Calling The Shots

Can targeted texts and mindfulness training reduce high-intensity drinking on college campuses?

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Five Figures to Consider

26% increase in alcohol-overdose hospitalizations among 18 to 24-year olds from 1998 to 2014
1,825 college students between the ages of 18 and 24 die from unintentional alcohol-related injuries annually
49% of college men and 30% of college women reported drinking past the binge threshold within the previous two weeks
10% less likelihood that a student will land a job immediately after college if he/she drinks heavily six or more times a month
90% reduction in frequency of binge drinking over six weeks among students who received tailored text messages that demand a response

Back then, there was the kegger. Now, there is the pregame. Back then, we “ralphed.” Now, they “blackout.” Ah, the good old days. Excessive drinking among restless youth has always given adults cause for concern. What’s changed is its intensity. From “slapping the bag” to “butt chugging” and from “shotgunning” to “beer funneling,” many of today’s collegians are laser-focused on “drinking to get drunk.” The result? Alcohol-overdose hospitalizations rose 26% among 18 to 24-year olds from 1998 to 2014 despite a decrease in overall alcohol consumption. For all the research, task forces and millions spent on novel anti-drinking programs, alcohol abuse on college campuses remains problematic. There is some evidence, though, that a student’s cell phone could be a useful tool in reducing binge episodes.

Undergrads binge drink (defined as consuming five or more drinks in two hours for men and four or more for women) at about the same rate their parents did (37% of students vs. 40% of parents). However, now almost half of college men and 30% of college women regularly drink past the binge threshold. There’s a name for it. High-intensity drinking. And it’s on the rise, particularly among women. It’s when ten or more drinks are quaffed in one session. Add energy drinks and prescription drugs (a historically high number of kids are coming to school with Adderall, Valium, Xanax or Klonopin prescriptions) to the mix, and results can turn deadly. Each year 1,825 college students between the ages of 18 and 24 die from unintentional alcohol-related injuries. Meanwhile, among underage drinkers, alcohol is the culprit in 696,000 cases of physical assault and 97,000 instances of sexual assault annually. Alcohol abuse leads to poor academic performance as well. Unsurprisingly, drinking heavily six or more times a month diminishes a student’s chances of landing a job immediately after graduation by 10%. Indeed, binging’s negative consequences put drinkers at a greater risk for problems that extend into adulthood.

These days almost all universities mandate alcohol education for entering students, offer substance-free housing, fund alcohol-free events and hire security (both campus police and off-duty town police) to monitor student parties. Some colleges have also instituted Friday morning classes and banned hard alcohol on campus or in fraternities. (All national fraternities will ban hard alcohol by September, 2019.) Those efforts offer healthy alternatives to the 20% of college students who don’t drink. Yet, the binge-drinking culture remains pervasive. That leaves college presidents continually challenged to incorporate new programs to make their campuses safer.

Move over abstinence. It’s time for mindfulness. Two promising binge-drinking interventions aim to make students more aware of how much they are drinking. The University of Pittsburgh piloted PantherTRAC, a Pennsylvania Liquor Control Board-funded text message intervention system that uses positive reinforcement to discourage binge drinking. In a 2014 study, an SMS program was used to send drinking-related queries every Thursday and Sunday for six weeks to Pitt students who had received alcohol citations. The texts required a response and depending on how students replied they would receive a tailored reply. For example, students were asked if they planned to drink that weekend. If they answered yes, they were asked if they would commit to a drinking-limit goal. If they responded no, they would receive a response to “Be Safe.” At the end of the weekend they received another text asking how much alcohol they actually consumed. Over the six weeks of the study the frequency of  reported weekend binge drinking decreased among the participants by about 90%. The study also indicated that committing to a drinking-limit goal was associated with less overall alcohol consumption. A similar study conducted by the same University of Pittsburgh researcher among 765 young adults admitted to hospital emergency rooms with alcohol-related injuries found that participants who received text messages that prompted them to respond to and receive feedback reduced their weekend binge drinking over 12 weeks as compared to those who received only text messages or no message at all. A follow-up of participants indicated that they had not been aware of the extent of their drinking prior to starting the TRAC intervention. For example, one participant said, “I really went into it thinking like, ‘I’m not really going to need this because I don’t drink too much.’” Many recalled that the repetitive nature of the week-to-week drinking assessments helped them develop a habit of paying attention to how much they drank.  

Likewise, a pilot study from researchers at Ohio University suggests that even a brief training in mindfulness can help binge-drinking college students reduce their consumption. A group of binge drinkers listened to guided meditations, learned mindfulness techniques and meditated individually over four weeks in a program designed to improve their awareness of their emotions related to drinking and to improve their response skills in situations in which they are offered a drink. A control group of bingers received no such training. In the four weeks following the training, students in the mindfulness group drank as often as the control group but binged 2.6 fewer times.

From $1 pitchers to “two-fers,” college students are bombarded with invitations to drink up, yet few have mastered the awareness necessary for moderation. Studies indicate students regularly overestimate how much their friends are drinking and underestimate their own intake. Helping young binge drinkers become more mindful of their emotions related to drinking and requiring regular engagement through texting can disrupt their impulse to join the next keg stand. Now, whether or not a bi-weekly text from a collegian’s parents is as helpful has yet to be studied.

FIVE FIGURE THINKING
It’s not drinking but drinking habits that lead to negative health outcomes. To curb excessive drinking on campus, it’s time to invest in and expand mobile and mindfulness interventions.

 

Sources

American Friends of Tel Aviv University, American Journal of Preventive Medicine, Annals of Emergency Medicine, Journal of Studies on Alcohol and Drugs, Ohio University, monitoringthefuture.org, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, University of Pittsburgh