Although alcohol abuse and dependence have, in general, been declining in American society, one specific segment of the American population continues to see epidemic use of alcohol. College campuses across the United States are filled with students who regularly use, and frequently abuse, alcohol. And, according to one Harvard researcher, many of today’s college students may be diagnosable as alcohol dependent.

In 1999, 67 percent of students responding to the Harvard School of Public Health’s College Alcohol Study (CAS) said that they had consumed alcohol in the last 30 days.

The study appeared in the March issue of the Journal of American College Health. The results were reported by Henry Wechsler, Ph.D., director of Harvard’s College Alcohol Study Program and principal investigator for the CAS at the "Medical Aspects of Addiction" conference in June in Myrtle Beach, S.C.

"These college kids," Wechsler told the group, "are drowning in a sea of alcohol."

Wechsler’s team surveyed more than 14,000 students at 140 colleges and universities across the U.S. in 1993, 1997, and again in 1999. The individual campuses were picked to represent a cross-section of college life in America.

The results provide a startling view of alcohol abuse and potential dependency among America’s college students.

"Binge drinking," Wechsler told Psychiatric News, "is a very serious, strongly impacting, and longstanding problem."

Although patterns vary widely from one campus to another, the overall picture is grim. The phenomenon of heavy, episodic, or "binge" drinking by college students has been known for decades. The Harvard team defined binge drinking as having five or more drinks in a row for men, four or more in a row for women. College drinkers were further defined in the survey as: abstainer (in the past year), nonbinge drinker (drinks alcohol, but does not binge), occasional binge drinker (binged one or two times in the two weeks prior to the survey), or frequent binge drinker (binged three or more times in the two weeks prior to the survey).

In the 1999 survey, 19.2 percent were abstainers, 36.6 percent were nonbinge drinkers, 21.4 percent were occasional binge drinkers, and 22.7 percent met the criteria for frequent binge drinking.

Frequent binge drinkers were found to average 17 drinks a week. However, the extent of binge drinking varied greatly among campuses. At some campuses, no students were identified as frequent binge drinkers, while at others, as high as 80 percent were frequent binge drinkers. At one-third of the campuses surveyed, over half of the students were identified as binge drinkers.

Although no change occurred in the overall binge-drinking rates from 1993 to 1999, there has been a significant increase in heavier drinking over the six years. The number of frequent binge drinkers increased as well as the proportion of students who were drunk three or more times in the prior two weeks and who drank on 10 or more occasions. Interestingly, during the same period, the rates of abstaining from alcohol also increased.

The CAS does not name any of the campuses surveyed, and Wechsler guaranteed their anonymity in return for their cooperation with the survey.

Wechsler pointed out that the CAS is a self-report survey, so some error undoubtedly exists in the results. However, the data closely match the results of other studies, using more reliable data-collection methods, said Wechsler.

Frequent binge drinkers reported that they have frequent, significant consequences to their drinking. Compared with nonbinge drinkers, they were 17 times more likely to miss class, five times more likely to engage in unplanned or unprotected sex, 12 times more likely to damage property, 13 times more likely to be involved with the police, and 21 times more likely to experience five or more alcohol-related problems.

Wechsler likened binge drinkers to the team of Clydesdale horses used in advertising for a popular beer product. "They are a very attractive team of horses," said Wechsler, "but have you ever tried to clean up after them? It’s the same with binge drinkers."

However, the effects of binge drinking are not confined simply to the drinkers themselves. "Secondhand effects from binge drinking," said Wechsler, "are widespread and significant."

Secondhand effects reported by nonbinge drinkers and abstainers included having sleep or study interrupted; having to babysit a drunken student; having property damaged; being hit, pushed, or assaulted; and experiencing an unwanted sexual advance.

Characteristics of likely binge drinkers are fairly predictable, said Wechsler. Being a white male, age 23 or younger, involved in intercollegiate athletics, living in or belonging to a fraternity house, and smoking cigarettes and/or marijuana drastically increase the odds that an individual binges.

Interestingly, added Wechsler, religious involvement was not found to be important in preventing binge drinking. Moreover, although women students do binge, they usually do so with men, and often in an attempt to keep up with the men’s alcohol consumption.

"It took a Harvard professor," commented Wechlser, "to figure out that in some sense, men lead women to drink."

The single most predictive factor for binge drinking in college, said Wechlser, was whether a student had binged in high school. "To that extent," Wechlser said, "colleges inherit one half of their binge-drinking problem."

Do binge drinkers fit the criteria to be diagnosed as alcoholics? "We have looked at that," Wechsler told Psychiatric News. Wechsler’s team will publish data in the near future on the number of students who meet DSM-IV diagnostic criteria for alcohol abuse and dependence. The numbers are substantial.

"To turn this around," Wechlser told a breakout session at the conference, "we are going to have to completely change the campus culture." Most college campuses are ringed by bars, said Wechsler, and most athletic events are heavily sponsored by alcohol manufacturers. Alcohol is easily and cheaply available in large quantities at almost all campuses nationwide.

No data are yet available, said Wechlser, to suggest whether college binge drinkers go on to become lifetime problem drinkers or alcoholics. "But, my guess," he told Psychiatric News, "would be that those numbers are substantial."

Wechsler’s recommendation would be to take a coalition approach and bring all aspects of the university and the community together to work jointly at changing the environment and the culture that encourages the problem.

Effective controls on price and access to alcohol and fraternity and off-campus parties, as well as reinforcement of the minimum drinking age laws, are necessary, suggested Wechlser, if the high levels of binge drinking and related health and behavioral problems are to be reduced.

"I’m not suggesting," Wechsler said, "that we give students a breathalyzer rather than an SAT. But I think that the admissions office should play a role, and at least spread the message, right from the beginning, about the college—no drinking."