Dr. Dean Drosnes
For students of legal age, having a few drinks provides the opportunity to socialize with classmates and friends, let off a little steam, and take a break from the stresses of coursework and exams. But drinking in college can be a slippery slope — the most recent statistics from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found an estimated 1,519 student deaths (ages 18 to 24) each year are related to drinking. That’s just one of the reasons why it’s so important for college students to learn how to drink responsibility and recognize problematic drinking habits that may lead to bad decisions, or even injury or death.
This guide helps all students gain a better understanding of what responsible drinking looks like, with additional insights for healthcare and medical students. It also features advice from a panel of alcohol behavior experts, actionable tips for staying safe while drinking, and resources for getting help when drinking goes too far.
College Students and Drinking: The Biggest Dangers
As a college student, alcohol is everywhere you look. That’s why learning about safe and responsible drinking – including learning what your limits are – is critical. As you figure out what you can handle, you need to understand the dangers and consequences that can come with drinking too much. Let’s take a closer look at some of the biggest dangers of drinking irresponsibly.
Binge Drinking in College
Binge drinking is defined as five or more drinks for men and four or more for women on a single occasion. According to the 2018 National Survey on Drug Use and Health (NSDUH), 36.9 percent of full-time college students engaged in binge drinking and 9.6 percent engaged in heavy alcohol use. Heavy alcohol use is defined as binge drinking at least five times in the previous month.
Besides the obvious concerns students might have about being impaired in class, during clinical rotations (for healthcare students), or times when their attention is desperately needed, binge drinking can be incredibly dangerous. According to the Centers for Disease Control (CDC), there are roughly 2,200 alcohol poisoning deaths each year in the U.S. alone. Other serious consequences violent behavior, unintended injuries, and long-term chronic health issues.
How to Stay Safe:
Avoid binge drinking by always being aware of how much you’re drinking, fill up with water before and between rounds, and look to friends to hold you accountable for how many shots, drinks, or beers you’re having in an evening.
Drunk Driving in College
Drunk driving is a major concern for anyone on the roads. In 2016, the CDC reported that more than a million drivers were arrested while driving under the influence of alcohol or drugs, and 111 million adults self-reported that they drove under the influence of alcohol each year. The consequences are horrific: In addition to the property damage, injuries, hospitalization, and legal trouble, DUIs accounted for over 10,400 deaths in 2016 alone.
How to Stay Safe:
Avoid the possibility of driving drunk by making a pact with yourself that you will never, ever get behind the wheel while intoxicated. Give the keys to a friend, count on a designated driver, or keep ride-sharing apps on your phone for easy access. Keep in mind your future goals and those who might bear the consequences of your actions.
Unsafe Intimate Encounters in College
Alcohol use lowers inhibitions, and that can lead to many behaviors that someone would otherwise never engage in. One of those is risky sexual encounters; for instance, studies have found that college men are more likely to engage in unprotected sexual hookups if they have been binge drinking. There’s also the question of college students being taken advantage of during their time under the influence. The NIAAA reports that about 696,000 students per year are assaulted by other students who have been drinking, and about 97,000 students report alcohol-related sexual assault or date rape.
How to Stay Safe:
The odds of staying safe are increased when you choose to drink in groups, especially among trusted friends, and keep track of what you’re drinking. Avoid those who are drinking too much, and always your drink in sight, in your hand, to avoid the possibility of it being spiked.
How to Drink Responsibly in College
Many students choose to drink to blow off steam, relax after a big exam week, or just feel more social when they are out among friends. There’s nothing at all wrong with that, as long as the drinking doesn’t lead to bigger issues or become a dangerous act. Keep in mind that for one person, “drinking responsibly” might mean having several drinks but taking an Uber or Lyft home; for others, one drink is enough to make them feel quite tipsy. That’s why it’s so important to learn your limits and then stick to them.
10 Tips for Staying Smart at Parties/Bars and Getting Home Safe
Whether you’re going out to a frat party or just checking out a new bar near campus, there are several ways to stay safe and healthy while enjoying yourself. Here are a few things to consider.
Watch your drink
Keep a close eye on your drink. Always watch it being poured or mixed, and never accept a drink from someone else. It’s far too easy for someone to spike that drink with something that could allow them to take advantage of you.
Always have a plan to get home
Never assume you will drive yourself home. Always have a designated driver, or plan for an Uber or Lyft ride to your destination. It’s also a good idea to go home in pairs or with a group rather than on your own.
Eat something before or while drinking
Drinking on an empty stomach magnifies the effects of alcohol. Have dinner before you go out, and make a point of eating little snacks throughout the night.
Have a round of water
Ease the effects of alcohol by having a glass of water in between rounds. The water will hydrate you while filling you up, so you won’t be tempted to drink as much.
Don’t guzzle your alcohol
Guzzling alcohol, such as through a nozzle during a party game, means you can’t keep track of how much you’re really drinking. This can quickly put you in a bad situation with alcohol intake.
Know where that drink comes from
Eye that punch bowl with suspicion. Alcohol at a party in unmarked containers? Steer clear. You never know if that extra “kick” is something that could make you drunk even faster.
Rule of thumb – one drink per hour
If you’re not entirely sure how much is too much, stick to the rule of one unit of alcohol per hour. That means one beer, one glass of wine, or one shot of liquor in one hour – no more than that.
Don’t do risky things
Alcohol lowers inhibitions, so be very aware of that as you begin to drink. Things like diving into swimming pools, jumping off roofs, or driving anything with wheels are all good ways to get yourself hurt or killed while intoxicated.
Figure out your limit before you go
Don’t let your first experience with alcohol be playing beer pong at a frat party. Try out alcohol first with a sober friend or two, and pace yourself to learn your limits. When you go out, you’ll be more prepared and know how alcohol affects you.
Never mix alcohol with drugs
If you’re on prescription drugs, be very careful when drinking alcohol, as the two could create very serious consequences or side effects. Always check the label of the medications you are on to ensure alcohol will not interact in a negative way.
When Drinking Causes Problems
For most people, drinking is simply part of a good time, and the worst consequence they might encounter is an occasional hangover. But for others, there comes a time when alcohol can lead to problems. These might be short-term, as in someone having too much to drink over a weekend, or long-term, as when someone begins to make drinking a daily occurrence.
Signs Someone’s Had Too Much to Drink
When someone has had too much to drink, there are usually some pretty clear signs. If you see any of the following in yourself or others, that’s a sign that it’s time to call off the drinking:
- Slurred speech
- Repeating themselves over and over
- Uncontrollable laughter
- Lack of balance and loss of coordination
- Aggression or anger over the smallest slights
- A flushed face and bright, teary eyes
- Losing control of emotions, such as sobbing for no reason
- Difficulty with fine motor control, such as the inability to write or to shake hands
- Confusion or inability to focus
- An inability to remember things that just happened
- Lowered inhibitions, such as doing things they would never normally do
What is alcohol poisoning?
Alcohol is considered a depressant. It will gradually depress the nerves that control certain bodily functions, such as breathing or the gag reflex. Alcohol poisoning happens when a person drinks so much that these bodily functions are impaired or cease, they lose consciousness, or they experience severe issues, such as aspirating vomit into their lungs or having seizures.
Signs of alcohol poisoning include:
- Stupor or mental confusion
- Unconsciousness and an inability to wake up
- Hypothermia (low body temperature)
- Slow breathing (fewer than eight breaths per minute)
- Irregular breathing (more than 10 seconds between breaths)
Be aware that alcohol poisoning can get worse even after a person has passed out. That’s because there is still alcohol in their system that is working its way into their bloodstream so their blood alcohol level continues to rise. If you see any signs of alcohol poisoning, don’t leave that person alone! Get help immediately.
Red Flags of Problem Drinking in College
From time to time, someone might drink a little too much. But how can you tell it’s gone from a one-off problem to something much more serious? Problem drinking can sneak up on a person and suddenly, they are in way over their head. Here are some of the signs to watch for.
- Missing class because you’re too hungover to get out of bed and go.
- Drinking to a point of “blacking out” and not remembering what happened the night before.
- Grades begin to drop because you’re not going to class or drinking instead of studying.
- Getting into trouble with the law, or having run-ins with campus police.
- Losing one set of friends to make new ones who allow or encourage drinking.
- Uncharacteristic mood swings that can take you from “high” to “low” in minutes.
- Moving from drinking to using heavier substances, such as illicit drugs.
- A significant change in sleeping patterns.
- Waking up shaky and feeling the need for more alcohol to calm the jitters.
Awareness for Medical and Healthcare Students
Medical healthcare students, especially those in patient-facing fields, might find themselves under enormous pressure, both in school itself and during their face-to-face work with patients during clinicals. In some cases, their training might lead them to see things that can be traumatic, such as the aftermath of car accidents, or things that evoke strong emotions, such as a child fighting cancer. The pressure of doing their best in school coupled with dealing with stress, concern, and grief can take a toll on their mental health – and as they search for an outlet for all that emotion, they might turn to alcohol or other substances to help them cope.
Studies on burnout have found that medical school students are more prone to alcohol use than their peers who are not in medical school, especially if they are single, young, and facing large amounts of student debt. And once out of medical school, about one in 10 physicians will face issues with alcohol or drug addiction. It’s important to be aware of and prepared for these serious issues.
Student debt stress
There’s no doubt that school is expensive. Student loan debt for nursing school and medical school can add up quickly, and it can take a while to find a job that allows graduates to make those payments without working themselves into the ground. And that often leads to the next point: burnout.
Burnout from long hours in clinical rotations
Long hours in school, clinicals, and residency can lead to symptoms of burnout, which can eventually lead a student to look for ways to alleviate the constant stress. Letting loose a bit with the help of alcohol from time to time can be a nice release, but when it happens too often, it becomes a problem rather than a solution.
Dealing with life and death situations
Doctors and other healthcare professionals often hold life or death matters in their hands – sometimes quite literally. This can be difficult for even the most stalwart person. There is no doubt that over time, these situations can have a massive impact on a person’s mental health. When looking for ways to cope, they might reach for alcohol and other substances.
Where to Get Help for Drinking
When you realize there’s a problem, you’re ready to get the help you need. In some cases that might mean backing away from the drinking for a while and finding your “old normal” again. For some, the problem might run deeper than that, and help might require stopping drinking for good or even getting professional help from a rehab facility. But to figure that out, it’s important to reach out to professionals who can help you figure out what the next step should be.
The student health center is the first place to go to find in-person help. Some student health centers might have counselors on staff, while other centers might refer you out to someone who can help. The student health center is often located right on campus; if the campus is connected to a hospital, the center might be located within a hospital building. Look at your college directory to find it.
There are other on-campus resources to try. Some campuses offer 12-step groups, therapy groups that focus on alcohol and substance abuse, and special one-on-one therapy sessions with student volunteers. The broader community might also offer options, such as 12-step programs, alcohol treatment facilities, mentors and sponsors specifically looking to help those with alcohol issues, and more.
Online Therapy / Apps
Online therapy through telehealth can be a wonderful way to connect with help and keep it as anonymous as you’d like. But you can also establish an ongoing relationship with a good therapist and experience that same kind of therapy sessions you might have if you were face-to-face. Numerous apps can either help you connect with a therapist or help you track your recovery and progress on your own. Here are a few:
- Better Help: This app connects users with over 3,000 therapists to help talk through issues, including depression, anxiety, and alcohol problems.
- Doctor on Demand: Looking for a good assessment? This app will help you figure out the kind of help you need and direct you to it.
- I Am Sober: This app offers group help, motivation, and ways to track your days of sober living.
- Sober Grid: This app works by connecting users with local individuals who are dealing with the same issues, thus creating a “grid” of support groups.
- Talkspace: Designed for those who prefer online meetings, this app connects individuals with over 2,000 licensed therapists.
College Alcohol Insights from the Experts
Alcohol can sometimes be a gateway to harder substances. Could you provide some insight and tips into how students can stop that downhill slide in its tracks?
Kelly Kitley: Awareness is key! Know your family’s history of mental health and addiction. It is a genetic disease that will try to convince you that you don’t have a problem. You are more predisposed to developing alcohol abuse if there’s a family history. Some of my clients have tried to cut back use of alcohol by smoking pot or taking edibles. It doesn’t matter what the substance is, addiction is addiction is addiction, is my saying. What’s underneath it? What are you trying to numb?
Dr. Dean Drosnes: It’s important for college students to understand that while alcohol use may lead to other substance use, alcohol is not simply a “gateway” substance – its use is illegal for those under the age of 21 and is dangerous on its own. In fact, alcohol use is the third leading preventable cause of death in the United States, ahead of opioid overdoses, automobile crashes and gun violence. Alcohol is as dangerous as other “harder” substances. For most people, the dangers of indulging in alcohol outweigh the benefits. In fact, the World Health Organization (WHO) says there is no safe amount of alcohol.
If a student finds that he or she is turning to alcohol to cope with social anxiety or academic pressure, that’s a red flag. It’s best to seek professional help immediately and most university systems offer behavioral healthcare support. There are plenty of ways to enjoy life and manage stress without turning to substances.
Medical and healthcare students are under great pressure with student debt, making the best grades, and sometimes facing situations that test their resiliency, such as difficult patient outcomes. What are some good coping mechanisms for this unique group of students?
What are some of the more subtle red flags that indicate a student has gone from “having a good time” to “having a problem”?
Sometimes college students want to pretend everything is fine, even when it’s not. How can they find the courage to admit to a problem and get help?
Anything you’d like to add about student alcohol use in college?
- Alcohol & Substance Abuse Prevention
This helpful page from California State University Monterey Bay provides tips on spotting alcohol poisoning and other problems.
- Alcoholics Anonymous
This popular organization has chapters all over the world, including on college campuses. Attendance is confidential.
- Centers for Disease Control and Prevention: Alcohol Portal
This answers numerous questions about drinking alcohol in various situations.
- College Drinking
This site focuses on the problem of drinking too much in college and what institutions of higher learning can do to help their students.
- The Drink Wheel
Not sure how many drinks your body can handle? This can give you a good idea of what that number might be.
- Federation of State Physician Health Programs
This organization focuses on the health of physicians, including those dealing with alcohol abuse.
- National Institute on Alcohol Abuse and Alcoholism
This website, part of the National Institutes of Health, focuses on the effects of drinking too much.
- Positive Sobriety Institute
This is a rehabilitation facility dedicated to medical professionals.
- Responsible Drinking
This is a fun website that focuses on a serious issue. Click through the various questions and articles to find a wealth of information on drinking responsibly.
- Substance Abuse and Mental Health Services Administration
This website offers a wealth of pertinent information as well as a 24/7 helpline.