Addressing Alcohol Use Among College Students: A National Perspective on a Growing Epidemic

1. Addressing Alcohol Use Among College Students: A National Perspective on a Growing Epidemic Presented by: Stacie M. Schroeder Fayette County SPF SIG Coordinator Helping Services for Northeast Iowa

2. High-Risk Drinking High-risk college student drinking includes the following: • Underage drinking • Drinking and driving or other activities where the use of alcohol is dangerous • Drinking when health conditions or medications make use dangerous • Binge drinking; that is, 5 drinks in a row per occasion for males and 4 for females* • *Moderate drinking by persons of legal age is defined as no more than 2 standard drinks per day for men and 1 drink per day for women.

3. Consequences • Death:  1,825 college students between the ages of 18 and 24 die from alcohol-related unintentional injuries, including motor vehicle crashes (Hingson et al., 2009).Injury:  599,000 students between the ages of 18 and 24 are unintentionally injured under the influence of alcohol (Hingson et al., 2009). • Assault:  696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking (Hingson et al., 2009). • Sexual Abuse:  97,000 students between the ages of 18 and 24 are victims of alcohol-related sexual assault or date rape (Hingson et al., 2009). • Unsafe Sex: 400,000 students between the ages of 18 and 24 had unprotected sex and more than 100,000 students between the ages of 18 and 24 report having been too intoxicated to know if they consented to having sex (Hingson et al., 2002). • Academic Problems: About 25 percent of college students report academic consequences of their drinking including missing class, falling behind, doing poorly on exams or papers, and receiving lower grades overall (Engs et al., 1996; Presley et al., 1996a, 1996b;Wechsler et al., 2002).

4. Consequences • Health Problems/Suicide Attempts: More than 150,000 students develop an alcohol-related health problem (Hingson et al., 2002), and between 1.2 and 1.5 percent of students indicate that they tried to commit suicide within the past year due to drinking or drug use (Presley et al., 1998). • Drunk Driving: 3,360,000 students between the ages of 18 and 24 drive under the influence of alcohol (Hingson et al., 2009). • Vandalism: About 11 percent of college student drinkers report that they have damaged property while under the influence of alcohol (Wechsler et al., 2002). • Property Damage: More than 25 percent of administrators from schools with relatively low drinking levels and over 50 percent from schools with high drinking levels say their campuses have a "moderate" or "major" problem with alcohol-related property damage (Wechsler et al., 1995). • Police Involvement: About 5 percent of 4-year college students are involved with the police or campus security as a result of their drinking (Wechsler et al., 2002), and  110,000 students between the ages of 18 and 24 are arrested for an alcohol-related violation such as public drunkenness or driving under the influence (Hingson et al., 2002). • Alcohol Abuse and Dependence: 31 percent of college students met criteria for a diagnosis of alcohol abuse and 6 percent for a diagnosis of alcohol dependence in the past 12 months, according to questionnaire-based self-reports about their drinking (Knight et al., 2002).

5. Past Education and Prevention Efforts • Educational Programming • Policy Development • Individual Intervention • Peer Education • Assessment/surveys of student drinking behaviors • Sanction classes, then online education • Changed “ladies night” in the bars • Incentive grants • Social norms marketing • Late-night programming

6. Did it work? College Drinking Patterns, 1980 - 2003 Johnston, et al., 2004

7. Did it work? Daily & Heavy Episodic Drinking, Ages 18-40 Monitoring the Future, 2002

8. How is college student drinking different? • Tendency to “bunch” drinks in heavy episodes. • Tendency to drink around known (and especially social) events. • Environmental, individual and developmental factors interact to determine drinking. • Most students change drinking after graduating. College drinking, for most, does not cause later problems.

11. First-year students • The first 6 weeks of enrollment are critical to first-year student success.  Because many students initiate heavy drinking during these early days of college, the potential exists for excessive alcohol consumption to interfere with successful adaptation to campus life.  The transition to college is often so difficult to negotiate that about one-third of first-year students fail to enroll for their second year. www.collegedrinkingprevention.gov

12. Living Arrangements • The proportion of college students who drink varies depending on where they live. Drinking rates are highest in fraternities and sororities, followed by on-campus housing (e.g., dormitories, residence halls). Students who live independently off-site (e.g., in apartments) drink less, while commuting students who live with their families drink the least. www.collegedrinkingprevention.gov

13. College Characteristics • A number of environmental influences working in concert with other factors may affect students’ alcohol consumption. Schools where excessive alcohol use is more likely to occur include: • Schools where Greek systems dominate (i.e., fraternities, sororities) • Schools where athletic teams are prominent • Schools located in the Northeast www.collegedrinkingprevention.gov

14. Established Drinking Patterns • Although some drinking problems begin during the college years, many students entering college bring established drinking practices with them. Thirty percent of 12th-graders, for example, report binge drinking in high school, slightly more report having “been drunk,” and almost three-quarters report drinking in the past year. Colleges and universities “inherit” a substantial number of drinking problems that developed earlier in adolescence. www.collegedrinkingprevention.gov

15. Secondhand Consequences • Students who do not drink or do not abuse alcohol experience secondhand consequences from others’ excessive use. In addition to physical and sexual assault and damaged property, these consequences include unwanted sexual advances and disrupted sleep and study. The problems produced by high-risk drinking are neither victimless nor cost-free. All students—whether they misuse alcohol or not—and their parents, faculty, and members of the surrounding community experience the negative consequences wrought by the culture of drinking on U.S. campuses. www.collegedrinkingprevention.gov

16. Other Factors Affecting Binge Drinking • Biological and genetic predisposition to use • Belief system and personality • Expectations about the effects of alcohol • Availability of alcohol in the area surrounding a campus www.collegedrinkingprevention.gov

18. How does this affect UIU? • As the numbers show, the consequences of college drinking are more significant, more destructive, and more costly than many Americans realize.  • In addition to the damage done to student lives, these consequences affect: • The reputation of the institution • The ability to attract and retain outstanding students • The college’s academic ranking • The institution’s operating costs • Legal ramifications • The relationship of the campus with the community www.collegedrinkingprevention.gov

19. High-Risk Drinking Prevention Efforts Now and into the Future • The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends a 3-in-1 framework to address high-risk drinking. • The research strongly supports the use of programs: • Comprehensive and integrated • Multiple complimentary components • Targeting: • Individuals, including at-risk or alcohol-dependent drinkers • The student population as a whole, and • The college and surrounding community (Hingson and Howland, 2002; DeJong, et al., 1998, Institute of Medicine, 1989; NIAAA, 2007)

20. The 3-in-1 Framework

21. 3-in-1 Framework: Individuals • Non-dependent, high-risk drinkers account for the majority of alcohol-related problems on college campuses (Lemmens, 1995; Kreitman, 1986). Individual Strategies: • Judicial Sanctions • Intervention • E-Chug • Brief Counseling • Referral • Treatment • Long-term Counseling • Support Groups • Screening for dependence or high-risk use

22. 3-in-1 Framework: Student Body • The key to affecting the behavior of the general student population is to address the factors that encourage high-risk drinking.DeJong and Langenbahn, 1996; DeJong and Linkenbach, 1999; DeJong and Langford, 2002; Perkins, 2002; Toomey and Wagenar, 2002; Toomey et al., 1993) Student Body Strategies • Substance Abuse Prevention Task Force • Clear Alcohol Policies • Policy Enforcement • Universal Prevention • Online education • Outreach presentations • Peer education • Social marketing • Counseling • Skilled Prevention Staff • Campus and Surrounding Community

23. 3-in-1 Framework: Campus and the Surrounding Community • Mutually Reinforcing Interventions: • Change the broader environment • Help reduce alcohol abuse and problems over the long term. • When college drinking is reframed as a community strategy as well as a college problem: • It is addressed comprehensively. • The total drinking environment is affected. • Campus and Community alliances also: • Improve relationships overall • Enable key University and community entities to work cooperatively in resolving issues involving students. (Hingson and Howland, 2002; Holder et al., 2000; Perry and Kelder, 1992)

24. 3-in-1 Framework: Campus and the Surrounding Community Strategies • Campus-Community Coalition • Environmental Strategies • Social Host Ordinance • Restricted Promotion of Alcoholic Beverages • Server Training • ID Checks • Alcohol-Free Events • Local Law Enforcement • Media Advocacy • Awareness and Information

25. Questions to Ask in Determining Next Steps… • 1. What type of problem needs to be addressed (e.g., high rates of heavy drinking, fights during sporting events, underage drinking)? • 2. What strategy is most likely to address each problem? • 3. At what level should the strategy be implemented (e.g., at sports stadiums, campus-wide, communitywide, Statewide)? • 4. Who should participate in developing strategies? Who should participate at the start and who should be brought in only after a supportive base for action is established? • 5. What strategies are currently being implemented? • 6. How well are existing policies being enforced? • 7. Would enforcement of existing policies be more effective than implementing new policies? • 8. How can environmental and individually focused approaches complement each other? • 9. What resources are needed to implement new strategies? Are resources available? • 10. How will new strategies be evaluated and fine-tuned to maximize their effect? • 11. Are the students who need help most actually getting it? That is, are your interventions reaching the students who need them the most? • 12. Are your strategies founded on solid, research-based findings? And are those strategies reaching the vast majority of your student population? SOURCE: Material for this checklist originally appeared in Toomey, T.L., and Wagenaar, A.C. Environmental policies to reduce college drinking: Options and research findings. Journal of Studies on Alcohol (Suppl.14):193–205, 2005, Updated January 2005 for NIAAA.

26. Comparison of Like-size Universities in Iowa • Wartburg College, Waverly • Luther College, Decorah • University of Dubuque, Dubuque • Buena Vista University, Storm Lake • Coe College, Cedar Rapids

31. Next steps…. • What are the next steps? • What additional policies and information should be considered? • When is the next meeting?