Etiology of Campus Binge Drinking Drinking and Alcoholism

A Failed Experiment in Social Control

The consumption of alcohol has always been a focus of government efforts to limits its use, due to the potential for abuse, the financial burden imposed upon social programs, and its association with criminal activity. Between 1920 and 1934 the consumption of alcohol was outlawed in the United States, with the intention of addressing these social problems. During the first year following the enactment of Prohibition, alcohol-related deaths, psychosis, and arrests all declined by 20-40%, but between 1921 and 1927 these measures reveal a sharp increase to near pre-Prohibition levels (Miron and Zwiebel, 1991). By the end of Prohibition, which correlates with the start of the Great Depression, alcohol consumption leveled out at around 60-70% of pre-Prohibition levels despite costing three times as much for a drink. Given the infamous criminal activity that emerged around the illegal manufacture and sale of alcohol, and the modest reduction in alcohol consumption during the Prohibition Era, the overall savings this law was supposed to produce were probably not realized.

The New Prohibition

A similar experiment in alcohol prohibition is currently underway in the United States for a limited segment of the population. Beginning in 1984 the federally-mandated Minimum Legal Drinking Age (MDLA) Act became law, which set the minimum drinking age to 21 for all states that wished to retain 10% of their federal highway funding. This law was designed to reduce the number of highway fatalities and other problems associated with abuse of alcohol among adolescents and young adults (Grucza, Norberg, and Beirut, 2009).

One measure of the prevalence of alcohol abuse is binge drinking (BD), which is defined as 5 or more drinks for an adult male, or 4 or more drinks for an adult female, over a period of 2 hours (U.S. Department of Health and Human Services, 2004). When the trends in binge drinking were examined between 1979 and 2006 for 12 to 20-year-olds, there appears to be some evidence that this law has had a positive effect (Grucza, Norberg, and Beirut, 2009, p. 697). Males in this age group experienced a significant decline in the prevalence of BD during this period (p < 0.001), but there was no change in this behavior among females.

The impact of raising the MLDA to 21 seems to have had a positive effect on traffic fatalities as well. For all drivers between the ages of 16 and 20 fatally injured in 2008, 33% had blood alcohol content above the legal limit (McCartt, Hellinga, and Kirley, 2011, p. 174). In 1982 the prevalence of fatally injured drunk drivers in this age group was 61%, which represents a nearly 50% reduction in this traffic statistic over the subsequent decades. This data seems to show that raising the legal drinking age to 21 significantly reduced traffic fatalities for this age group.

Unexpected Outcomes of the New Prohibition

In June 2008 a group of 120 college professors from liberal arts colleges released a statement expressing the need to reopen the debate about whether the MDLA of 21 is working, because in their experience it isn't (Amethyst Initiative, 2008). This statement caused a stir in the press and was inaccurately restated as an endorsement of lowering the drinking age to 18. The signatories to the Amethyst Initiative cited their concerns about what is a growing culture of clandestine drinking parties, the manufacture of fake identification cards, and other criminal activities on college campuses, not unlike the speakeasies and other criminal activities that emerged during Prohibition. The data seems to support their concerns.

Between the years of 1979 and 2006, male students 18 to 23-year of age experienced a slight, non-significant trend downward in the prevalence of BD (Table 1; Grucza, Norberg, and Beirut, 2009, p. 697). The pattern for female students indicates a move in the opposite direction; between the ages of 18 and 20 the prevalence was unchanged, but for female students between 21 and 23 there was a 2-3 fold increase in BD (p = 0.02). Overall, the prevalence of BD among college students seems to have increased since the MLDA was raised to 21.

The dramatic increase in BD prevalence among female college students is certainly cause for concern, but should there be a similar level of concern about male students? A comparison of BD prevalence among male nonstudents between the ages of 18 and 20 reveals a significant, 2-3 fold decrease for the period 1979 to 2006 (p < 0.001; Grucza, Norberg, and Beirut, 2009, p. 697). Nonstudent males between the ages of 21 and 23 also experienced a significant (p = 0.03), but modest decline in BD. When compared to nonstudents, being a male college student represents a significant risk factor for engaging in BD.

Female nonstudents also experienced an increase in BD prevalence between 1979 and 2006, but this modest increase (< 30%) was limited to the ages of 21-23 (Grucza, Norberg, and Beirut, 2009, p. 697). When compared to the 200-300% increase in BD among female college students in this age group, attending college is also a major BD risk factor for women.

These trends seem to...

Although there are no statistics comparing traffic fatalities between students and nonstudents, the 46% decline in drunk driver fatalities between 1982 and 2008 for the age group 16-20 was not replicated for the age group 21-24, which saw only a 17% decline (McCartt, Hellinga, and Kirley, 2011, p. 174). For the age group 25 and above, there was a 29% decline in drunk driver fatalities.
A number of confounding factors are probably contributing to the overall decline in drunk driver fatalities for the period 1982 to 2006, including improvements in vehicle design. If the 29% decline for ages 25 and above is assumed to represent the influence this and similar confounding factors, then drivers between 16 and 20 experienced only a 17% decline in drunk driver fatalities and drivers between 21 and 24 experienced a 12% increase. If this calculation is a reasonable estimate of the impact that raising the MLDA to 21 has had, then there is only a 5% overall reduction in drunk driver fatalities for the ages 16-24. This small difference could easily be due to other factors besides raising the MLDA to 21.

Table 1: Historical Change in BD Prevalence Between 1979 and 2006

Sex

Age

Student Status

BD Change

Significance

Age

Drunk Driver Fatalities

male

12-20

-50%

< 0.001

16-20

-46%

male

21-23

-19%

0.049

21-24

-17%

female

12-20

no change

N/A

25 and above

-29%

female

21-23

+82%

< 0.001

male

18-20

nonstudents

-225%

< 0.001

male

18-20

students negative trend

N/A

male

21-23

nonstudents

-24%

0.03

male

21-23

students negative trend

N/A

female

18-20

nonstudents no change

N/A

female

18-20

students no change

N/A

female

21-23

nonstudents

+44%

< 0.001

female

21-23

students

+253%

0.02

Why is Campus Binge Drinking Resistant to Social Trends

Overall, the above analysis suggests male and female college students are 2 to 3-fold more likely to engage in BD when compared to their nonstudent counterparts. Given this finding the concerns of the Amethyst Institute appear to be well founded. Social science research has revealed environmental forces can sometimes become the dominant controlling factors in a person's life (Zimbardo, 2007) and the large difference in BD prevalence between college students and nonstudents points to campus culture as the primary culprit.

Social control theory suggests the elements of attachment, involvement, commitment, and beliefs play an important role in determining an individual's behavior (reviewed by Leppel, 2006). When a student leaves home for four years and moves into a college dormitory, or a sorority or fraternity house, the prevailing value system at these locations may become dominant. In other words, the norms of a life lived within the confines of a family may no longer be relevant to the norms of campus life where BD and similar risky behaviors may actually be encouraged. When the influence of living in a fraternity or sorority was studied relative to the likelihood that a student would engage in BD behavior, a significant positive association was found (p = 0.01; Leppel, 2006, p. 523). Other factors associated with an increased chance of engaging in BD include attending a four-year vs. A two-year school (p = 0.05/0.01) and being unmarried (p = 0.01). Factors that predicted a lower risk of engaging in BD while attending college included being 25 or older (p = 0.05 for women only) and having a part-time or full-time job (p = 0.05/0.01). These results suggest maintaining ties to an off-campus life through work, a marriage, or prior experiences provide some measure of protection against engaging in BD behavior, but becoming entrenched into campus culture has the opposite effect.

When the DSM-IV diagnostic criteria for alcohol-use disorder were used to assess the degree of severity that BD represents, along a severity continuum between alcohol abstinence and alcoholism, it fell in the less severe end (Beseler, Taylor, Leeman, 2010). Tolerance, which is defined as requiring more alcohol to obtain the same effect, was lower on the severity scale together with drinking more and longer. The factors best able to discriminate alcohol-use disorder propensity were the amount of time spent drinking and social/legal difficulties. In contrast, BD was not very useful in predicting this disorder. These results suggest BD behavior is not tightly associated with alcoholism when compared to other…