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High-Risk Drinking in College: What We Know and What We Need To Learn

The Panel on Contexts and Consequences

The Panel on Contexts and Consequences examined the current situation regarding alcohol consumption among college students to define the parameters, magnitude, and characteristics of problem drinking in college. It then summarized and integrated information from varying data sources in an effort to translate research findings more effectively for university administrators, faculty, staff, and students. The Panel’s ultimate goal was to develop a report that would help colleges and universities reduce excessive alcohol use on campus. The Panel’s deliberations included a special focus on heavy episodic drinking by college students under the legal drinking age of 21 because of the impact of this behavior on students and the institutions they attend.

The purpose of the Panel’s report was to:

  • Provide a current overview of alcohol consumption among college students;
  • Integrate research findings, summarize what is known, and identify gaps in knowledge about college student drinking;
  • Suggest factors, problems, and issues that colleges and universities should consider in developing strategies to reduce excessive student drinking; and
  • Suggest factors, problems, and issues that researchers and NIAAA should consider in designing and supporting studies to bridge gaps in knowledge.

In a series of meetings held in the Washington, D.C., metropolitan area, members of the Panel on Contexts and Consequences discussed the topics to be included in the commissioned papers; invited authors with the necessary backgrounds and expertise to develop the papers; listened to the authors of the papers present their draft articles; critiqued multiple drafts of the papers in an ongoing peer-review process; and identified areas in need of more research (see Exhibit 2 for a list of commissioned papers). The Panel’s sessions were marked by a free sharing of scientific ideas and discussion that gave every Panel member and author an opportunity to present his or her point of view.

The following sections summarize and synthesize the principal points made in the commissioned papers and during the Panel’s discussions. Figures providing a graphic presentation on the scope of the problem can be found in the appendix.

Overview of College Student Drinking

Alcohol misuse on college campuses is not a new problem. It is entrenched in the culture of many institutions of higher learning and in students’ social lives. U.S. youth and college administrators alike cite alcohol as the most pervasively misused substance on campus. Recent news stories publicizing alcohol-related deaths on college campuses have drawn attention to this public health problem. Alcohol misuse among college students is taking its toll not only on the students who drink alcohol to excess, but also on other students affected by the behavior of their drinking peers, college administrators, health care personnel who counsel student drinkers, the community, and the institution’s physical plant and grounds, which often sustain heavy damage from vandalism by inebriated college students.

Recent concerns have often focused on the practice of binge drinking, typically defined as consuming five or more drinks in a row for men, and four or more drinks in a row for women. A shorthand description of this type of heavy episodic drinking is the “5/4 definition.” Approximately two of five college studentsmore than 40 percenthave engaged in binge drinking in the past 2 weeks, according to this definition. It should be noted, however, that colleges vary widely in their binge drinking ratesfrom 1 percent to more than 70 percentand a study on one campus may not apply to others (Wechsler et al., 1994, 1998, 2000b).

The U.S. Surgeon General and the U.S. Department of Health and Human Services (USDHHS) have identified binge drinking among college students as a major public health problem. In Healthy People 2010, which sets U.S. public health goals through the year 2010, the Federal government has singled out binge drinking among college students for a specific, targeted reduction (i.e., from 39 to 20 percent) by the year 2010. Healthy People 2010 notes that: “Binge drinking is a national problem, especially among males and young adults.” The report also observes that: “The perception that alcohol use is socially acceptable correlates with the fact that more than 80 percent of American youth consume alcohol before their 21st birthday, whereas the lack of social acceptance of other drugs correlates with comparatively lower rates of use. Similarly, widespread societal expectations that young persons will engage in binge drinking may encourage this highly dangerous form of alcohol consumption” (USDHHS, 2000).

There is evidence that more extreme forms of drinking by college students are escalating. In one study, frequent binge drinkers grew from 20 to 23 percent between 1993 and 1999. The number of students who reported three or more incidents of intoxication in the past month also increased (Wechsler, et al., 2000b). It should be noted, however, that the number of college students who do not drink is also growing. In the same study, the percentage of abstainers increased from 15 to 19 percent.

Binge drinking is not unique to the United States. Although the cross-cultural literature is scant, college students in the United States seem to drink somewhat less than their counterparts in European countries and somewhat more than their counterparts in Asian countries. There is some evidence that problematic drinking-related behaviors such as rowdiness, aggressiveness, and inappropriate actions are more pronounced in the United States than in some other countries (Delk and Meilman, 1996; Hong and Isralowitz, 1989; Leadley and Greenfield, 1999).

Barriers to Reducing Alcohol Misuse

Barriers to reducing alcohol misuse on college campuses are numerous. Alcohol use is woven into U.S. culture, is sanctioned by adults for the pleasure of adults, and is associated with times of celebration and happiness. From an early age, many American children see adults drinking at home, in restaurants and clubs, and at parties. They expect to participate in this activity as they grow into adulthood. Although the legal U.S. drinking age is 21 in all States, students know that enforcement of this law is lax in many college environments.

All too frequently, adults sell liquor to underage students without asking for proper identification. Underage students also obtain alcoholic beverages from older students or obtain false identification so they can buy liquor before they reach the age of 21. As one student put it, “[Our] campus culture is most easily identified by the drinking culture. Within weeks of their arrival, freshmen have purchased fake IDs and are frequenting the bars…” (Murphy and Trejos, 2000). Drink specials in bars such as two-for Tuesdays (days on which two beers can be had for the price of one) reinforce drinking as a cultural norm and a way for college students to socialize. “Part of college life is drinking, and you’re not going to change that,” said another student. “I like the bar scene because it’s one way I get to hang out with my friends” (Murphy and Ly, 2000).

Drinking alcohol to excess impairs judgment and self-control. When drinking among college students leads to destructive consequences, including fights, college students themselves are often hard-pressed to explain what happened. “It’s a really weird mix of testosterone, alcohol, and some really unseemly behavior,” said one young man (Murphy and Trejos, 2000).

While recognizing that students and colleges and universities are increasingly diverse, this report focuses primarily on students who attend 4-year, residential colleges immediately or shortly after high school. The report focuses on this group because of concerns that certain factors related to the “traditional” college experience may inadvertently encourage, permit, or even reward excessive drinking behavior.


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Historical document
Last reviewed: 9/23/2005

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