Just Say KnowA blackout is a form of alcohol-induced amnesia. Do not confuse this with passing out or fainting. While it is happening, the drinker is conscious but unaware that he or she is in a blackout. Although obviously impaired, the drinker appears to function ordinarily, but after sobering up cannot recall some of the people or events from the night before. It’s usually not until the next day when the previous night’s “war stories” are being shared in the dining hall that the drinker realizes a blackout occurred.
It has been difficult to research this phenomenon because we don’t know when or how someone enters a blackout. Apparently, the neurotransmitters in the brain responsible for maintaining memories for some reason cease functioning. We don’t know how much or how often a person needs to drink in order to experience a blackout. However, we do know that most, but not all, alcoholics have experienced blackouts. More importantly, we know that you do not need to be an alcoholic to experience a blackout. A blackout places you at risk for a serious impairment problem and indicates that a serious alcohol problem has developed or is developing.
One other point regarding blackouts: many people mistakenly say, “I never get so wasted that I have a blackout.” You do not need to be “totally wasted” in order to experience a blackout. Slight impairment alone can contribute to a blackout.
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The Germans call it wailing of cats (Katzenjammer), the Italians out of tune (stonato), the French woody mouth (gueule de bois), the Norwegians workmen in my head (jeg har tommermenn) and the Swedes call it – my favorite – pain in the roots of my hair (hont i haret). If you have experienced a hangover, I’m sure you can relate to any or all of these descriptions of a hangover.
Basically, a hangover is the body’s way of telling us we have had too much to drink. Alcohol not only irritates the digestive system, it also dehydrates the body. It is important to rehydrate after a night of alcohol consumption. Be careful though – there is evidence that rehydrating too quickly can actually worsen the headache due to the erratic changes in body fluids. Congeners, the by-product of the fermentation process, also contribute to hangovers. Although alcohol is eliminated from the body at an average rate of one-half ounce per hour, the congeners take much longer. These substances provide the unique flavor to various alcoholic beverages, but they are toxic. If you drink, when cons
idering what type of alcoholic beverage to consume and the hangover potential, keep in mind that vodka and gin are low in congener content, blended scotch has about four times the amount of congeners as vodka and gin, while brandy, rum and pure malt scotch have six times more. Bourbon contains approximately thirty times the amount of congeners than vodka.
There are no real “cures” for a hangover. So-called cures simply relieve only some of the discomfort and stress of the painful symptoms of the hangover. Even so, there are many bizarre suggestions for curing a hangover. Voodoo legend suggests that you stick pins into the cork of the bottle from which you drank. The Norwegians drink a glass of heavy cream, the Russians prefer salted cucumber juice, and the Swiss use brandy with peppermint. In one way, none of these work, and in another, all of them do. The reason: the most powerful hangover remedy is belief in the curative value of whatever you do, whether it is steaming in a sauna or sticking your head in a freezer. Physiologically, however, we find that none of these actually “cure” the hangover.
By the way, do not mix alcohol with aspirin, ibuprofen or other anti-inflammatory drugs. This combination can cause serious damage to your stomach. Also do not mix alcohol with acetaminophen, the medicine found in Tylenol. This combination can cause serious damage to your liver.
I’m sure you’ve noticed that people experiencing a hangover tend to be anxious and on edge. Some students have learned they can relieve this anxiety by having a little “hair of the dog that bit them.” This means curing your hangover by taking a drink of whatever it was that caused it.
“A little hair of the dog” may seem like a viable solution, and here’s why: Picture yourself standing in a pool of water that is about chest high. Hold a ball in your hands, depress it underwater, then release it; it will rebound above the waterline. Depress it even further and it rebounds further. It’s the same with alcohol and the central nervous system. If I depress my central nervous system with the depressant drug alcohol and then stop, it will rebound – not back to normal, but to a level of high anxiety. What can I do to relieve this anxiety? Have a drink of the depressant alcohol. We should, however, be very clear about this: drinking to cure a hangover is an indication that alcohol has become or is becoming a problem in your life.
Why don’t we recognize the use of “a little hair of the dog” as problematic behavior? Probably because society, and in particular the alcohol and restaurant industries, have normalized this addictive activity. Champagne breakfasts and brunches, complete with champagne and many other drinks like Bloody Marys, screwdrivers, and mimosas, are considered socially acceptable, even though they encourage the development of addictive behavior patterns.
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One serious concern about alcohol consumption that sometimes falls through the cracks when it comes to alcohol education and abuse prevention, is the reality that heavy alcohol consumption can kill. This is not meant as a scare tactic – however, death due to heavy alcohol consumption is a reality. It is a tragic reality that hits students and their families and friends too often, every semester, throughout the country. Just a few of these tragedies include a student who, in 1996, after attending a couple of parties, had a BAL of .31 percent and died of alcohol poisoning. That same year, another student died of alcohol poisoning after drinking six beers and twelve shots during a two-hour period and developing a BAL of .34 percent. In 1997 a student died of alcohol poisoning after an initiation activity which included chugging exorbitant amounts of alcohol resulting in a BAL of .48 percent. As part of a twenty-first birthday celebration in 1998, a student died of alcohol poisoning after consuming 24 shots during a three-hour period, resulting in a BAL of more than .45 percent. These are just a few examples of how dangerous high-risk drinking can be.
How much alcohol does it take to kill someone? The answer varies with each individual and with different circumstances. As you can see by the tragedies described previously, some people can die from a BAL of .31 percent while others can consume more alcohol before reaching a deadly BAL. We know that a BAL of .25 percent and above puts us at much greater risk for falls, traffic crashes, asphyxiation from choking while vomiting, and other serious incidents. The risk for death from alcohol poisoning starts around here, too. The higher the BAL, the greater the risk for death due to alcohol poisoning. At .30 percent you may pass out. The BAL that would cause someone to pass out is dangerously close to a deadly BAL. At .35 percent you could stop breathing, and at .40 percent you could fall into a coma, cause possible brain damage, and be more likely to die from alcohol poisoning.
Helping an intoxicated person
Here are some tips to consider when dealing with an intoxicated person:
- if the person is vomiting, have him/her either sit up or lie on his/her side in the fetal position to avoid choking.
- if the person has cold, clammy, pale or bluish skin, call medical personnel immediately.
- passing out is a sign of a potentially serious situation. If you can’t wake up the person, either call 911, your college emergency service, or get them to the hospital. Do not assume the drinker will simply sleep it off.
- in cases where there is erratic breathing (less than 8 breaths per minute or more than 10 seconds between breaths), get to the emergency room immediately.
- in the meantime, do not give the drinker coffee, liquids, food, or a cold shower. Also do not force the person to exercise.
- if in doubt, get assistance immediately. While seeking assistance, if possible, try to have someone stay with the drinker. This can be a life and death situation.
One of the primary reasons students do not seek help for their friends who may be at risk for deadly acute alcohol poisoning is they are afraid the drinker will get in trouble with college officials or the police. Please keep in mind, the minor inconvenience of dealing with some later campus judicial action is nothing compared to the pain of the tragedy you may prevent. By reporting your concern about the intoxication level of your friend or acquaintance to the police, medical personnel or college officials, you could save his/her life.
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Alcohol is implicated in more than 40 percent of all academic problems and 28 percent of all dropouts. Research indicates that, on average, college students who drink the most alcohol earn the lowest grades. Students with D or F grade point averages report consuming an average of 10 drinks weekly, C students average 8 drinks weekly, B students average 6 drinks per week and A students average 4 drinks per week. Yes, there are students who can “party hard” and still maintain an A average, but they are the exception to the rule. Most students who drink at a high-risk level experience academic problems.
Alcohol consumption can affect your grade point average for a number of reasons. High-risk drinkers miss more classes due to their drinking. After all, it’s quite difficult to sit through an hour-and-a-half lecture while dealing with a severe hangover. National research indicates that 21 percent of students who binge drank* had fallen behind in their schoolwork, and 30 percent had missed class because of their drinking since the beginning of the school year. Among frequent binge drinkers – students who had binged three or more times in two weeks prior to the survey – 46 percent had fallen behind in schoolwork and 60 percent had missed class because of their drinking. Only a fraction of non-binge drinkers fell behind in their studies or missed class because of drinking (6 percent and 8 percent, respectively). I suspect many high-risk drinkers also submit projects late due to their lifestyle choices. It’s difficult to keep up with schoolwork when your primary concern is which party will have the most kegs.
Finally, and most importantly, many students believe that as long as they don’t drink the night before an exam, alcohol consumption will have no impact on their test-taking ability. This couldn’t be further from the truth. Here’s why: our brains are made up of millions of nerve cells that transmit messages through an intricate series of chemical and electrical impulses. The sensitive chemical balance necessary to keep this neurological network operating is disrupted by the presence of alcohol. And this chemical imbalance caused by the alcohol remains even after the alcohol is metabolized. Research indicates that this chemical imbalance can last for up to thirty days after the alcohol has been metabolized, even when a person is completely sober. This imbalance impairs our abstract thinking skills. Those are the skills needed to bring two separate thoughts together in order to develop a third concept. So, the bottom line is drinking can possibly impair our abstract thinking skills, resulting in impaired test-taking ability even thirty days after consuming alcohol.
*A binge is defined by researchers as five or more drinks in one sitting for men, and four or more drinks in one sitting for women. One of the problems with this definition is that it does not take into account the period of time during which the drinking took place. For the purposes of this book, whenever referring to a binge, it will refer to the aforementioned definition. Both the definition of binge as well as the use of the term have been called into question by many alcohol education and abuse prevention specialists and certainly deserve further analysis.
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During the time it takes you to read this book, approximately ten people will die – approximately one every twenty to thirty minutes – due to an alcohol-related car crash. And chances are that many of these victims will be college students. In spite of all the educational programs now being conducted, all the prevention programs now implemented, all the increased enforcement of DUI laws, more than 30 percent of our college students still report driving while under the influence of alcohol. In 1995, sixteen- to twenty-four-year-olds accounted for 40% of fatal alcohol-related highway crashes. And alcohol-related crashes are still the number one cause of death for sixteen- to twenty-four-year-olds.
Contrary to what many high-risk drinkers would like to believe, you do not drive better while under the influence of alcohol. You may think you do, because you know you take extra care while driving. But your perception of your driving performance is also impaired. Research indicates that the greater your impairment, the higher your risk of an impairment problem, especially the problem of an alcohol-related car crash.
What more can be said about this continuing problem? The education and prevention programs are working only minimally. One of the difficulties is that when you need to make one of the most important decisions of your life – to drive or not – you may never be less capable of making that decision than if you are under the influence of alcohol. Also keep in mind that the choice to have a designated driver is not a license to drink uncontrollably. Using a designated driver will lower your risk for an alcohol-related car crash, but will not lower your risk for the numerous other dangers associated with high-risk drinking.
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If we were to believe all the statements and images presented by the alcohol advertising industry, we would view alcohol as a necessity for a successful, pleasurable sex life. Some people do believe that alcohol increases your sexual desire and improves your performance. But, physiologically speaking, alcohol has the opposite effect. Research strongly indicates that alcohol contributes to sexual dysfunction in men. As Shakespeare noted in the tragedy Macbeth, alcohol “provokes the desire, but it takes away the performance.” In one study, the ability of college men to achieve an erection while watching erotic films was
impaired at blood alcohol levels below the legal intoxication point. In much the same way, alcohol decreases the sexual pleasure of women. This is due to the fact that alcohol reduces vaginal vasocongestion during sexual activity. The conclusions of this research are inescapable: Alcohol negatively affects the ability to perform and/or enjoy sexual activity.
Just like music and lighting, alcohol may enhance or establish a romantic mood. But, due to its disinhibiting action, high-risk alcohol consumption also contributes to increased sexual promiscuity on our campuses today. Between 35 and 70 percent of college students report engaging in some type of sexual activity primarily as a result of alcohol. For example, at Dartmouth, 46 percent of students admit that, while under the influence of alcohol, they had sex they would not have engaged in had they been sober. And nearly one out of five students report abandoning safer sex practices while under the influence of alcohol. Students engaging in unplanned sexual encounters as a result of alcohol consumption risk a number of assorted problems ranging from embarrassment, guilt, and other emotional difficulties, to pregnancy and sexually transmitted disease (STD), including, of course, AIDS. Sixty percent of college women surveyed who had acquired sexually transmitted diseases, including AIDS and genital herpes, reported being under the influence of alcohol at the time they had intercourse.
When someone experiences problems as a result of their drinking, they are, at the very least, a problem drinker and are considered to be abusing alcohol. Is the problem drinker an alcoholic? It depends. An acceptable definition of alcoholism for most professionals is the continued consumption of alcohol despite the physical, psychological, and/or social problems caused by the drinking, combined with an inability to consistently control the drinking occasions or the amount of alcohol consumed.
For example, a husband calls his wife to tell her he’s stopping for a few beers at the bar on the way home from work. He arrives home drunk at three in the morning. This lack of control continues; it threatens his marriage and he loses his job. A college student may plan on going to parties and not getting drunk but, more often than not, the student gets drunk and passes out. Schoolwork suffers, classes are missed, and the student fails. In addition to the problems described in the Risks chapter of this book, a college student who is abusing alcohol may experience relationship problems with parents and friends, money problems, health problems, difficulty keeping a part-time job and/or many other more subtle problems due to drinking.
Both the husband and the student continue to drink despite the fact that drinking is causing these problems. According to the textbook definition, we could consider both of them alcoholics. The difficulty arises in actually diagnosing them as alcoholic or not. This diagnosis should be left to the professionals. As you can see, there is no real clear criteria for early differentiation between the problem drinker and the alcoholic. Someone who abuses alcohol experiences many of the same problems as the alcoholic, but may not be an alcoholic – yet. What we do know is that abuse of alcohol can lead to alcoholism. If you minimize your abuse of alcohol then you will minimize your risk for alcoholism.
Rather than confuse yourself with definitions and labels, it might serve you better to analyze what impact alcohol is having on your life. At the end of this chapter is a questionnaire that may help. It will not assess whether or not you are an alcoholic, but it will help you, at the very least, determine if alcohol is or is not affecting your life. If it is, then I suggest you make adjustments in your drinking patterns.
Following is a description of the behaviors associated with the phases of drinking. As you read through it, try to determine what phase you are in if you drink. You do not need to experience all of the issues to be considered in a particular phase. You might experience all or some of those things described in each phase.
PHASE ONE: Social Drinker
- Joe and Jane may choose to drink once in awhile.
- When they do drink, they do not get impaired. Since they do not drink to impairment, there’s no increase in their tolerance.
- There are no negative outcomes from their drinking.
- They have a take-it-or-leave-it attitude about drinking.
PHASE TWO: Social Drinker
- Jane and Joe enjoy drinking. They drink regularly, perhaps two or three times per week.
- When they do drink, they usually get impaired. Because they are drinking to impairment, their tolerance is increasing.
- There are no apparent negative outcomes from their drinking, except maybe a hangover once in awhile.
- They generally look forward to the weekend so they can “really let loose.”
PHASE THREE: Problem Drinker
Early Phase:
- Jane and Joe drink regularly.
- They get impaired regularly. Their tolerance is continuing to increase.
- They arrive late for classes and sometimes cut classes due to drinking and/or hangovers.
- The quality of their schoolwork is inconsistent. They are missing deadlines.
- They seem to be preoccupied with drinking.
- They might experience a blackout.
Middle Phase:
- Jane and Joe begin to cut classes regularly.
- They become unreliable. Their personal relationships begin to suffer from disagreements with roommates, teammates and/or friends.
- They avoid situations where there is no drinking.
- They become ill more frequently.
- They experience more money problems.
- They drink in the morning once in awhile to cure their hangovers.
Late Phase:
- Jane and Joe cut classes a week at a time.
- At times their attitudes are belligerent and aggressive, or passive and withdrawn.
- They experience many personal problems with friends and family.
- They have more money problems. Maybe they get a job to support their partying.
- They may get a DUI violation or encounter serious trouble with school administration.
- Their academic performance may deteriorate drastically.
PHASE FOUR: Addicted to Alcohol – Alcoholic
- Jane and Joe become totally undependable. They experience serious family and other relationship problems.
- They drink to cure their withdrawal from alcohol.
- They experience serious legal difficulties.
- They get suspended or drop out of school.
- They experience many other negative outcomes.
Can you consume alcohol and not experience any serious alcohol problems? As you can see, drinkers in Phase Two may be doing just that. They are out drinking, getting impaired yet not experiencing any problems. But – and it’s a huge but – as explained earlier, each time you drink to impairment your tolerance increases. We know that if you continue to drink to impairment, your tolerance will continue to increase. As a result, you will eventually move to Phase Three and possibly Phase Four. That is why increasing tolerance is always an indicator of increased risk for alcoholism. The student who brags about his or her ability to consume excessive quantities of alcohol is actually revealing, and ignorantly bragging about, his or her increased risk for alcoholism.
Many students believe that high-risk drinking in college is simply an expected phase of life they go through, that it is a rite of passage. Many believe they will simply discontinue their high-risk consumption after they graduate. Does “I’ll quit when I graduate” sound familiar? Research indicates that this is not always the case. Based on a 27-year follow-up of college students begun in 1950, we see that 50 percent of those students who drank five or more drinks on four or more days per week while in college experienced alcoholism or other serious alcohol-related problems twenty years later. Today, unfortunately, many more students fit this drinking profile than was true when this study began.
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People drink alcohol for a variety of reasons: to quench their thirst, for flavor, for sacred ritual, for celebration. Many people, especially college students, drink to get impaired. If you start drinking, it may take you two or three drinks to get impaired. If you continue drinking to impairment on a regular basis, each time you drink you will need a little more alcohol to reach the same level of impairment because your body will have adapted due to the previous drinking episode. In other words, the body has increased its tolerance to alcohol.
Here’s why: Our bodies are wonderful machines. They adapt very well. Take for instance the body’s ability to adapt to varying temperatures. As we live through a warm summer, our bodies adapt to the warmer temperatures. When a cool September day hits us, say around 50 degrees, we would normally put on a jacket. Our bodies adapted to the warmer temperatures of summer and are not accustomed to the colder fall temperatures. Then, during a very cold winter, our bodies adapt to the cold. When spring arrives with an occasional warmer day around 50 degrees, students around the campus will be wearing T-shirts and shorts! Their bodies have adapted to winter and can tolerate colder temperatures.
If you stop drinking to impairment for a few weeks, your tolerance will then decrease. For instance, the tolerance for many students fluctuates as their school circumstances change. They may begin school in September and have fairly low tolerance. Maybe three or four beers get them impaired. As the semester continues and they continue drinking to impairment each weekend, their tolerance will increase. They may go home for winter break and decrease their consumption. As a result, their tolerance may subside a bit. But once they return to school in January, back to the bars and parties and increased alcohol consumption, their tolerance will continue to rise again. When summer rolls around, maybe they will return home to their parents. They may work at a full-time job or hang around with their non-college friends who tend to drink less than they do. Their consumption decreases, and therefore their tolerance once again begins to decrease.
But remember that increased tolerance only delays impairment, it cannot prevent it. Whenever we drink to impairment, we are at greater risk for impairment problems such as falls, fights, DUI infractions or car crashes, unplanned sexual encounters and the like.
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The risk of running into trouble with the law increases significantly when a student engages in high-risk drinking. There have been laws regarding alcohol on the books for some time. For example, it has been illegal to consume alcohol if someone is underage. It is illegal to sell alcoholic beverages to someone who is underage. Disorderly conduct arising from intoxication has traditionally been considered a legal offense as well. However, historically the law has regarded college life as somewhat distinct from mainstream community life and has carved a de facto free space for high-risk drinking. It is not that the law condoned high-risk drinking, it is simply that the law functioned to overlook many of the problems associated with high-risk drinking. In many ways, the law showed a prominent symptom of alcoholism – the law was in denial about the real issues associated with high- risk alcohol use on college campuses.
In recent times the law has changed dramatically. Courts and prosecutors now view high-risk alcohol use by college students as a prominent problem. Thus, students now face increased risks of running afoul of the law if they engage in high-risk drinking. These risks include:
- criminal prosecution for various alcohol-related crimes including disorderly conduct, DUI, use of a false identification, serving or facilitating the use of alcohol by a minor, etc.;
- discipline in the college judicial systems;
- loss of opportunities to sue people who cause injury to a student because the victim was under the influence of alcohol at the time of the injury;
- civil liability for injuries arising from high-risk alcohol use;
- notification of a student’s alcohol use to parents and other parties;
- loss of opportunities in professional schools and legal problems with professional boards that offer certification in fields such as law, medicine and accounting;
- loss of licenses or the inability to obtain state licenses.
To give you some idea about how serious the law has gotten about high-risk drinking on college campuses, it is worth looking at a couple of prominent situations that developed in the 1990s and have serious implications for the future. A first-year student at Massachusetts Institute of Technology died of an overdose of alcohol. The students who furnished the alcohol to the first-year student, who was underage, were pursued by criminal authorities. In other cases, students who supplied alcohol to fraternity brothers were held civilly responsible for injuries to other students. Florida has recently enacted a law which does not permit a student who has been injured to recover anything if that student was heavily involved in alcohol use. Also, parents may be held responsible for their college-aged student’s activities. This can arise through the use of a family automobile and, in some cases, states now have laws which penalize parents who provide spaces for underage students to consume alcoholic beverages unlawfully.*
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As the host of a party you can be responsible to your guests by helping them minimize their risk for the problems listed in this chapter. In so doing, you will also be minimizing your legal responsibility for the injuries or damages that might occur as a result of your guests’ drinking. You can have a wonderful time hosting a party as well as minimize the risk of alcohol-related problems for your guests, and in turn for yourself, by following a few responsible hosting:
- Arrange for reliable sober monitors that can watch out for guests who may be consuming at a high-risk level. They can also help diffuse potentially dangerous situations that may arise.
- Collect car keys when guests arrive. This necessitates that guests get a second opinion on whether they are sober enough to drive. Promote the use of designated drivers and be prepared to arrange for taxi rides or public transportation.
- Stop serving alcohol an hour before the party ends. As the party draws to a close, provide coffee and food. Remember, however, that coffee and/or a cold shower does not sober up anyone, it simply wakes them up. Only time allows someone to sober up.
- Mix and serve the drinks yourself or designate a bartender instead of having an open bar. Avoid serving doubles. Use standard measures when mixing drinks.
- If serving an alcoholic punch, use a non-carbonated beverage such as fruit juice as a mixer.
- Always serve food. Cheese, meats, veggies, breads and light dips taste great and don’t increase thirst. (Pretzels, popcorn, potato chips, etc. are salty and cause people to drink more.)
- Do not encourage or force people to drink. Discourage drinking games.
- Always provide low-alcohol and alcohol-free drinks such as coffee, soda, fruit juices, and water.
- Avoid games that involve physical activity because guests who are drinking are more prone to accidents and injuries.
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If it hasn’t happened already, sooner or later someone close to you will experience a problem with alcohol or other drugs. While in college it may be a roommate, a teammate, a loved one or a friend. Beyond college it might be a relative, perhaps your father or mother, an employer, an employee, a future spouse or maybe a son or daughter. I guarantee that it will happen.
When confronted with this situation, we tend to feel helpless and hopeless. After all, conventional wisdom states that you need to wait for the person to hit bottom before he or she will seek help. But conventional wisdom isn’t always wise, especially when it comes to alcohol and other drugs. You may not be able to help someone who has an alcohol problem until that person hits bottom, but you can raise the bottom.
As indicated in the Addiction chapter of this book, it is difficult to assess whether or not someone is actually addicted to alcohol. But that should not be the question you are asking yourself. If drinking is causing problems in someone’s life, then the person should be confronted about the drinking. In the situation cited above, it is obvious that the drinking is causing problems. Is the person an addict? We do not know – but she definitely needs immediate help.
You don’t need to wait – you shouldn’t wait – until a more serious problem arises. You don’t need to wait until the person hits bottom. That’s like saying if you had a friend or loved one perched on the edge of a bridge ready to jump, ready to commit suicide, you would allow the person to jump, then run down to where your friend hit the bottom and pick up the pieces. Consider this: If not now, when? If not you, who?
Look back at the Phases of Drinking. During what phase would you confront someone about their drinking? Most well-intentioned friends or relatives might confront Joe or Jane in Phase Two. And that might seem to be an appropriate time. However, as much as we would like to see it, we should not expect them to change their behavior if they are in Phase Two. After all, they are drinking, having a good time and are experiencing no apparent negative outcomes. In their minds, they believe that drinking is harmless and fun – that they have everything under control. This does not mean we should not say something to them. Their tolerance is rising, and they will probably experience problems sooner or later. They need to be informed that their increased tolerance is an indication of increased risk.
If you confront them in Early Phase Three, there are more concrete reasons for them to examine their drinking. They are experiencing negative outcomes, and these can be highlighted as reasons for considering a reduction in consumption. Also, their tolerance is becoming dangerously high. They are continuing to come closer to their trigger level for alcoholism.
Alcoholism is considered to be the disease of denial. But the seeds of denial are planted long before the actual addiction. There are ways to break through the denial. Here are some guidelines to follow when confronting someone you believe has an alcohol or other drug problem.
- Be well-informed about alcohol. There are professionals on most campuses trained to work with students and their alcohol concerns. Some campuses offer academic courses about alcohol and other drugs.
- Choose your time and place carefully. Confront the person in private and when the person is sober.
- Expect denial. Most people experiencing problems with alcohol have developed an intricate web of psychological defenses. These defenses manifest themselves in the form of denial of the problem.
- Be confident and positive. Indicate you care for the person but not the behavior.
- Call for help when necessary. Friends, residential life staff, relatives and/or counselors can be of valuable assistance. In some situations, an organized intervention coordinated by a professional health care worker may be necessary.
- Get help for yourself. Relatives and friends of people experiencing alcohol problems also experience their own difficulties. Find help through your own friends or support groups such as Al-Anon.
- Choose your words carefully. Don’t label the person. Avoid terms like alcoholic or problem drinker. Simply state that the drinking is causing problems.
Here’s a framework within which you can present your concerns. This may make your confrontation more acceptable to the drinker.
- I care... Indicate your care and concern for the person. For instance: “I love you.” “You are my best friend.” “I care about you.”
- I see… Describe the specific behaviors that concern you. For instance: “For the past three weekends you have gotten into a fight after drinking.” “You have missed class every Friday morning for the past five weeks because you were hung over.”
- I feel… Describe how you feel. For instance: “I’m concerned that you are going to fail out of school.” “I’m worried about our relationship. I get angry when I know I can’t count on you.”
- Listen… Give the person an opportunity to respond.
- I’d like… Indicate what you’d like the person to do. For instance: “I’d like you to go to the Counseling Center.” “I’d like you to stop coming over here when you are drunk.”
- I will… Offer your support and indicate what you will do to assist the person. For instance: “I’ll find out about what professional assistance is available.” “I’ll go with you to see the counselor.”
You can be sure that if you confront someone regarding their alcohol or other drug use, their immediate response will not be “Thanks for pointing that out. I’ll go see a counselor right away.” More often than not the response will be some form of denial:
- Excuses: “I’ve been really stressed out lately.” “I’m carrying 18 credits and need to loosen up when I can.” “We lost the game by two points.”
- Anger: “Get off my case.” “Up yours!”
- Blame: “My boyfriend has been really bugging me lately.” “I had a tough test today.” “My professors are too demanding.”
- Projection: “Yeah right, well what about you?” “So what, this is college. Everyone drinks.”
- Minimizing: “It’s no big deal.” “I’ve got it under control.”
If you are serious about helping someone, you need to understand that success in this situation comes in a variety of forms. Obviously, if the drinker were to agree with you, seek help and reduce the drinking, you were extremely successful. Great! There are also other levels of success. The person may simply agree and decrease the consumption but not seek professional help. And that might be OK.
However, the person may simply agree but make no changes. Is this failure? No! Most people in rehabilitation say they sought help because a friend and/or relative suggested they seek help. For many of them, it may have taken up to thirty confrontations before the person actually sought help. In your situation, maybe you are the first person to confront the problem drinker, and maybe you are the tenth, but maybe you are the thirtieth – the person might finally make the move. At the very least, despite the denial, the person will never drink again without having your concern echo in the back of his or her mind. And that helps!
A behavior pattern that’s easy to fall into if you have a friend or relative with an alcohol problem is enabling. Enabling is the process of removing the normal consequences of drinking from the drinker. The wife who calls her husband’s boss and claims he has the flu when he is really hung over is enabling his drinking. The enabler shelters the drinker from the drinking problems. The drinker fails to see the drinking as a problem when the enabler provides protection from the consequences of drinking. The drinker then fails to see the need for help. Enabling can be defined quite simply as good intentions with harmful results.
Students tend to believe they are helping their friends when they enable in the following ways:
- Make excuses for the drinking behavior
- Obtain notes from classes missed by the drinker due to her drinking or hangover
- Lend money for alcohol purchases
- Submit projects for the drinker because she was too hung over to make it to class
- Buy alcohol for the drinker
- Try to occupy the drinker’s time so there won’t be time to drink
- Blame the drinking on friends or circumstances
- Drink with the person so you can watch over him when he is drinking
- Vow not to do any of the above yet find yourself doing it again
These may seem like friendly gestures, but they simply contribute to further drinking. Why should the drinker make any changes if there are no perceived problems due to the drinking?
There may come a time when you believe you can no longer associate with the drinker while he or she is using. Only you know when this time has been reached. It is extremely important that you let the person know why you are severing the ties of your friendship. Do not simply avoid the drinker. If you do, he or she will probably project the problem back onto you. Let the drinker know how you feel. Use the process suggested above. Then, at some point you may need to lovingly detach from the drinker if the situation becomes too difficult for you. Yes, this can be extremely difficult. But what is your choice? Finally, be sure to leave the door open for the time when the person may finally agree to seek help.
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Membership in a fraternity or sorority provides many opportunities for leadership development, academic improvement, socialization, fun, community service and personal growth. Fraternities and sororities can also be the source of a large degree of high-risk activity. Presenting the following information is not meant as an attack nor a condemnation of Greek life. However, in revealing this information I hope to challenge and consequently motivate Greek organizations to confront the one issue that consistently sheds a negative light on Greek life – high-risk alcohol consumption. As identified by one leading college researcher, “If, from an alcohol risk point of view, the college campus is a dangerous place, then the fraternity houses are the Bermuda Triangle of the campus ocean.” “Fraternity or sorority members are significantly more likely than other college students to endorse less-than-responsible attitudes about alcohol.”
A large national study of binge drinking found that sorority members were almost twice as likely to be binge drinkers compared with non-sorority women (62 percent compared with 35 percent). Among men, 75 percent of fraternity members were binge drinkers, whereas 45 percent of other male students were not. This heavy and frequent drinking has a damaging impact on the health, safety and academic environment, not only for the binge drinkers but also for the entire fraternity or sorority. In a related study, nearly half (45 percent) of fraternity residents and a fifth (19 percent) of sorority residents reported suffering five or more alcohol-related problems since the start of the school year. Only 17 percent of male and 11 percent of female students not involved in the Greek system had experienced as many problems. This study also revealed that 83 percent of fraternity residents and 78 percent of sorority residents reported having their studying or sleep interrupted in the previous year because of another person’s drinking, while less than half of men (42 percent) and women (38 percent) not involved in the Greek system reported the same negative experience with other people’s drinking. Finally, three times as many fraternity residents as non-member male students reported being pushed, hit or assaulted in the previous year by someone who was intoxicated (34 percent versus 13 percent). And twice as many sorority residents as non-member females reported being pushed, hit or assaulted.
Be sure the members of the organization will accept you for who you are, not who they want you to be or how well you can handle your booze. If you are required to consume alcohol as a part of the membership process, I suggest you look for another organization. The group does not have your best interest in mind. Ninety percent of fraternity and sorority hazing accidents that result in death are related to alcohol use.
Here’s why. First of all, women tend to be smaller than men. Also, women tend to have a different body fluid content and a larger proportion of fat content than men. As a result, drink for drink, women will have a higher concentration of alcohol in their bloodstream due to the different levels of fat and body fluids of men and women. More important, however, is the difference in the way men and women metabolize alcohol. When the alcohol reaches the stomach it goes through what’s called first pass metabolism. A small quantity of the alcohol is metabolized in the stomach even before it reaches the bloodstream through the small intestine. This first pass metabolism occurs due to the presence of the enzyme alcohol dehydrogenase (ADH). Women have less ADH than men. There is some evidence that this decreased level of ADH may result in women absorbing almost one third more alcohol than men from each drink.
Many women drink wine coolers, which often contain more alcohol than beer. Women possibly absorb up to one third more alcohol than men do, and their body makeup often results in a higher concentration of the alcohol in their bloodstream. No wonder women seem to be unable to handle alcohol like men. (Of course this is not the case for women who have developed increased tolerance to alcohol due to continued high-risk alcohol consumption.) There are long-term consequences for women as well. Women become addicted sooner, they develop alcohol-related problems earlier and they die younger compared to men with similar drinking patterns.
But some women seem to be determined to be as ignorant as some men when it comes to alcohol consumption. The onset of alcohol consumption by women is occurring earlier. Women are also drinking more alcohol. More than one third of college women reported drinking for the sole purpose of getting drunk in 1993, more than triple the 10 percent in 1977. This shift in attitude by women is extremely risky since we know that women develop liver disease in a shorter period of time and at lower levels of consumption than men. Additionally, research indicates that a woman’s risk for a fatal car crash is twice that of a man’s when her blood alcohol level is between .05 percent and .14 percent.
Here are two other factors women need to consider if they choose to drink. Premenstrual hormonal changes can cause intoxication to set in faster during the days just before a woman gets her period. Also, some birth control pills or medication with estrogen will increase the level of intoxication for a woman who is drinking. So, if you fall into one or both of these two categories, you need to be extra careful about your alcohol decisions.
The connection between beer and athletics is longstanding. It dates back to a period when beer was perceived as and consumed for refreshment more than for intoxication. A 1909 ad for Budweiser, under the headline Ball Players Use Beer in Training, quoted C.H. Ebbets, president of the Brooklyn Trolley Dodgers (later the Brooklyn Dodgers and still later the Los Angeles Dodgers), describing the ideal meal for his team: “We would request a simple dinner with light beer, as that is our idea of a proper drink for athletes in training.” And yet, in Austria, laws prohibit all public references at sporting events to alcoholic beverages. In a country that brews some of the most beautiful beer in the world, the very idea of a brewery involved with sports is considered appalling. “We would never think of it,” huffs Dr. Klaus Leistner, director of the Austrian Ski Federation. “Sports and alcohol should never be placed together.”
There is, in addition, the stress that comes with the spotlight, the expectation to perform. Athletes are often on display, pushed by coaches, parents and fans to achieve perfection. People applaud when they win and criticize them mercilessly when they fail. In addition to striving to excel athletically, academically, and socially, athletes may experience stress due to isolated living conditions in athletic residence halls and long hours spent practicing, training, and traveling. Sometimes the stress builds up. And like a lot of students, athletes find it easier to relieve that stress and to forget about things when they use alcohol or other drugs. Even though they may know they can’t be at their best when “under the influence,” they take chances. It doesn’t matter if you are in the greatest shape of your life, alcohol and other drugs affect an athlete the same way they affect non-athletes.
Research conducted by The College of William and Mary provides insight into some of the deleterious effects alcohol can have on athletic performance:
- Evidence is mounting that even moderate drinking results in a loss of motor coordination 12 to 18 hours after consumption. Depleted aerobic capacity can last as long as 48 hours after use – many hours after alcohol can no longer be detected in the blood.
- Regular metabolic processes in the liver are interrupted while alcohol is being metabolized. The liver is primarily a producer of glycogen, a basic body fuel. Alcohol metabolism interrupts glycogen production, leading to the depletion of natural glycogen reserves. Thus, alcohol metabolism depletes the body of its natural fuel.
- This glycogen depletion leads directly to an early onset of muscle fatigue during athletic performance. Additionally, without a sufficient glycogen supply, the muscle tissue does not have the energy necessary for cell repair following strenuous exercise.
- Alcohol ingestion and metabolism inhibit functions of the skeletal musculature. Chronic alcohol use causes a progressive weakening of the muscles, both cardiac and skeletal.
Adverse effects of alcohol use that have been seen to last up to 48 hours also include:
- impaired reaction time, balance and eye-hand coordination
- distorted perception, affecting accuracy
- impaired fine motor and gross motor coordination
- decrease in strength
- increased fatigue and decreased aerobic capacity
- difficulty regulating body temperature.
Athletes who cannot handle stress sometimes end up binge drinking, picking a night to “go crazy” with alcohol or other drugs. Using alcohol to relieve stress usually results in some trouble, little enjoyment, and more stress. Alcohol causes you to lose your good judgment, and athletes sometimes overestimate their abilities, doing dangerous stunts or taking unnecessary chances. Athletes need to remember that if they injure themselves at a party because they were drunk, it is still an injury. If they commit a crime while under the influence, it is still a crime.
As an athlete, work hard to manage your time and balance your academic, athletic and personal obligations. When you feel stress building up, look for healthy ways to relax. For some people, that means spending time with supportive friends. For others it is a good workout, extra sleep, time with family, or religion. Whatever it is, work it into your schedule before you get stressed out.
A Word About Steroids
- depression and/or aggression;
- if needles are used for injection, sharing needles could lead to HIV or other infections;
- for young men, testicular shrinkage, acne, and loss of hair;
- for young women, irregular menstrual cycle, facial hair, and lower voice;
- damage to the growth area of the bones resulting in a permanent stunting of growth;
- weakening of tendons resulting in tearing and rupture.
Here are a few guidelines that may help you maintain your mental and physical health while performing at an optimal level:
- develop an effective time management plan for balancing studies, practice, work and social time;
- maintain a healthy diet;
- take advantage of campus support services;
- sleep whenever possible;
- attend classes regularly;
- practice healthy stress reduction exercises such as meditation or prayer;
- socialize with your non-athlete peers as well as teammates;
- take extra special care when making decisions about alcohol or other drug use.
