Alcohol Abuse Among College Students
R. Wade Wheeler
Texas State University-San Marcos
Introduction
Data from several national surveys indicate that the vast majority of college students (85 to 95%) consume alcohol (Presley, Meilman, and Lyerla, 1994). The heaviest drinkers in the United States are young adults (Naimi et al, 2003), and college students drink more frequently and in greater numbers than their peers who do not attend college (Johnston et al, 1997).
In recent years researchers have focused much of their attention on the “binge drinking” phenomenon. From a medical or clinical perspective, binge drinking is thought of as drinking over an extended period of time coupled with giving up one’s usual activities (Schuckit, 1998). In the psychological literature however, binge drinking is typically defined as consuming five or more drinks in succession for males and four or more drinks for females on one or more occasions during a two-week period (Centers for Disease Control and Prevention, 1997; Douglas et al, 1997; Weschler et al, 1994). Surveys conducted in 1993, 1997, 1999 and 2001 have yielded consistent results; over 40 percent of students attending four-year colleges in the United States are binge drinkers (Wechsler, et al, 2002). According to the Harvard School of Public Health, half of students who binge drink do so more than once a week.
In addition to the deleterious effects on health and its impairment of cognitive and motor functions, heavy drinking among college students is associated with a number of other adverse consequences including missed classes, property damage, an increased likelihood of engaging in unprotected sex, and trouble with campus and local police (Wechsler, et al., 1994). Because of the disinhibiting effects of alcohol, its abuse is also linked to aggressive behavior (Ito, Miller and Pollock, 1996). Aggression coupled with impaired judgment may also contribute to the high incidence of date rape on college campuses (Modestin, et al., 1996). Alcohol consumption by college students has been linked to 500,000 injuries and 1400 deaths each year (The National Institute of Alcohol Abuse and Addiction, 2002).
The U.S. Surgeon General, the U.S. Department of Health, as well as Senator Joe Lieberman, D-Conn. have described heavy episodic or binge drinking as a serious health issue (USDHHS, 2000), Joe Lieberman (press statement, May 2002). More than one-third of college students meet the DSM-IV criteria for alcohol abuse. A survey report published in 1990 indicated that 67 percent of college presidents rated alcohol misuse as either a moderate or major problem on their campuses (Carnegie Foundation for the Advancement of Teaching, 1990). Researchers have observed that “Drinking is perceived as part of the college experience by most students” (Engs, Diebold, and Hanson 1996, p. 28).
Despite various types of prevention efforts on the part of health professionals and college administrators (Dodge, 1991; Kunz, Irving, and Black, 1993), college student binge drinking has not decreased significantly in recent years (Schuckit, et al., 1994). Some researchers have suggested that college students are now not only drinking more frequently but in greater amounts (Presley, Meilman, Cashin, 1996). For example, recent research by White, et al (2003) found that approximately 1 of 5 male and 1 of 10 female students consumed twice the binge threshold, at least once in the previous two-week period. Further, the National Center on Addiction and Substance Abuse at Columbia University (2007), recently reported that between 1993 and 2005, there has been an increase in both the intensity of binge drinking and the rates of drug abuse (marijuana, cocaine, heroin and other illegal drugs). While some studies have shown that men consume alcohol more frequently and in greater amounts than women (Engs, Diebold & Hanson, 1996), other studies report no significant gender differences (Perkins, 2002).
Motivating Factors
A number of research efforts have focused on the motives for college student drinking. Two general types of motives have been identified: drinking in order to socialize and drinking to relieve stress (Brennan, et al, 1986). Drinking just to “get drunk” has also been reported (Weschler, et al (2000). The effectiveness of alcohol as a sedative was established almost 50 years ago (Carpenter, 1957). More recently, Cornin (1997) developed a reason for drinking scale which yielded measurements on three dimensions: social camaraderie, mood enhancement and tension reduction. To some degree all three dimensions predicted drinking rates among college students. A social motive that has received relatively little research attention is one advanced by Sobel and Sobel (1973) which suggests that “Alcohol intoxication is socially acceptable as an excuse for engaging in certain otherwise inappropriate behaviors” (in Lilenfeld, Seeing Both Sides (1995, p. 331). In a study on the relationship between cognitive processes and alcohol consumption in a sample of college students Caldwell, Billingham and Gross (1995), found that alcohol consumption was related to the total number of reasons a student gave for drinking: self-monitoring, and the age of the drinker.
Consequences of heavy drinking
A large amount of empirical evidence is available which shows a link between alcohol consumption and impaired academic performance (failed tests, missed classes due to hangovers, and lower grade point averages (Perkins, 2002). Data from nationwide surveys indicate that among heavy drinkers in college, 40% reported hangovers, and 47% reported having nausea or vomiting as a result of alcohol or other drug use. Blackouts and memory losses were also reported. Fifteen percent of those surveyed reported injury to oneself as a consequence of alcohol or other drug use within a year (Presley et al, 1996, Perkins 2002).
In nationwide surveys, 5% to 12% of students admitted to having trouble with the law (open container restrictions, public intoxication, etc) as a direct consequence of alcohol use (Engs and Hanson, 1994). In addition, 56% of males and 43% of female students who were relatively heavy drinkers admitted to having driven drunk during a single academic year (Engs et al, 1996). Further, 8% of students have admitted to damaging property or pulling a fire alarm during an academic year (Wechsler, et al, 1998) and 30% of all students have reported being involved in arguments or fights as a consequence of their drinking (Presley et al, 1996).
Alcohol consumption is widely assumed to lead to risky sexual behavior (Steel and Josephs, 1990). In one study involving 210 participants at a large Southeastern University, 70% reported that they were less likely to use a condom in sexual activity after they had been drinking (Poulson, et al, 1998). Sixty percent of college women who were victims of sexual assault or attempted sexual assault reported that their judgment had been moderately or severely impaired at the time due to drinking (Frintner and Robinson, 1993). Heavy alcohol use by the perpetrator and/or the victim increases the likelihood of acquaintance rape and according to Abby, (2002) 50% of college students’ sexual assault is directly related to alcohol use.
Research seems to indicate that men anticipate feeling more powerful and aggressive after drinking alcohol (Presley et al, 1996) and that college men tend to perceive women who drink in bars as being sexually promiscuous and thus become targets of sexual aggression (Kanin, 1985). Women are 9 times more likely to experience sexual aggression on days of heavy alcohol consumption than on days of no alcohol consumption (Parks, et al, 2004).
Peer Influence
Peer influence has been identified as a critical factor in alcohol abuse among both high school and college students. Studies have shown that individuals who have friends who drink are more likely to begin drinking (Reifman, et al 1998), and that individuals who engage in binge drinking are more likely to have friends who binge drink (Manski,, 1993; Moffitt, 2001). Based on a survey of 930 high school students (Arata, Stafford, and Tims, 2003) problem drinkers reported more susceptibility to peer pressure and also perceived their peers as drinking more. Furthermore, Beck and Treiman (1996) found that high-intensity drinkers as opposed to low-intensity drinkers were more likely to drink in order to facilitate social interaction. They also reported that perceptions of peer norms were more important than peer approval in problem drinking among teenagers. In research related to normative influence on drinking, Baer, Stacy and Larimer (1991) found that there was a strong tendency for college students to believe that members of their social reference group drink more frequently than themselves. In addition, college students tend to overestimate how much fluid they should pour in a cup to create a standard drink. A recent study found that students over-poured shots by 26%, mixed drinks by 80% and beer by 25% (White, et al 2003). These common misperceptions may cause some students to engage in heavy drinking because of their false beliefs that excessive drinking is typical of their peers – that everyone does it and/or their misperceptions concerning the quantity of alcohol contained in alcoholic beverages. According to Bosari and Carey (2001) there are three basic determinants of peer influence on student drinking; “overt offers of alcohol, modeling and social norms” (p. 391). The effects of peer pressure cannot be overstated. As Berkowitz (1990) observes, “comprehensive reviews of research examining collegiate alcohol and other drug use have repeatedly found that peer influence outweighs all others including familial, religious, personality and other factors which mediate but are less powerful than peer effects “(p. 13).
Environmental Factors
Researchers have identified a number of environmental factors related to heavy episodic drinking in college student samples. According to Wechsler, et al, (2000), some of the major factors are: “alcohol marketing, outlet density, price, special promotions, and the volume in which alcohol is sold” (p. 9). Other factors include the easy access to alcohol, attending a school with many binge drinkers, living in a residence with binge drinkers; and parental behavior and attitudes (students who have parents who drink are more likely to begin binge drinking than students whose parents do not drink (Department of Public Health and Social Behavior, 2003). Based on a review of the literature focusing on various aspects of the environment that potentially influence binge drinking among college students, Presley, Meilman and Leichliter (2002) conclude that “Predominantly white institutions will show more problematic alcohol use, and historically black institutions will show less” (p. 84). Other researchers report that students who live on campus tend to engage in higher levels of alcohol consumption than those students who live off-campus (Presley, et al, 1996a). In addition, students at smaller schools tend to drink more heavily than students at larger campuses and students attending schools in the Northeast section of the U.S. have higher episodic drinking rates than those students attending schools in other sections of the country (Presley, et al 1996b). Finally and perhaps most importantly, a national study of the environmental context related to heavy drinking (Hilton, 1991) indicated that the presence of other people increased the amount of alcohol consumed. Thus, the social context within which heavy drinking occurs cannot be over emphasized. With respect to the marketing of alcohol it should be noted that in 2002 the alcohol industry spent an estimated 990 million dollars in advertising and that young people between 12 and 20 were exposed to approximately 66,000 alcohol ads (http://www.brad21.org/Facts.html). Drinking with friends and having many people intoxicated at an event have been found to be predictive of heavy episodic drinking. As mentioned earlier, alcohol prices have been found to play a major role in influencing alcohol consumption in college populations – increases in the price of alcoholic beverages can reduce consumption (Chaloupka, et al, 2002). Studies have also examined the role of religiosity in alcohol consumption. While an inverse relationship has been reported between religiosity and alcohol consumption for females, no such relationship has been found for males (Martin, et al, 1999). Fraternity and sorority members engage in higher rates of binge drinking than other students. In a survey of over 12,000 college students, Engs, Diebold, and Hanson (1996), found that “pledge members of fraternity/sorority consumed almost twice as many drinks per week compared to non-Greeks” (p.22).
Studies have shown that there is more problematic alcohol use at predominantly white institutions than at predominantly black institutions, but because of inconsistencies in national findings, it is unclear as to whether or not single-gender institutions such as women’s colleges experience less alcohol-related problems than do students at co- educational colleges (Presley, Meilman and Leichliter, 2002).
Prevention Programs
To address the problems associated with heavy drinking among students, many colleges and universities have employed various types of prevention programs. In the early 1980’s approximately 88 percent of college campuses offered some type of alcohol prevention programs for students (Berkowitz and Perkins, 1986). A variety of strategies have been used including informational approaches (lectures, films and written materials), non-drinking pledges, support groups for problem drinkers, alcohol-free activities, values clarification sessions, and others too numerous to mention. All such strategies have resulted in only a modicum of success. The widespread use of informational approaches, based on the assumption that students are unaware of the harmful effects of alcohol, have been especially ineffective in reducing problem drinking (Alden, 1980, Nathan 1983). Further, based on a review of 15 empirically evaluated alcohol prevention programs, Walters and Bennett (2000) indicated that “overall, information-based interventions were not as effective as skills or attitudinal based interventions in decreasing student drinking” (p.73) and that “shorter programs were on average just as effective as longer ones” (p. 74).
A comprehensive review of all the various strategies that have been used in colleges and universities is beyond the scope of this paper. Additional information about such programs and resources can be obtained from the following organizations.
National Institute on Alcohol Abuse and Alcoholism-College Drinking Prevention
http://www.collegedrinkingprevention.gov
The Higher Education Center For Alcohol and Other Prevention
http://www.edc.org/hec
The Core Institute
http://www.siu.edu/departments/coreinst/public_html
Conclusion
Heavy episodic or binge drinking and its deleterious consequences for college students and the institutions they attend has been, is and will likely continue to be a significant problem on college campuses in the future. It should be emphasized however, that the prevalence of binge drinking varies among campuses depending on the demographics of the student body and the region of the country where the campus is located (Wechsler, et al, 1994). Thus, each college is responsible for an accurate assessment of the degree of alcohol abuse among its students.
Thanks to the herculean efforts of researchers who pioneered efforts to identify personal, social and environmental factors related to the abuse of alcohol in college population, much is known about the conditions under which drinking occurs. Students who are at the greatest risk of alcohol abuse have been described as “under 21, white, male, low grade-point average, fraternity/pledge and non-religious” (Engs Diebold and Hanson, 1996, p. 29). What is known about binge drinking however, has for the most part, been based primarily on survey or correlational data. It is now time for researchers to find new and creative ways to discover why college students continue to engage in such self-destructive and socially disruptive behavior. Perhaps approaching the problem from a social-cognitive perspective, that is, learning more about how students interpret, remember, use, and feel about situations in which heavy drinking occurs will provide greater insight into this serious health issue.
According to Brennen, et al, (1986) “There is still a great deal to be learned about university campus culture as it interacts with demographic and personality variables to influence the use and abuse of alcohol” (p. 490). More recently Weschler, et al (2000) have emphasized the notion that “There are no magic solutions, just as no single technique applied to all students, no single approach applies to all situations (p. 209). Thus, all individuals in campus setting, administrators, faculty members, health professionals, and especially students must assume the responsibility to contribute to efforts to learn more about the dynamics of binge drinking, and of discovering new and creative ways of solving this serious health problem.
References
Abbey, S. (1991). Acquaintance rape and alcohol consumption on college campuses: How are they linked?
Journal of AmericanCollege Health, 39, 165-169.
Abbey, A. (2002) Alcohol-related sexual assault: A common problem among college students. J. Stud. Alcohol,
supplement No. 14: 118-128.
Alden, L. (1980). Preventative strategies in the treatment of alcohol abuse: A review and proposal. In
P.O. Davidson & S.M. Davidson (Eds.), Behavioral medicine: Changing health lifestyles.
New York: Brunner/Mazel.
Arata, C.M., Stafford, G., and Tims, M.S. (2003). Adolescence, 001.38, Issue 151.
Baer, J.S., Stacy, Al, & Larimer, M. (1991). Biases in the perception of drinking norms among college students.
Journal of Studies on Alcohol, 52, 580-586.
Beck, K.H., & Treiman, K.A. (1996). The relationship of social context of drinking, perceived social norms, and parental
influence to various drinking patterns of adolescents. Addictive
Berkowitz, A.D. (1990). Reducing alcohol and other drug use on campus: effective strategies for prevention programs.
The Eta Sigma Gamman, 22, 1, 12-12.
Berkowitz, A.D., & Perkins, H.W. (1986). Problem drinking among college students: A review of recent research.
Journal of AmericanCollege Health, 35, 21-28.
Bosari, B., & Carey, K.B. (2001) Peer influences on college drinking: A review of the research. Journal of Substance Abuse,
13, 391-424.
Brennan, A.F., Walfish, S. and Au Buchon, P. (1986) Alcohol use and abuse in college students: A review of individual
and personality correlates, Int. J. Addiction 21, 449-474.
CARNEGIE FOUNDATION FOR THE ADVANCEMENT OF TEACHING (1990). Campus Life: In Search of a Community,
Princeton, NJ: Carnegie Foundation for the Advancement of Teaching,
Carpenter, J.A. (1957) Effects of alcoholic beverages on skin conductance: An exploratory study. Quarlely Journal of
Studies on Alcohol, 18, 1-18.
Colwell, R., Billingham, & R., & Gross, W. (1995) Reasons for drinking, cognitive processes, and alcohol consumption.
Health Values, 19, 30-38.
Centers for Disease Control and Prevention (1997)
Chaloupka, F., Grossman, M. and Saffer, H. (2002) The effects of price on alcohol consumption and alcohol-related problems.
Alcohol Research and Health, vol. 26
Cronin, C. (1997) Reasons for drinking versus outcome expectancies in the prediction of college student drinking. Subst.
Use Misuse 32: 1287-1311
Department of Public Health and Social Behavior (2003)
Dodge, S. (1991). The use of beer kegs banned by some colleges and national fraternities. The Chronicle of Higher Education,
October, 24-27.
Douglas, K.A., Collins, J. L., Warren, C. et al. (1997). Results from the 1995 National College Health Risk Behavior Survey.
Journal of AmericanCollege Health, 46, 2, 55-66.
Diagnostic and Statistical Manual (1994) The American Psychiatric Association, 4th Edition.
Engs, R. C., Diebold, B.A., & Hanson, D.J. (1996). The drinking patterns and problems of national sample college students,
1994. Journal of Alcohol and Drug Education, 41, 13
Engs, R.C. and Hanson, D.J. (1994) Boozing and brawling on campus: A national survey of violent problems associated with
drinking over the past decade. J. Criminal Justice 22: 171-180.
Frintner, M.P. and Robinson, L. (1993) Acquaintance rape: The influence of alcohol, fraternity membership, and sports team
membership. J. Sex Educ. Ther. 19: 272-284.
Hilton, M. The presence of alcohol in four social situations: Survey results from 1964 and 1984. In: Clark, W.B. and
Hilton, M.E. (Eds.) Alcohol in America: Drinking Practices and Problems, Albany, NY: State University of
New York Press, 1991, pp. 280-289.
Ito, T.A. Miller, N., & Pollock, V.E. (1996). Alcohol and aggression: A meta-analysis on the moderating effects of inhibitory
cues, triggering events, and self-focused attention. Psychological Bulletin, 120, 60-82.
Johnston, L.D., O’Malley, P.M., and Bachman, J.G. (1997). National survey results on drug use from the Monitoring the
Future Study, 1975-1995. College Students and Young Adults, 2, 98-4140. Rockville, MD: National Institute on Drug Use.
Kanin, E.J. Date rapists: Differential sexual socialization and relative deprivation. Arch. Sexual Behav. 14: 219-231, 1985.
Kunz, M.L., Irving, W.M. & Black, D.R. (1993). Health services at large public institutions: Funding, utilization, and staffing.
Journal of AmericanCollege Health, 42, 3-14.
Manski, C. (1993). Identification of Endogenous Social Effects: The Reflection Problem. Review of Economic Studies,
60, 531-542.
Meilman, P., Presley, A., Lycrla. (2006) Black College students and Binge Drinking. Journal of Blacks in Higher Education:
No. 4, p. 70
Modestin, J., Berger, A., & Mannann, R. (1996). Mental disorder and criminality: Male Alcoholism.
Journal of Nervous and Mental Disease, 184 (7), 393-402.
Moffitt, R.A. (2001). Policy interventions, low-level equilibria and social interactions. In Durlauf, S. And Young, P. (eds.)
Social Dynamics, Cambridge: MIT Press.
Naimi, T.S.,, Brewer, R.D., Mokdad, A. et al. (2003). Binge drinking among U.S. adults. Journal of the American Medical
Association, 289,1, 70-75.
Nathan, P.E. (1983). Failures in prevention: Why we can’t prevent the devastating effect of alcoholism and drug abuse.
American Psychologist, 38, 459-467.
National Institute on Alcohol Abuse and Alcoholism Task Force of the National Advisory
Council on Alcohol Abuse and Alcoholism. (2002). A call to action: changing the culture of drinking at U.S. colleges,
02-5010. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism. Retrieved November 7, 2004, from
www.collegedrinkingprevention.gov/Reports.
Perkins, H.W. Surveying the damage (2002): A review of research on consequences of alcohol misuse in college populations.
J. Stud. Alcohol, Supplement No. 14, pp. 91-100.
Presley, C.A. Meilman, P.W. and Cashin, J.R. (1996). Alcohol and Drugs on AmericanCollege Campuses: Use,
Consequences, and Perceptions of the Campus Environment, 4, 1992-94. Carbondale, IL: Core Institute,
Southern Illinois University.
Presley, C.A., Meilman, P.W. & Lyerla, R.)1994). Development of the core alcohol and drug survey: Initial findings
and future directions. Journal of AmericanCollege Health, 42, 248-255.
Presley, C.A., Meilman, P.W. and Cashin, J.R. (1996) Alcohol and Drugs on American College Campuses: Use,
Consequences, and Perceptions of the Campus Environment, Volume IV: 1992-94, Cabondale, IL: Core Institute,
Southern Illinois University.
Presley, C.A., Meilman, P.W. and Leichliter, J.S. (2002)
College Factors That Influence Drinking. J Stud. Alcohol, Supplement No 14:82-90.
Poulson, R.L., Eppler, M.A., Satterwhite, T.N. Wuensch, K.L., and Bass, L.A. (1998) Alcohol consumption, strength of
religious beliefs, and risky sexual behavior in college students. J. Amer. Coll. Hith 46: 227-232.
Press statement: Lieberman condems binge drinking among college students as serious public health issue, May 15, 2002.
(http//hsgac.senate.gov/051502press2.htm)
Reifman, A., Barnes, G., Dintcheff, B., Farrell, M. and Uhteg, L. (1998). Parental and peer influences on the onset of heavier
drinking among adolescents. Journal of Studies on Alcohol, 59, 3, 311-318.
Schuckit, Marc A. (1998). The editor responds. The Journal of Studies on Alcohol, 123-126.
Schuckit, M.A., Kelin, J.L., Twitchell, G.R., & Springer, L.M. (1994). Increases in alcohol related problems for men on a
college campus between 1980 and 1992. Journal of Studies on Alccohol, 55, 739-742.
Sobel, M.B., and Sobel, L.C., (1973). Individualized behavior therapy for alcoholics, in Lilenfield, Seeing Both Sides:
Brooks/Cole, 1995, p. 331.
Steele, C.M. and Josephs, R.A. (1990). Alcohol myopia: Its prized and dangerous effects. Amer. Psychol. 45: 921-933.
The National Center on Addiction and Substance Abuse (CASA) at Columbia University (2007).
United States Department of Health and Human Services, 2000.
Walters, S.T. and Bennett, M.E. (2000) Addressing drinking among college students: A review of the empivical literature.
Alcoholism Treatment Quarterly, vol. 18 (1), 61-77.
Wechsler, H., Davenport, A., Dowdall, G., Hoeykens, B., & Castillo, S. (1994). Health and behavioral consequences of
binge drinking in college: A national survey of students at 140 campuses. Journal of the American Medical Association,
272, 1672-1677.
Wechsler, H., Lee, J., Kuo, M. and Lee, H. (2000). College binge drinking in the 1990s: A continuing problem. Journal of
American College Health, 48, 5, 199-210.
Wechsler, H. and Rohman (1981) Extensive users of alcohol among college students. Journal Stud. Alcohol, Jun;
42 (1): 149-155.
Wechsler, H., Davenport, A., Dowdall, G., Moeykens, B., & Castillo, S. (1994). Health and behavioral consequences of binge
drinking in college: A national survey of students at 140 campuses. Journal of the American Medical Association,
272, 1672-1677.
Wechsler H, Lee JE, Kuo M, Seibring M, Nelson TF and Lee H (2002). “Trends in College Binge Drinking During a Period
of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys:
1993-2001. Journal of AmericanCollege Health, 50(5): 203-217.
Wechsler, H., Dowdall, G.W., Maenner, G., Gledhill-Hoyt, J. and Lee, (1998) H. Changes in binge drinking and related
problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health
College Alcohol Survey. J. Amer. Coll. Hlth 47: 57-68.
Wechsler H, Lee JE, Kuo M and Lee H. (2000). “College Binge Drinking in the 1990s: A Continuing Problem Results of the
Harvard School of Public Health 1999 College Alcohol Study.” Journal of American College Health, 48(10): 199-210.
Wechsler, H., Dowdall, G.W., Maenner, G., Gledhill-Hoyt, J. and Lee, H. (1998) Changes in binge drinking and related
problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health
College Alcohol Survey. J. Amer. Coll. Hlth 47: 57-68.
White, A.; Kraus, C., McCracken, L.; Swartzwelder, H.S. (2003) Neurobiological, Behavioral and Environmental Relations
to Drinking. Alcoholism: clinical & experimental research. 27. (11): 1750-1756. |
