On September 29 of last year, M.I.T. freshman Scott Krueger died of alcohol poisoning in a Boston hospital after being comatose for three days. Krueger, a fraternity pledge who had binged on sixteen drinks, had been rushed to the hospital with a blood-alcohol level of .41, more than four times the legal limit for intoxication. A month before Krueger's death, Benjamin Wynne, a student at Louisiana State University, died under similar circumstances. Alcohol-related deaths had also occurred recently at the University of Virginia, Fordham University, Virginia Tech, and six other schools.
Suddenly, newspapers around the country began carrying articles about binge drinking, which reporters portrayed as a new and menacing phenomenon. A lengthy article on the subject in the New York Times was subtitled "The Emergency on Campus," and the Providence Journal-Bulletin joined the fray with a feature on a Thursday-night binge by four Brown fraternity brothers. Amid the sensational reporting, however, crucial questions became obscured. How serious a problem is binge drinking among college students? Is it the most serious alcohol-related problem universities face?
Until recently, statistics on excessive drinking were scant; even now there are no reliable figures on how many students die each year due to alcohol poisoning. Experts define a binge as five or more drinks on one occasion for a man, or four or more for a woman, but the quantity of alcohol is less significant than the pace of its consumption. "When you're drinking slowly," explains MaryLou McMillan, Brown's director of health education, "your body has the opportunity to respond. At a .3 blood-alcohol level, you pass out." However, when the same amount is drunk all at once, the body keeps absorbing alcohol even after the drinker passes the .3 threshold. "You've ingested a dose fifteen times stronger than that of someone who's drinking slowly," McMillan continues. "That's when we see serious consequences."
A comprehensive 1993 study by Henry Wechsler and his colleagues at Harvard's School of Public Health has been instrumental in defining the scope of the college binge-drinking problem. The survey, which appeared in late 1994 in the Journal of the American Medical Association, was based on the drinking habits of 7,000 college students, including 128 students from Brown. The number of binge drinkers at Brown was slightly lower than the national average: 36.5 percent had binged at least once during the two weeks prior to the survey, compared with 44 percent for the entire national sample. "Binging is a problem at all colleges," Wechsler explains, "not just at the ones with low S.A.T. scores."
Wechsler believes that the percentage of binge drinkers remains stable. What is changing, however, is the profile of the typical binge drinker. McMillan says that over the last decade, women drinkers have caught up to men drinkers. "There are fewer taboos against women being drunk," she says. "In terms of the number of drinks consumed, men still drink more, but they're bigger and are able to metabolize alcohol better. I tell women, `Don't try to keep up with the guys on this one.' "
There will always be more binge drinking among college students than among the general population. It's a social activity, something done among friends to blow off steam or celebrate a football victory. A student who misses a nine o'clock class because of a hangover suffers fewer consequences than someone who doesn't show up for work. When their responsibilities change after graduation, most college bingers go on to lead normal, unaddicted lives.
But one of the great dangers of binge drinking is that it can serve as a cover for students who are in danger of becoming, or who have already become, alcoholics. "Some binge drinkers have the disease of alcoholism," says David Lewis, director of Brown's Center for Alcohol and Addiction Studies and a professor of medicine and community health, "and their disease is facilitated by hiding it among a group of people who are episodic heavy drinkers." Wechsler's study reported that 80 percent of fraternity members are binge drinkers; at least some among them will develop a serious drinking problem.
A student doesn't have to belong to a fraternity, however, to be a binge drinker or alcoholic, as Scott's story proves. A junior biology concentrator, Scott (not his real name) neither belongs to a fraternity nor frequents Greek parties. He is, however, a recovering alcoholic. In five semesters of college, he has put his hand through a window in the University's greenhouse, vomited in Perkins Hall, and been carried by paramedics from the stage of Salomon 101. As an alcoholic, he is one of the 20 percent of Brown students McMillan believes to be most at risk, a figure that includes both alcoholics and those whom she labels "excess drinkers."
Binge drinking can serve as a cover for students who are either alcoholics or on the verge of serious alcoholism.
Scott describes himself as coming from a long line of Irish-American alcoholics. His father is in recovery, and his grandfather died of alcoholism. "I grew up knowing to be careful with alcohol," he says. "I used to tell my dad that it would be easy for me not to become an alcoholic. All I had to do was never take a drink."
Scott's commitment to sobriety lasted until his sophomore year in high school, when he tried Jack Daniels with a group of friends. He remembers his first drinking experience as being "fun," but his second, a month later, as "negative and scary." What frightened him most was a four-hour stretch of time that he could not remember. "I later came to understand that it was my first blackout," Scott says.
Throughout high school, Scott drank on most, but not all, weekends. "When I was drinking, everything seemed less serious," he says. "It reduced my anxiety and allowed me to feel more comfortable." Scott threw up a lot and regularly experienced "grayouts" (occasions when his recollection of events was muddled), but he didn't let drinking interfere with his schoolwork. In fact, Scott didn't suspect anything was wrong until he got to Brown. One night during his freshman year, he got drunk and began jumping down staircases in Andrews Hall. "I felt like Superman,"he recalls. "In reality I was lucky I didn't break something."
Similar incidents followed. He vomited in Perkins Hall one night, but on a subsequent visit to the dorm, he had no recollection of having been there before. At Campus Dance that May, Scott feared that since he was underage, he'd have trouble getting alcohol. So he drank "a lot of hard liquor, really fast" beforehand. "I somehow got separated from my friends when I got there," he says. "It's a big gray blur." What he does remember is punching his hand through a window in the greenhouse.
His hand bleeding, Scott made his way into the Salomon Center's cavernous auditorium and sat down in a rolling chair on stage. "I felt like Ken Miller," he says, referring to the biology professor who uses the lecture hall for his Bio 20 class. Eventually someone called Brown's paramedics, and they took Scott to Health Services, where he convinced the staff that he had hurt his hand by falling on a bottle. "They concluded that I was only moderately drunk," he says.
By sophomore year, Scott had fallen into serious depression. "I wasn't drinking much then, but I was in bed all the time and I cried a lot," he recalls. Bruce Donovan '59, dean of chemical dependency, was randomly assigned to be Scott's academic adviser, and in the course of discussing how depression was affecting his schoolwork, Scott mentioned that he believed his drinking might be related. The two agreed he should take some time off from school. In the year Scott spent away from Brown, he cycled in and out of binging. "Drinking was no longer enjoyable," he says. "Every time I would drink I would feel anxious for days afterward. I would stay away from alcohol for a couple of weeks, then go back."
Many experts believe that banning alcohol on campus would not reduce drinking, but would move it to the more dangerous world of public bars and unsupervised apartments.
When Scott returned to Brown, he met with Donovan and told him, "I feel like I need to not drink this semester." Donovan told Scott about E-SOB - the Early Sobriety Group, a campus support group for recovering alcoholics. "He said I had to be willing to consider stopping altogether," Scott says, "not just for a semester." He found the stringency of Donovan's request troubling. Though he had finally realized that he, in his own words, "had a problem," Scott was still unwilling to admit, either to himself or to anyone else, that he was an alcoholic.
A freshman in E-SOB encouraged Scott to attend a meeting of Alcoholics Anonymous and eventually became Scott's "sponsor" - A.A.-speak for a fellow A.A. member who is willing to offer individual support. Scott began to view sobriety as a long-term, rather than a semester-long, goal. He now attends A.A. meetings six times per week and E-SOB once a week. He has been sober for one year.
"It's hard, but not impossible, to be sober in college," he says. "It doesn't lead to a miserable existence. Getting sober is the best thing I could have done. Itruly feel blessed. I wasted a lot of time when I was drunk. Important things, like building relationships, are hard to do in a drunken stupor."
What can universities do to prevent deaths from binge drinking and students from becoming alcoholics? Negative publicity over college drinking is often followed by calls to ban alcohol on campuses, either temporarily or altogether. However, many experts agree with Donovan, McMillan, and Scott that such easy policy changes would not reduce student alcohol consumption, but would only move it off-campus to the potentially more dangerous realm of public bars and unsupervised apartments. Off-campus drinking, McMillan adds, could also increase incidents of drunk driving.
Donovan believes that the single best approach to dealing with the problem of college drinking is to be realistic. Excessive drinking on college campuses has been happening for decades, and it is a problem that is here to stay. It is crucial, he maintains, "to recognize it for what it is and embrace the truth." McMillan agrees. "There will always be a segment of the population that drinks heavily," she says. "There will always be a search for an altered state of human consciousness. It's why children spin around until they're dizzy. It's why we ride roller coasters. It's why college students drink. It's our job to teach them how to avoid serious consequences."
Education may suffice for most bingers, who can be warned of the risks inherent to excessive drinking. But because alcoholics require much more intervention and treatment, they present a distinct, and perhaps more difficult, challenge for universities. Administrators at Brown refer such students for treatment and sponsor a support group for recovering alcoholics, but as McMillan says, "It's a matter of getting people into the system." A student treated medically for drunkenness gets a mandatory visit to the health education office, and a student charged with an alcohol-related offense often receives alcohol education as part of his sentence.
Various University treatment programs may help students become aware of their problems; however, the determination to choose a better life must come from within. "When you're ready to stop drinking," says Brian, another recovering alcoholic, "there are plenty of resources at Brown. But you have to be ready."