effects are not new and have been
presented to students throughout the elementary/high school
period. What should we be teaching about the immediate effects
that may make more of an impact?
3. What consequences should students who violate a school’s alcohol
or other drug policies be? Is the practice of calling the student’s
parents or taking away their financial aid a deterrent?
4. What responsibility do administrators have to change the social
norm? What role does the educational institution need to play in
offering social opportunities that do not involve alcohol? What
would make non-alcohol events more attractive to students to
attend? What is the student’s responsibility in programming for his
or her own social needs?
5. Is there a mixed message when college administrators tell students
they need to act like adults but then tell them what our specific
expectations of their behavior are? Are we legislating too much or
too little on those expectations?
Future Implications:
Legal versus " illegal" recreational drugs
— what is on the horizon?
About Sally Deters. . .
Sally Deters is Coordinator of Residence Life –Judicial Affairs at Iowa State University, where she has been
for 22 years. Deters has been active on campus by serving on campus committees to assess the climate and
program for the need of the students.
For more information, log on to http://www.usatodaycollege.com