16 January 2005 Just Say No? No Need Here


New York Times, New York, N.Y.

LIKE many students enjoying the newfound freedom of college, the young man accelerated the drinking he had begun at prep school. You go nuts, he explains, looking back, seemingly both amazed and disgusted. At 6-foot-1 and 215 pounds, he was able to put away up to 18 beers a night at weekend parties. It was crazy, says the student, now a junior at Fairfield University, adding that afterward, Id feel like death all day.

At one party last spring, he drank so much rum that he doesnt remember anything that happened. Other students complained about his behavior and a graduate assistant escorted him to his room. When a campus security guard showed up to talk to him the next day, I was still drunk at 3 p.m., he says.

The university bans alcohol for students under the legal drinking age of 21. Twice before that worrisome blackout, university authorities had penalized him for drinking. For beer in his dormitory room on a substance-free floor in freshman year, he paid a $50 fine and lost his spot there. The next year, a security guard caught him smuggling a 30-pack of beer into his dorm to entertain friends from Marist College. I was almost compelled to get it, he says. Its a standard of a good time in college. As punishment, he paid a $75 fine and had a talk with his coach on the varsity baseball team.

But for this last violation, he was evaluated by a licensed drug and alcohol counselor, ordered to attend the universitys fledgling drinking-reduction program and placed on probation. If he didnt comply, he would have to leave school and lose his academic scholarship.

The eight-session therapeutic program was life-changing, perhaps life-saving. That is why this likable, driven young man is willing to share his story, though not his name, fearing that his past will interfere with his chance of getting into law school. I dont binge, thats the most important thing, he says. Binging is defined as having at least five drinks in a two-hour period, four for women. Now, he says, he has only an occasional beer and doesnt drink and drive.

The fact that he continues to drink is an acceptable part of his therapy. The programs goal is to get heavy drinkers who are not alcoholics to want to cut back, not necessarily to quit. Using a method called motivational interviewing, a counselor asks questions that nudge students, in a nonjudgmental way, to examine their drinking, their ambivalence about it and its effect on their daily life and long-term ambitions.

Its not anti-drinking; its anti-harmful drinking, explains G. Alan Marlatt, a psychology professor who uses the techniques for the drinking reduction program he created at the University of Washington in Seattle.

In the last five years, programs using a nonjudgmental approach have been slowly spreading on college campuses. They range from Fairfields intensive group program to an online self-assessment of drinking patterns, called e-CHUG, now used by students at some 110 colleges.

When you sit with a person and ask them what the trouble is with their drinking, theyve got a whole list of problems like hangovers, drinking-related traffic violations and other risky behavior, says William R. Miller, a psychology professor at the University of New Mexico who developed the approach. But label the same person an alcoholic and he will deny it, he says. The nonconfrontational approach works well with college students. Whos more oppositional than an adolescent? Dr. Miller says.

Another element of motivational programs is to show alcohol-abusing students that theyre not in step with the norm. Heavy student drinkers overestimate how much their peers typically consume by three or more drinks, according to a study last year by H. Wesley Perkins, a sociology professor at Hobart and William Smith Colleges. Since most students want to fit in and be normal, educating them about the norm may help them change their behavior.

Drinking has been a part of college life and a concern for decades. A 2002 study by the National Institute on Alcohol Abuse and Alcoholism linked alcohol to the deaths of at least 1,400 students annually, including in car accidents, and the assault of at least 600,000 others. At least four students died this past fall from binging, the most publicized of those incidents occurring at the University of Colorado at Boulder and the University of Oklahoma. Research results are conflicting, but anywhere from 22 to 44 percent of all students drink to excess.

With students drinking regularly in high school, freshmen with deeply ingrained drinking habits are arriving at campuses in record numbers, college officials say. Over time, many moderate their drinking. In fact, only 12 percent of people who drink become alcoholics. What worries health educators and researchers on alcohol abuse is the window of time when students engage in the heaviest drinking and the perilous behavior associated with it.

The most popular approach prevention programs that lecture students about the effects of alcohol abuse seems to be failing, researchers say. Given the diversity of colleges, experts agree there is no one-size-fits-all solution, and programs must be comprehensive and aimed at a campuss specific student population.

Experts cite Fairfields strategy as one of the most promising for at-risk drinkers. Three months after the program, all participants for the 2002-03 year reported less drinking, with more than 50 percent describing their reduction as considerable. In 2003-04, 25 percent of participants said they were drinking considerably less and 69 percent somewhat less.

At the University of Washington, Professor Marlatt has also documented positive results among graduates of his two-session program, which has been chosen as a national model by the Department of Health and Human Services. In his program, alcohol-abusing students meet one-on-one with counselors to assess their drinking patterns, family history and perceptions about drinking. The counselors also present students with information about their peers lesser drinking levels and options on how to change their behavior.

This is a big step for us, says Mark C. Reed, Fairfields dean of students, of the universitys decision to start a program aimed at reducing student drinking rather than eliminating it. Some parents say underage students should forgo all alcohol, Mr. Reed says. But the reality to go from all to nothing is pretty unrealistic.

Most students in the program have had at least one health-threatening encounter with drinking and are mandated to attend by the university (a handful of others were referred for marijuana use). Students with a diagnosis of alcoholism are referred for more intensive help off campus. A few students in the program referred themselves. Theyve been dry-heaving at the health center until theyre bringing up blood on the 21st birthday, they do 21 shots, says Lisa Arnold, the programs facilitator and an alcohol and drug counselor. The program is not a get out of jail free card: participants who are on probation with the university can be expelled if caught drinking again.

Initially, many of the students are resistant, seeing the program as a version of the abstinence-based Alcoholics Anonymous. Adding to their resistance is the fact that so many of their friends drink, too, although clearly not all to such extremes.

The kids struggle most with the fact that they got in trouble but could point to 20 other kids on their floor who could be sitting in their chair, says Ms. Arnold, adding that her response is: I understand, but lets figure out why youre sitting in this seat and theyre not.

During sessions, students learn to identify internal triggers for drinking like stress and depression. They figure out the effects of certain drinking buddies, happy hours and unstructured weekends, as well as learning practical information like the importance of hydration and how to drink safely.

Students also keep drinking diaries. On Thursdays, they plan how much to drink on the weekend. They drink more if they wing it, Ms. Arnold explains. The next session, they share their experiences, talking about the weekend and what their friends did. The biggest drinkers have a literally sobering effect. Some of these kids get scared straight, says Deirdre Barrett, a psychologist and director of a similar program at the Addiction Institute of New York.

For many students, such programs are the first opportunity to reflect on their drinking. Kids at this age are drinking a lot they tolerate blackouts and fights, says Ms. Barrett, who works with students from Fordham, Columbia, Barnard, New York University and City College. This is the first chance theyve had to say maybe this isnt so good.

The varsity baseball player at Fairfield had mixed feelings about the class at first. I wasnt embarrassed, but I felt like I should have been, he says. He also felt relieved. He began to look forward to his 90-minute sessions with Ms. Arnold and the nine or so other students. Students attend four to eight sessions, according to their need; a relapsing few have repeated the program.

She kind of helped you along to realize that things were suffering, the young athlete says, adding that he came to understand that it was impossible to compete on the baseball team, maintain good grades and drink heavily, even if only on weekends. He was also disappointing his parents, with whom he is close. Your parents are paying money for what, to be burned? he says.

But it has been hard to resume a social life. It made you realize you didnt need to go out to get plastered to have a good time, he says. Now he works off campus on Friday and Saturday nights as a waiter and saves his money for the future.

He is eager to finish college, saying he feels kind of isolated a little bit, and he keeps apart from friends who continue to binge. I was one of the first to start, he says. Now, Im one of the first to stop.

Abigail Sullivan Moore contributes regularly to the Connecticut section of The Times.