High-Risk Drinking in College: What We Know and What We Need To Learn

Summary and Conclusions

The problem of excessive drinking by college students is entrenched, complex, and multifaceted. Drinking in college has the potential to cause considerable harm to the students who drink and to those around them. Excessive drinking also negatively affects institutional property, community property, and the institution’s academic and financial well-being.

Ongoing scientific research to fill gaps in knowledge about this important public health problem—especially longitudinal studies that track trends over time—is needed to guide policies and programs to reduce excessive alcohol use among college students. Carefully designed research on alcohol consumption by college students can separate myth from fact, explain incompletely understood behavior, illuminate the reasons for inconsistent findings from previous studies, and suggest promising preventive strategies based on evidence and outcomes. Prevention programs built on a foundation of scientifically defensible practices are more likely to be successful.

On the basis of the papers it commissioned and its 18 months of deliberations, the Panel on Contexts and Consequences determined that the following general conclusions can be drawn from the research on college student drinking:

Epidemiology

• About two out of five college students report consuming five or more (four or more for females) drinks in a row at least once in the past 2 weeks;
• Many students experience a range of alcohol-related problems;
• Many students who drink heavily do not perceive their problem;
• There is heterogeneity in drinking trajectories across the college years; and
• Patterns and rates of drinking and drinking-related problems vary by race and gender.

Etiology and Context

• Prior drinking history is related to alcohol consumption in college;
• Drinking behavior should be looked at in a broad contextual manner;
• Peer pressure and self-selection are major factors in explaining differences in drinking levels across different social groups;
• The presence of a Greek system, the prominence of athletics, type of residence halls, type of school (e.g., historically Black college, women’s college), geographic region, and religious affiliation, if any, are associated with drinking patterns on campus; and
• Belonging to a Greek house and participating in college athletics are associated with heavier drinking.

Consequences

• The consequences of drinking by college students are numerous and varied;
• Personal consequences range from hangover or missing class to traumatic injury or fatal alcohol poisoning;
• Drinking by college students creates “secondhand” consequences for nondrinkers and the larger community, including noise, litter, vandalism, and an increased need for services of various kinds (e.g., security, maintenance);
• There is an association between alcohol consumption and aggressive behavior;
• Drinking increases the risks for being both a victim and a perpetrator of a crime, including sexual assault; and
• Unrealistic attitudes among women and men about their relative invulnerability may predispose them to sexual assault and the consequences of high-risk sex.

Opportunities for Intervention

• Alcohol misuse is a modifiable behavior;
• Effective interventions are available for changing alcohol-related behavior patterns;
• The multiple transitions college students are experiencing represent windows of opportunity for intervention;
• Alcohol misuse in college is a complex, multifaceted problem that is influenced by many variables; successful approaches to preventing it are likely to be similarly complex and multifaceted;
• A clearly defined mission and statement of values should shape campus policies and programs designed to reduce alcohol consumption;
• Forming coalitions involving all stakeholders—including Greeks, athletes, and other students—supported by the college president is a promising approach to preventing college alcohol misuse; and
• An agenda for change should incorporate needs assessment and include an evaluation mechanism for any strategies to be implemented.

As with other complex and entrenched human behaviors, changes in alcohol consumption on college campuses will likely require a broad-based socioenvironmental and economic effort that is sensitive to individual student freedoms and campus culture and that is implemented in ways that promote acceptance by relevant constituencies. College students themselves should have an opportunity to participate with college presidents, staff, faculty, and representatives of the surrounding community in a rational decision-making process aimed at reducing alcohol misuse and its consequences. A primary outcome of such a process is an institution-specific plan to assess and change the campus cultural norm from widespread acceptance of underage and excessive drinking to one of support for healthy social gatherings and responsible drinking behavior.

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Historical document
Last reviewed: 9/23/2005