Prevention File Alcohol, Tobacco, and Other Drugs May 2007 Special Edition: Prevention in Higher Education This document is also available in pdf format (with images) Contents Removing the Barriers to Effective Prevention on Campus by William DeJong and Robert F. Saltz The most effective way to reduce campus alcohol problems is to change the campus and community environment. Recommendations for College Presidents A Call To Action From the Surgeon General Happy Safe 21ST Birthday It's a rite of passage. One way students celebrate is by consuming Alcohol-and lots of it. Putting the Lid on Unruly Parties New alliances between colleges and law enforcement agencies All in Good Fun? Theme parties are all the rage, but heavy drinking is also a theme at many of these events. One Lawyer's View of Prevention and the Law An interview with Peter Lake, professor of law at Stetson University College of Law Drinking and Driving Prevention on Campus Most alcohol-related student deaths are due to drinking and driving. Prevention Briefs ------------------------------------------------------------------------ Removing the Barriers to Effective Prevention on Campus by William DeJong and Robert F. Saltz IN 1997, with student alcohol poisoning deaths at Louisiana State University and Massachusetts Institute of Technology making national headlines, the nation's academic community seemed poised to fight campus alcohol problems in a big way. Now, ten years later, it is time to ask: Are U.S. colleges and universities putting the right strategies in place to combat student misuse of alcohol? A Prevention Blueprint Over the past decade several commissions published recommendations for college officials concerned about campus alcohol problems. The first of these was the Presidents Leadership Group (PLG), which published its report, Be Vocal, Be Visible, Be Visionary, in 1997. Later reports were issued by MADD's Commission on Colleges (2001), the National Institute on Alcohol Abuse and Alcoholism (NIAAA, 2002), and the Institute of Medicine (2004). Every report made the same essential point: the most effective way to reduce campus alcohol problems is to change the campus and community environment in which students make decisions about alcohol use. Moving forward with this approach requires establishing a permanent campus task force participating in an active campus and community coalition. The NIAAA report, A Call to Action: Changing the Culture of Drinking at U.S. Colleges, urged college officials to focus on five key policy areas: 1) enforcement of the age 21 minimum legal drinking age; 2) implementation and enforcement of laws to reduce alcohol-impaired driving; 3) restrictions on alcohol retail outlet density; 4) higher prices and excise taxes for alcoholic beverages; and 5) responsible beverage service policies to reduce alcohol sales to minors and intoxicated patrons. National Progress Report Are the nation's colleges and universities following this blueprint? Unfortunately, most are not, as revealed by a study recently reported by the Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention. In 2005, the Center surveyed senior administrator from 1,400 two- and four-year institutions of higher education. The survey finding were: * Only 29 percent of the administrators reported that their institution had an active campus task force. * About one in five (19 percent) of the administrators stated that representatives from their school were participating in a campus and community coalition. * Just over half (52 percent) of the administrators reported that their school had an alcohol and other drug prevention plan. * Even fewer administrators indicated progress in implementing the environmental management strategies recommended by NIAAA. * As expected, checking IDs on campus was the most frequently cited strategy. Increased efforts to check IDs off campus were rarer. * Working to restrict the density of alcohol retail outlets was cited by under 10 percent of campuses. * Fewer than 6 percent of the campuses said there were cooperative agreements with local businesses in place to limit special drink promotions. * Responsible beverage service efforts were reported by less that a quarter of the campuses. There is no other way to state it: these findings are a disappointment. Senior college officials have been given a clear blueprint for improving their alcohol prevention efforts, but most have not yet taken action. What's getting in the way? Perceived Barriers Diffusion of innovation studies have shown that institutional leaders will act only when there is a felt need to change and the new approach promises greater benefit than risk. With that general principle in mind, we can identify several barriers that prevent campus administrators from adopting environmental approaches. Campus administrators may believe that student alcohol problems fall outside their purview. This viewpoint is especially common when the vast majority of students live off campus, as is the case with virtually all community colleges. Moreover, dealing with off-campus problems necessarily requires working with community leaders, which complicates the process. Campus administrators may think that the alcohol problem is not severe enough to warrant a new course of action. Unfortunately, many schools officials are not moved to act until they experience negative publicity about a student death, riots, or protests from angry neighborhood residents. Complacency can also set in when officials think that their heavy drinking rate is lower than that found at their peer institutions. As educators, campus administrators have faith that people can take in new information and make rational decisions that serve their best interests. Here, that conviction can translate into a preference for using persuasion rather than overt control or social engineering to direct student behavior. There is scant evidence that education-when used alone-reduces student drinking, but most colleges and universities continue to put their heaviest emphasis on this approach. Most environmental prevention strategies affect all students. Campus administrators may argue that the greater need is to identify and intervene with problem drinkers, rather than worry about the vast majority of students who drink moderately and only occasionally abuse alcohol. From this point of view, they may argue that it is unfair to "penalize" all students by imposing stricter policies and enforcement when only a minority of students gets in serious trouble. Campus administrators may be discouraged by the fact that working to change the campus and community environment is a complex and time-consuming effort. It may take several years, with revisions made along the way, to see meaningful improvements. Moreover, success cannot be guaranteed. The research may show that certain programs and policies are effective, but that does not necessarily mean that they will work everywhere. Campus administrators may worry about backlash. If they act, will the public conclude that their institution has a greater alcohol problem than other schools? If they impose more alcohol controls, will potential students shun the school and go elsewhere? Will faculty object, arguing that students need to be allowed to make and learn from mistakes? Will alumni rebel and donate less money? Institutional Capacity There are other barriers related to institutional capacity. To lead a coalition effectively requires strong community organizing and political skills. First, without proper leadership, a coalition can get bogged down in the early stages of the process-complaining about the problem, arguing over who is most to blame, wrangling over the wording of goals and objectives-and never move on to more productive collaboration. Second, many environmental prevention strategies, because they involve policy changes that will affect landlords, alcohol retailers, and other businesses, or because they involve reallocation of government resources, will be resisted. If the political process is not properly managed, that resistance can translate into negative publicity and soured town-gown relations. Unfortunately, most campus-based prevention coordinators are trained as health educators, with little background or experience in political action. Another complication is that colleges and universities are complex and diffuse institutions, with multiple decision-makers and a political culture that emphasizes consensus-building over decisive action. Effective prevention requires a comprehensive and well-integrated effort, but typically there is no single campus official who has been given the authority to organize, launch, and maintain such an initiative. Breaking the Logjam We can remind top administrators that creating a safe environment for educational and social development, which is essential for being competitive in the academic marketplace, is dependent on their institution having a reputation for proactively addressing these problems. We can argue that it is better to engage the student alcohol problem proactively, rather than waiting until a student dies or is severely injured, and that having relatively lower heavy drinking rates does not mean that a campus is immune to tragedy, as Massachusetts Institute of Technology learned in 1997. We can instruct administrators about the "prevention paradox"-the fact that most alcohol-related problems on campus are not caused by the small minority of problem drinkers, but rather by the large majority of students who only occasionally misuse alcohol. We can explain why environmentally focused strategies are the best means of dealing with a population-wide problem of this type, while noting that such approaches are strongly endorsed by the NIAAA report and other reviews of the literature. None of this will matter, however, unless there is a campus-based coordinator who has community organizing and political skills. Knowing what to do is one thing, but knowing how to bring it about is quite another. Moreover, that coordinator needs to be supported by a president who is strongly committed to address the issue. That means granting the coordinator the authority to act, making resources available, and taking on whatever political battles ensure. Where do such presidents come from? Many campuses are blessed to have effective leadership. Others are not, and in those cases it is up to students, parents, faculty, alumni, and community leaders to draw attention to the issue and to compel the school's governing board to make alcohol prevention a priority. William DeJong, PhD, is a professor of social and behavioral sciences at the Boston University School of Public Health. Robert F. Saltz, PhD, is a senior research scientist and an associate director at the Prevention Research Center in Berkeley, California. Wasting the Best and the Brightest: Substance Abuse at America's Colleges and Universities "Accepting as inevitable this college culture of alcohol and other drug abuse threatens not only the present well being of millions of college students, but also the future capacity of our nation to maintain its leadership in the fiercely competitive global economy," says Joseph A. Califano, Jr., director of the National Center on Addiction and Substance Abuse, in Wasting the Best and the Brightest: Substance Abuse at America's Colleges and Universities, a new CASA report. "It is time to take the "high" out of higher education. Rather than the few and disconnected education and policy strategies schools now employ, school administrators and trustees must step up to the plate. But school administrators cannot do it alone. This growing public health crisis reflects today's society where students are socialized to consider substance abuse a harmless rite of passage and to medicate every ill. To change this culture, college and university presidents will need help from parents, alumni, students, Greek and athletic organizations, and state and federal governments. And, to solve this problem the aggressive practices of the alcohol and tobacco merchants marketing to teens and young adults must cease," the report says. Wasting the Best and the Brightest is an almost 300-page document that provides a comprehensive overview of the extent and nature of alcohol and other drug use and problems among U.S. college students, as well as recommendations for colleges and universities, communities, law enforcement and parents alike. To read the full report go to www.casacolumbia.org ------------------------------------------------------------------------ Recommendations for College Presidents 1. College presidents should work to ensure that school officials routinely collect data on the extent of the alcohol and other drug problem on campus and to make this information available. 2. College presidents should frame discussions about alcohol and other drug prevention in a context that other senior administrators, faculty, students, alumni, and trustees care about-excellence in education. 3. College presidents should define alcohol and other drug use not as a problem of the campus alone, but of the entire community, which will require community-level action to solve. 4. College presidents should use every opportunity to speak out and write about alcohol and other drug prevention to reinforce it as a priority concern and to push for change. 5. College presidents should work to ensure that all elements of the college community avoid providing "mixed messages" that might encourage alcohol and other drug abuse. 6. College presidents should demonstrate their commitment to alcohol and other drug prevention by budgeting sufficient resources to address the problem. 7. College presidents should appoint a campus wide task force that (a) includes other senior administrators, faculty, and students, (b) has community representation, and (c) reports directly to the president. 8. College presidents should appoint other senior administrators, faculty, and students to participate in a campus-community coalition that is mandated to address alcohol and other drug issues in the community as a whole. 9. College presidents should lead a broad exploration of their institution's infrastructure and the basic premises of its educational program to see how they affect alcohol and other drug use. 10. College presidents should offer new initiatives to help students become better integrated into the intellectual life of the school, change student norms away from alcohol and other drug use, and make it easier to identify students in trouble with substance use. 11. College presidents should take the lead in identifying ways to effect alcohol and other drug prevention through economic development in the community. 12. As private citizens, college presidents should be involved in policy change at the state and local level, working for new laws and regulations that will affect the community as a whole. 13. Acknowledging that substance abuse is a problem that their schools have in common, college presidents should participate in state, regional, and national associations to build support for appropriate changes in public policy. From /Be Vocal, Be Visible, Be Visionary: Recommendation for College and University Presidents on Alcohol and Other Drug Prevention,/ Presidents Leadership Group, Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention. www.higheredcenter.org/pubs/plgvisionary.htm A CALL TO ACTION FROM THE SURGEON GENERAL Acting U.S. Surgeon General Kenneth P. Moritsugu has issued The Surgeon General's Call to Action To Prevent and Reduce Underage Drinking-2007 to focus national attention on ways to stop America's 11 million current underage drinkers from using alcohol, and to keep other young people from starting. "Alcohol remains the most heavily abused substance by America's youth," said Moritsugu. "This Call to Action is attempting to change the culture and attitudes toward drinking in America. We can no longer ignore what alcohol is doing to our children." In addition to an overview of the problems, the report includes a number of specific recommendations for actions by colleges and communities. It says: "Given the prevalence of underage drinking on college campuses, institutions of higher education should examine their policies and practices on alcohol use by their students and the extent to which they may directly or indirectly encourage, support, or facilitate underage alcohol use. Colleges and universities can change a campus culture that contributes to underage alcohol use. Some measures to consider are to: * Establish, review, and enforce rules against underage alcohol use with consequences that are developmentally appropriate and sufficient to ensure compliance. This practice helps to confirm the seriousness with which the institution views underage alcohol use by its students. * Eliminate alcohol sponsorship of athletic events and other campus social activities. * Restrict the sale of alcoholic beverages on campus or at campus facilities, such as football stadiums and concert halls. * Implement responsible beverage service policies at campus facilities, such as sports arenas, concert halls, and campus pubs. * Hold all student groups on campus, including fraternities, sororities, athletics teams, and student clubs and organizations, strictly accountable for underage alcohol use at their facilities and during functions that they sponsor. * Eliminate alcohol advertising in college publications. * Educate parents, instructors, and administrators about the consequences of underage drinking on college campuses, including secondhand effects that range from interference with studying to being the victim of an alcohol-related assault or date rape, and enlist their assistance in changing any culture that currently supports alcohol use by underage students. * Partner with community stakeholders to address underage drinking as a community problem as well as a college problem and to forge collaborative efforts that can achieve a solution. * Expand opportunities for students to make spontaneous social choices that do not include alcohol (e.g., by providing frequent alcohol-free late night events, extending the hours of student centers and athletics facilities, and increasing public service opportunities)." For communities, the report points out that "adolescents generally obtain alcohol from adults who sell it to them, purchase it on their behalf, or allow them to attend or give parties where it is served. Therefore, it is critical that adults refuse to provide alcohol to adolescents and that communities value, encourage, and reward an adolescent's commitment not to drink. A number of strategies can contribute to a culture that discourages adults from providing alcohol to minors and that supports an adolescent's decision not to drink. Communities can: * Invest in alcohol-free youth-friendly programs and environments. * Widely publicize all policies and laws that prohibit underage alcohol use. * Work with sponsors of community or ethnic holiday events to ensure that such events do not promote a culture in which underage drinking is acceptable. * Urge the alcohol industry to voluntarily reduce outdoor alcohol advertising. * Promote the idea that underage alcohol use is a local problem that local citizens can solve through concerted and dedicated action. * Establish organizations and coalitions committed to establishing a local culture that disapproves of underage alcohol use, that works diligently to prevent and reduce it, and that is dedicated to informing the public about the extent and consequences of underage drinking. * Work to ensure that members of the community are aware of the latest research on adolescent alcohol use and, in particular, the adverse consequences of alcohol use on underage drinkers and other members of the community who suffer from its secondhand effects. An informed public is an essential part of an overall plan to prevent and reduce underage drinking and to change the culture that supports it. * Change community norms to decrease the acceptability of underage drinking, in part, through public awareness campaigns. * Focus as much attention on underage drinking as on tobacco and illicit drugs, making it clear that underage alcohol use is a community problem. When the American people rejected the use of tobacco and illicit drugs as a culturally acceptable behavior, the use of those substances declined, and the culture of acceptance shifted to disapproval. The same change process is possible with underage drinking." The full report is available online at www.surgeongeneral.gov ------------------------------------------------------------------------ HAPPY SAFE 21st BIRTHDAY A 21st birthday is a rite of passage, an event that marks the transition to adulthood and with it, the transition to the legal drinking age. One way students celebrate is by consuming alcohol-and lots of it. The so-called Power Hour is the hour between midnight when a student turns 21 and 1 a.m. (when bars close in some states) during which the birthday celebrant attempts to down 21 shots. And consider the drinking game called 21-run, where students try to consume 21 drinks on their 21st birthdays. Too often, such extreme over-consumption of alcohol proves to be fatal. That was the case at Michigan State University in November 1998 when Bradley McCue died of alcohol poisoning from consuming 24 drinks on his 21st birthday. After this tragedy, McCue's parents and friends, determined to prevent similar deaths, founded the Be Responsible about Drinking Foundation (B.R.A.D., www.brad21.org. The nonprofit organization educates students and parents about alcohol's effects and how to deal with excess use. As part of this educational effort, B.R.A.D. initiated a 21st birthday card program. Beginning in April 1999, the organization sent greeting cards to MSU students approximately one week prior to their 21st birthdays. The cards wished students a happy birthday, but also urged them to celebrate responsibly. The story of McCue's death was included, as was a laminated wallet-sized card with information about alcohol poisoning. The birthday card program, which is relatively inexpensive and easy to implement, captured the imaginations of health advocates on college campuses nationwide. In less than seven years, it has spread to more than 100 colleges in 33 states and the District of Columbia. But does it work? At first, there was no published research to answer that question. In 2003-2004, however, a group of researchers examined the prevalence and magnitude of heavy drinking among college students celebrating their 21st birthdays ("Celebration intoxication: An evaluation of 21st birthday alcohol consumption," Journal of American College Health, No. 54, 2005). For the study, researchers sent humorous birthday cards urging moderation in 21st birthday celebrations to randomly selected students. A second randomly selected group received no cards. After the birthdays, researchers asked students how they celebrated and how much they drank. One hundred sixty-four (32.6 percent) of the students responded. "In general, the prevalence (of heavy drinking on a 21st birthday) is disturbing," says Clayton Neighbors, PhD, principal researcher and currently associate professor of psychiatry and behavioral science at the University of Washington. Indeed, the study found that 90 percent of respondents celebrated their 21st birthdays by drinking, and 44 percent consumed ten drinks or more. Students reported that the average amount consumed was in the range where nausea and vomiting typically begin to occur, and 43 percent said they drank at least to the point where unconsciousness and memory blackout could begin. Further, based on an analysis of number of drinks, amount of time, gender, and body weight, 63 percent reached a blood alcohol content above the legal driving limit. What was the impact of the birthday card on alcohol consumption? Simply stated, none. A second study, conducted by Neighbors in 2006, "ramped up" the first one. Since birthday cards alone had no apparent effect upon students' celebratory drinking, what would happen if, along with the cards, students received BAC charts and guides for responsible consumption of alcohol? According to the research, neither piece of information changed student behavior. A third study added normative feedback to the mix. For this study, conducted by Neighbors and Melissa Lewis, researchers sent birthday cards to students, but also gathered data about the number of drinks the students thought their peers consumed (the perceived norm), as well as how much they actually consumed on their birthdays (the actual norm). The perceived norm was 10.58 drinks, a marked overestimation of the 7.42 drinks that students reported consuming. The study concluded that students who overestimate the norm drink more and that once students become aware of the correct norm, they drink less. However, the results were not statistically significant. An October 2006-January 2007 Web-based study of 314 University of Washington students extended the normative feedback idea by personalizing the feedback to individual students. Along with humorous birthday cards, randomly selected students received via computer a graphic representation of perceived and actual norms. They answered questions about their planned celebrations and the expected consequences of their alcohol consumption. Based on their responses, students received personalized estimates of BACs, possible consequences of their planned consumption, tips for reducing unwanted consequences and information correcting some of their positive expectations. Students were instructed to review the information, print it and look at it prior to their birthdays. A randomly selected control group, which received no intervention, was also part of the study. After their birthdays, students in both groups answered questions about their actual celebrations. The results- Students who received the Web-based intervention consumed significantly fewer drinks (5.98 versus 6.83) and had a BAC significantly less (.10 versus .12) than those who were in the control group. Neighbors plans further research. In the meantime, he says his studies show that birthday cards appear to be effective if they incorporate personalized normative information and tell students what they can expect if they drink a certain amount of alcohol in a certain amount of time. "We've got to communicate risks," he says. "They've got to know the consequences." At Michigan State University, the Olin Health Center and the College of Communication Arts and Sciences did research of its own, thanks to a two-year grant from the U.S. Department of Education. During the 2001-2002 academic year, MSU researchers looked at the effectiveness of B.R.A.D. birthday cards, and recently they submitted their work for peer review. According to Jasmine Greenamyer, program director for B.R.A.D., the /Journal of American College Health/ has completed the peer review process and plans to publish the results. Greenamyer says the soon-to-be published article shows that students who received the card, read it and recalled its contents appeared to significantly reduce the total number of drinks consumed when celebrating their 21st birthdays. These students were also more likely to practice protective behaviors. Greenamyer attributes the findings in part to the fact that the cards are signed by McCue's parents and include the story of his death. "There is a personal connection," she says. "Students know it could happen to them because Brad was an MSU student." For Neighbors, the extreme heavy drinking associated with 21st birthdays cries out for event specific interventions, not only for 21st birthdays, but also for spring break, graduation and other times when students consume alcohol with predictable excess. Yet, he notes that most colleges take a "macro" approach, attempting to reduce average amounts consumed over a period of time or across many situations. To target specific events, Neighbors says colleges should take existing approaches that are backed by peer-reviewed research and adapt them appropriately. In addition to sending 21st birthday cards with personalized feedback or the McCue story, these approaches could include distributing safe birthday tips, involving friends in protective practices, and implementing policies that prohibit bars from giving away drinks or serving students at midnight on their 21st birthdays. With limited resources available for prevention activities, universities need to avoid programs (such as 21st birthday cards alone or accompanied by ineffective information) that "seem to be a good idea," according to Neighbors. On the other hand, evidence-based interventions may hasten the time when Power Hours, 21-runs and the fatalities caused by heavy consumption of alcohol are things of the past. ------------------------------------------------------------------------ Putting the Lid on Unruly Parties Off-campus parties that foster underage and high-risk drinking-and become a nuisance to neighbors-are leading to new alliances between colleges and universities and the enforcement agencies in their surrounding communities. New policies and programs linking concern for student health and safety with local law enforcement do not always sit well with students or even campus administrators. "Law enforcement exists in a different culture from university administration, the student body and other community and government sectors typically involved in the prevention area," says a report on a California effort to forge new campus-law enforcement links. But circumstances may demand a meeting of these cultures. "Prevention and education simply do not work without a healthy dose of enforcement to set clear, swift consequences and to create the deterrence necessary to stop high-risk drinking before it starts," the California report continues. The report summarizes a "California Law Enforcement Executive Forum on College Drinking" held in July 2006. Campus communities are likely to see prevention in terms of education and persuasion. Enforcement may look at prevention in terms of laws and regulations and the allocation of resources to see that they are observed. Both of these "cultures," however, are aiming at the same goal in protecting individual students and communities. New legal weapons have emerged in recent years to deal with parties that lie outside the jurisdiction of campus police and the disciplinary measures that can back up campus alcohol policies. One weapon is the concept of social host liability, making hosts subject to criminal action or civil suits if a person becoming intoxicated at a party causes harm to himself or another. Another is local ordinances aimed specifically at underage drinkers, making party hosts accountable for violation of laws against furnishing alcohol to minors. Mothers Against Drunk Driving reports that 33 states have enacted laws establishing social host liability as a weapon against irresponsible party-givers. The number of "teen party" ordinances is harder to calculate because they are adopted usually at the local level as a weapon for police and county sheriff deputies trying to deal with parties where alcohol flows freely and the accompanying noise and disorder leads to calls from neighbors appealing for relief. Tough policies aimed at reducing underage drinking and rowdy parties in campus housing can have the effect of moving such problems elsewhere-usually into residential neighborhoods surrounding the campus. The party problems often emerge at "mini dorms" where students have collectively rented a house which becomes both a residence and a convenient party scene-one free of the restraints often found at bars and clubs fearing loss of their alcohol license if they aren't diligent in denying service to underage or intoxicated patrons. While colleges and universities cannot police off-campus residences on their own, they often take the heat when partying leads to disturbance calls to police or worse-student injuries or deaths. Hence their support of teen-party ordinances in surrounding communities. However, supporting passage of local ordinances does not guarantee that they will be enforced with diligence, and better enforcement may be a victim of a disconnect between campus officials and local enforcement agencies. Paul Oliaro, PhD, vice president for student affairs and dean of students at California State University at Fresno, told the California forum that "misperceptions" between college administrators and law enforcement officials may present a barrier to the enforcement piece necessary in a prevention strategy. "Law enforcement officials often see administrators as unwilling to hold students accountable, and administrators often see law enforcement officials as people who don't understand the education process." Giving enforcement people a significant role in campus-community prevention collaboratives may be step-one in solving this problem. Community enforcement officials have complained in some cases that they lack the resources to be more diligent in enforcing ordinances aimed at underage drinking and rowdiness at off-campus residences. Campus leaders may have to lobby for higher community enforcement budgets, or provide a subsidy from their institution's funds. The University of California, Santa Cruz, for instance, gave $25,000 to the Santa Cruz police department to pay for stepped-up enforcement of a city ordinance targeting parties considered a threat to public safety or "the quiet enjoyment of residential property or general welfare." The payment was the outgrowth of a meeting between the university chancellor and a neighborhood organization. Elsewhere in California, University of California, Santa Barbara, foots the bill for six full-time officers working in the Isla Vista neighborhood, which became notorious for its alcohol-fueled rowdiness. In Ohio, a state legislator has suggested that the state give local governments permission to levy a tax on alcoholic beverages to pay for the cost of dealing with raucous partying and other threats to public safety traced to alcohol consumption. Inspiration for the proposal came from problems surrounding the Kent State campus in Ohio. "Being a college town, we have tremendous financial outlays on alcohol-related events, such as house parties that are out of control," said a Kent City councilman, quoted in a Feb. 12, 2007, Associated Press dispatch. After Winona State in Minnesota adopted a policy limiting on-campus party organizers to purchase of only one keg of beer, a neighborhood organization urged that a similar limit be imposed on off-campus parties. This did not sit well with some students living off campus. A student told the campus newspaper that there are reasons why students don't want to live on campus, and being free of campus regulations is one of them. "The University has no right to infringe on students' rights," he declared. Another student pointed out that non-students living in the same neighborhood would not be subject to the one-keg limit. "How can you enforce different standards for people who live in the same area?" Keg registration laws can help enforcement people trace lines of responsibility when beer-bust parties lead to law violations. Santa Barbara County in California decided that keg registration did not go far enough as a deterrent. The county increased the required deposit for obtaining a keg from $12 to $75. Fees and fines serve not only as deterrents but can produce extra revenue that can be used for enforcement. Some cities have adopted a "second response" policy that increases the fine when there are recurring complaints about noisy parties at the same location. Duke University took a novel approach to a similar problem. The university simply bought 12 rental units popular as off-campus "mini dorms" in a Durham neighborhood adjacent to the campus and re-sold them with provisions that they be occupied by the new owners as a family residence. The maneuver was in keeping with a 1996 Duke-Durham Neighborhood Partnership designed to improve the quality of life in areas near the campus. Editors note: The report from the California Law Enforcement Forum on College Drinking is available at www.socialhost.org/socialhost/documents/CA%20LE%20Forum%20Coll%20Drink.pdf ------------------------------------------------------------------------ All in Good Fun? The toga parties of Animal House days seem tame compared with the "Pimp and Ho" and "Lingerie" theme parties that are becoming increasing popular at colleges and universities. The idea of throwing a get-together where students dress up according to a particular theme sounds like fun. But, it turns out that in addition to the donning of costumes, heavy drinking is also a theme at many of these events. Three exploratory studies of alcohol consumption in college theme parties conducted by researchers at San Diego State University and the University California, Los Angeles, found that themes tend to be highly sexualized. And, compared to non-themed parties, theme parties tend to be more rowdy, louder, involve drinking games, feature kegs, and feature hard liquor. According to the studies, themed parties are associated with heavy drinking and are marked by a greater number of alcohol-related problems. And, risque themed events, such as "Suits and Sluts," seem to be riskier than the typical themed party. To learn more about theme parties and why they seem to be growing in Popularity-there are even Web pages devoted to theme parties-the researchers conducted focus groups and surveys, as well as observing actual parties. Students said that alcohol consumption at themed events typically exceeds that of non-themed events. Alcohol is generally provided free at themed events, and availability tends to be greater at these events. Students also said the available alcohol at theme parties is usually distilled spirits and mixed drinks, while beer is typically offered at regular parties. "I think there is more of a variety. Usually at themed parties they have a lot of mixed drinks and a bar. But other parties it is just kind of more like a keg, so all beer," said one focus group participant. Women discussed the concept of pre-party drinking while preparing for themed parties, indicating that they drank hard alcohol to prepare for the night. They acknowledged that they were drinking to get drunk and said that themed parties were nights to "go wild." One consequence of "going wild" is that theme parties are broken up by law enforcement officials more often than regular parties, said John. D. Clapp, PhD, lead researcher and professor of social work at SDSU. "Students said that's because of the large size of these parties, heavier drinking and the costumes," said Clapp. These findings on alcohol use at theme parties flies in the face of much of the party planning advice found on college Websites, which often advise that having a theme party can help take the focus away from drinking. For example, the party planning page on the Denison University Website says: Alcohol, if served, should not be a major focus of the event. Consider a theme party; and plan non-alcoholic games. While the findings from these preliminary studies raise a red flag when it comes to theme parties and heavy alcohol use, Clapp cautions that they only begin to explore the potential impact themed settings have on drinking behavior and potential negative outcomes such as unsafe or unwanted sex and drug use. "Further research is needed to better understand this phenomenon," said Clapp. ------------------------------------------------------------------------ One Lawyer's View of Prevention and the Law by Peter F. Lake The Higher Education Center's many contributions to the field of alcohol and other drug prevention are widely known to those whose careers are devoted to prevention. A decade or so ago, few lawyers and legalists were familiar with the work of the Higher Education Center, or developments in the prevention field. This has changed, and so has the law. Prevention is increasingly influencing the law, lawyers, and legalists. At the same time, the law itself has been evolving rapidly in a parallel fashion to prevention. From a prevention standpoint, lawyers, legalists, and judges can be categorized as follows: IGNORATI. This type knows virtually nothing about prevention. While their numbers are decreasing, Ignorati can be an obstacle to prevention by not being an agent of prevention. Symptoms: The alcohol and other drug coordinator has never met the campus lawyer or cannot find the lawyer's office (Hint: look for the President's Office), or a judge takes judicial notice of facts that prevention science has proven false. For example, some judges of the 1970s determined with no evidence that prevention efforts with college students would have no effect. MODERNISTS. The Mods dominate the legal field, a.k.a. prevention. Mods actually know some prevention. They believe in personal choice and accountability, and education and enforcement. Mods view the campus world through the lens of physical boundaries and individual choice and causation. Mods have had a large dose of alcohol's functionalities from the romanticized good times of the Rat Pack to its current close cousin-the work hard, play hard ethic-and implicitly accept these functionalities as positives. Mods accept science, but assume that the burden of proof is very high for new science, and resist anything that smells like Prohibition. Symptoms: A Mod seriously debates whether to regulate any off-campus behavior or whether to have any safe transportation plan for fear of enabling. Or, uses blame, as in, "This is a Greek issue." Or, exhibits a Malthusian rescue-aversion, which manifests itself in a fear of assuming duties to or responsibilities over others (usually students) because of the risk of potential legal liability and the wrongness of overcoming others' choices and responsibilities. PROHIBITIONISTS. This type is a distinct subset of the Mods that is naturally attracted to strong responses to alcohol and other drug use by college students. These legalists like zero-tolerance policies, strict enforcement, dry campuses, bans of all kinds, three or fewer strikes policies, mandatory parental notification, and can quote Toby Keith, General Curtis LeMay, and jurisprudence theorist John Austin, who believed that all law is a species of power and punishment. Prohibitionists are essentially Modernists who believe in tough love. Symptoms: The school's student handbook and student code feature strong statements about what not to do, with little or no attention to what is good to do, and also contain bizarre super-punishments such as expungement-the act of erasing all records of the student-or the X grade. Or, the school's Core [Survey] drinking rate sits at least one standard deviation above national or regional averages, and students engage in extreme student avoidance behaviors that are often high risk, such as "drunk dumping" alcohol casualties at the health center. FACILITATORS/LWPPJs (Lawyers who practice preventative jurisprudence), as described by William Kaplin and Barbara Lee in the leading treatise on higher education law, Law of Higher Education: A Comprehensive Guide to Legal Implications of Administrative Decision Making, Jossey Bass Higher and Adult Education Series, 1995) This type recognizes that legal responsibility is increasingly conceptual and collaborative. LWPPJs recognize that danger and liability move across physical boundaries and understand that many individuals share responsibility for an outcome. LWPPJs gravitate to science and technology and prefer collaborative, proactive responses that reduce risks that could create the types of harms that trigger lawsuits. These legalists recognize that the best legal position for an IHE is to create reasonably safe conditions under which students are most likely to make wise choices regarding alcohol use. They accept basic tenets of environmental management, even if they do not have scientific mastery of the concept. Fortunately, the numbers of such legalists are growing. The Higher Education Center has played a vital role in bringing prevention forward into the legal dimension. Its goals for the future should now be a little clearer, given these law-types. Let's view the Ignorati as we would in any public health crisis and strive to eliminate ignorance of prevention. Unlike the Ignorati, the Modernists and Prohibitionists, however, need reeducation. We recognize them. They hold beliefs that were more common in prevention 20 or 30 years ago. (We should be careful too, that in reeducating we do not inadvertently reinforce the wrong message. As an example, it is common to hear the cry for more, and more consistent, enforcement. For the Prohibitionist, this may fan the flame hyper-enforcement; for the LWPPJs, it may discourage them from using nonenforcement techniques to create a safer campus.) In addition, we should strive to promote preventative jurisprudence as a goal of prevention generally. As clients, we should ask our lawyers to adopt this orientation, as it is essential for success in combating high-risk alcohol and other drug use. If our campus regards prevention as a primary health and wellness goal, then we must insist that our lawyers accept the LWPPJ orientation. This orientation is essential to effective environmental management. Thus, the legal dimensions of the environment should support good prevention efforts, not hinder them. Below are some thoughts about how those of us-lawyers and nonlawyers Alike-working in the higher education prevention field can put these goals into practice. FIRST, we need to continue to interact with lawyers in higher education through national and regional training for lawyers. SECOND, we need to create resources and develop training programs for presidents, and for trustees or other governing board members, regarding the role of law and lawyers in prevention. THIRD, we need to develop specific strategies for statewide initiatives, campus and campus and community coalitions, campus task forces, and so on, to educate and train legalists in best practices for effective prevention. FOURTH, we need to develop specific education and training modules for IHE lawyers and legalists tailored specifically to type. Thus, LWPPJs would receive advanced education, whereas the Ignorati would receive more basic introductory training. As a related matter, we need to develop an assessment device to help a campus identify its legal type, so that it can design training and education accordingly. *The U.S. Department of Education and its Higher Education Center, in partnership with campuses across the nation, have pioneered a model that has brought wider circles of involvement to prevention.* FIFTH, we need to work specifically on the concept of law as an environmental partner in prevention. For instance, prevention has a great deal to offer law in terms of successful strategies that are not enforcement based. Moreover, the law is a successful partner in other public health and environmental initiatives; for instance, after years of wetlands decline in America, the new strategy of wetlands mitigation has turned the tide on the destruction of wetlands. Creative, collaborative solutions reached in other fields may have application to prevention. The U.S. Department of Education and its Higher Education Center, in partnership with campuses across the nation, have pioneered a model that has brought wider circles of involvement to prevention. I know that there is a great unrealized potential that law has to be a force in environmental management. A multipronged approach to law and legalists will bring even greater rewards to environmental strategies. Peter F. Lake, JD, is the Charles A. Dana Professor of Law and the director of the Center for Excellence in Higher Education Law and Policy at Stetson University College of Law. He is a former member of the U.S. Department of Education's Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention. Center for Excellence in Higher Education Law and Policy at Stetson University The Center's mission is to advance the field of higher education law and policy by: * developing a unique curriculum for students interested in pursuing a law degree that prepares them for a career in the practice of higher education law, or a policy role in higher education for which a law degree is preferred * conducting quality research and producing outstanding scholarship in the area of higher education law and policy * presenting interdisciplinary conferences and special programs in areas affecting higher education law and policy * forging productive relationships with other organizations devoted to the advancement of law and higher education both within the United States and throughout the world. For more information, visit www.law.stetson.edu/excellence/HigherEd/ ------------------------------------------------------------------------ DRINKING AND DRIVING PREVENTION ON CAMPUS When it comes to alcohol problems among college students, most people think about the heavy drinking that sometimes leads to alcohol poisoning and all too often hospitalizations and even death. Those are the tragedies that grab the headlines. Fortunately, such events are, in fact rare. But deaths and injuries from alcohol-related traffic crashes are not. In 2001, of all the 1,717 estimated alcohol-related deaths 1,349 were due to drinking and driving. Despite the extent of alcohol-related traffic deaths and high reported rates of driving under the influence-over 30 percent-for the most part college and university prevention efforts don't focus on DUI. According to a report by the Automobile Club of Southern California, one estimate is that just 5 percent of campus alcohol programs focus directly or indirectly on drinking and driving. In order to bring greater attention to the problems of drinking and driving by college students the Automobile Club of Southern California and the Center for College Health and Safety developed the College and University Drinking and Driving Prevention Awards Program in 1997 to respond to the continuing campus need for innovative and effective approaches to alcohol and other drug problems. Its goal is to identify and disseminate model approaches to reducing drinking and driving by students and preventing alcohol and other drug use that can result in impaired driving. Since then the award program has operated in eight states-California, Texas, New Mexico, Hawaii, Texas, Vermont, New Hampshire and Maine-under the auspices of the Automobile Club of Southern California, AAA New Mexico, AAA Texas, AAA Hawaii, and AAA Northern New England. Since the award program's inception 41 colleges and universities have received awards. The Automobile Club has published /Reducing Drinking and Driving on Campus: Best Practices from the College/ /and University Drinking and Driving/ /Prevention Awards Program, 1998-2006./ According to the report, the best programs tend to have certain elements in common. Some of those elements are: * Pre-assessment. Assessing a school's alcohol, other drug, and drinking and driving problems before creating a program not only establishes a benchmark against which later changes can be measured, it also helps to determine the kinds of programs needed. On-line student alcohol and other drug use surveys are now possible, and quick and easy to administer. * Clear specification of who or what are the targets or target groups. Targets may be campus or community policies or practices or problem groups on campus. * Firm grounding in a theoretical (or other applied) framework. Theory-driven programs are better at defining the nature of the problem, linking the problem with activities and solutions and guiding development of effective countermeasures. * High quality program promotional activities/events and materials. If materials are to be read, they need to be appealing to the eye and cover the major points in an easy-to-read and absorbing style. Events should be appropriate for the target audience. * Be institutionalized. For programs to show long-term effects, particularly where audiences change as quickly as colleges, they need to be linked to continued sources of funding and administrative support. Specific staff should be assigned specific administrative responsibilities to assure that major tasks are regularly completed. To read the full report, which includes descriptions of all 41 award winners, go to www2.edc.org/cchs/aaa-awards ------------------------------------------------------------------------ Prevention Updates Stop the Madness At the kick-off of the 2007 NCAA men's basketball tournament the American Medical Association called on the alcohol industry to Stop the Madness by banning alcohol marketing from college sports. It ran a full-page ad in papers in six cities, the Chronicle of Higher Education and student newspapers at Georgia Tech, University of Iowa, University of Wisconsin, Indiana University, University of Mississippi, and DePaul University. The ad reads "The truly insane thing about March basketball is all the money universities get from alcohol advertising." The AMA has criticized NCAA alcohol advertising in the past. In 2002, it objected to Anheuser-Busch ads featuring college team mascots, and in 2005, it sent a letter to NCAA Division I board members requesting a ban on alcohol print and broadcast ads linked to sports events. Preventing Rape by Intoxication The goal of the San Diego Preventing Rape by Intoxication through Community Education-PRICE-program, is to prevent sexual assaults connected to drinking. The theme of the campaign is "Sex Shouldn't be Wasted-Neither Should Your Life" (see www.wastedsex.com/). A woman who is intoxicated cannot give her legal consent for sex, so proceeding under these circumstances amounts to rape, said San Diego District Attorney Bonnie Dumanis, JD, when she announced the campaign on April 12, 2007. Most of those who are victimized are in the 18 to 25 age group, so law enforcement is collaborating with universities and the Navy to reach many of those young people. Posters with the campaign slogan and a photograph depicting a woman who is passed out on a bed are posted on college campuses, on military Web sites, and on coasters in area bars. At a press conference, San Diego State University President Stephen Weber, PhD, said this is a "very real Crime" that happens to young people who are often testing their limits with alcohol. The effects can be devastating, he said. "It lasts for the rest of their lives whether they are the victim or the perpetrator of this crime." As for the military, Jerry Moore, Navy sexual assault response coordinator, said at the press conference, "This will be an education tool to get them to understand the legal side." College Students Only! According to the Chico Enterprise-Record (March 29, 2007), Chico State University students went door-to-door to try to educate other students about how to avoid having teenagers attend their parties. Desiree Bewley, a junior at Chico High School, told the Enterprise-Record that she and others at her school are concerned that high school students are attending college parties. On Monday mornings it's alarming, she said, to hear about some of the things that went on over the weekend. The one-day event included about 45 Chico State and high school students who went to various student neighborhoods and hung cards on residents' door knobs encouraging college students to be more careful about who they allow to drink at their parties. The card, printed on both sides, reminded people to check IDs and ensure that someone monitors the alcohol. Fliers warned students that in California charges of contributing to the delinquency of a minor could occur, and that the fine for a minor in possession is $250 with up to 32 hours of community service. A second offense can be a fine of $500 and 48 hours community service, as well as suspension of their drivers license. Making the Grade Alcohol and academic achievement is an oxymoron, according to a recent survey of University of Iowa students. It found that U of I freshmen who reported binge drinking more than six times in two weeks had grade averages 0.28 a grade point lower than their peers who reported no binge drinking. The roughly quarter-point reduction in grades is significant because a "C" student who participates in binge drinking could find his or her grade average falling from 2.12 to 1.84. U of I students must have a 1.85 grade-point average to avoid academic probation. "In the fall, I taught a section of college transition," Associate Provost Tom Rocklin said about a course for freshmen and transfer students in The Des Moines Register (March 22, 2007). "To be able to show to students that binge drinking hurts your GPA helped the conversation." The survey found that nearly 70 percent of U of I freshmen said they had been involved in binge drinking at least once in a typical two-week period in college. More than 46 percent of those freshmen said their binge drinking occurred at least once in a two-week period in high school. Binge drinking is defined as drinking five or more alcoholic beverages in one sitting. Another Alcohol-Related Problem Heavy drinking is linked to higher rates of sexually transmitted diseases among young adults, according to a new report by the U.S. Substance Abuse and Mental Health Services Administration. Combined drug and alcohol use was associated with even higher STD rates. The study found that that 3.1 percent of past month heavy drinkers ages 18 to 25 had an STD in the previous year, compared with 1.4 percent of young adults who did not drink in the past month. Heavy alcohol use involves consuming five or more drinks on the same occasion on five or more days in the past month. When young adults used both illicit drugs and alcohol in the past month, the rate of reported STDs rose to 3.9 percent. Reported STDs in young adults were lowest for those who did not drink or use drugs during the past month (1.3 percent). Rates of reported STDs for those who used either an illicit drug or alcohol, but not both, were similar at 2.1 percent for both categories. "Substance abuse and risky sexual behavior are closely connected," said Terry Cline, PhD, SAMHSA administrator. "This report puts into sharp focus just one of the many potential lifetime consequences for young adults of heavy drinking and drug use. Unchecked heavy drinking and drug use can lead to serious dependence-related problems, including loss of friends and family, employment, housing, health, and even life. Young adults need to seriously consider the choices they are making and the impact those choices can have on their futures." Sexually Transmitted Diseases and Substance Use, based on data from the National Survey on Drug Use and Health 2005 is available at oas.samhsa.gov/2k7/std/std.cfm. Changing the Culture of Smoking California has the second lowest smoking rate in the nation. Now a new report from the University of California, San Diego, says that smoking among young adults has plummeted since California implemented a groundbreaking tobacco-control plan 12 years ago (Tobacco Control, April 2007). According to the report, the California Tobacco Control Program, established in 1989, has been credited with reducing smoking among all adult smokers. But the decline among young adults has been especially striking, researchers said. Notably, cessation rates among young Californians were higher than among young adults in New York and New Jersey, which have similarly high tobacco prices but lack comprehensive stop-smoking campaigns, as well as compared to young adults in tobacco-growing states (Kentucky, Tennessee, North Carolina, South Carolina, Virginia and Georgia). "We were surprised to find that, since the advent of the California campaign, young people have increased their rate of quitting by 50 percent, far more than their older counterparts," said the paper's first author, Karen Messer, PhD. "It used to be that smokers over age 50 were the ones quitting because they understood the health consequences of smoking." Messer cited the changes in social norms wrought by the California Campaign-such as restrictions on smoking in the workplace and in the Home-as the likely reason for the upward trajectory in quitting rates among younger smokers. "These young adults have grown up in a tobacco-controlled climate, where smoking isn't the norm and isn't socially supported," she said. "We may be seeing the first generation who believe it's not cool to smoke, which could pay huge dividends in their future health," she said. It Takes a Village When residents are actively involved in their neighborhoods, they can clean up crime and violence. That's according to a new study from the Prevention Research Center that found a significant decrease in assaults, car crashes and other alcohol-related crime came with community participation. Calls to police and emergency medical services also dropped with this intervention program that addresses alcohol sales and service (Journal of Studies on Alcohol and Drugs, March 2007). The study found that changing the way alcohol is sold and served can reduce alcohol-related problems-even in high-crime neighborhoods. "These are neighborhoods that are most vulnerable to alcohol-related problems. Even these rather tough neighborhoods can take control of their own environments and reduce the negative effects of alcohol," said study author, Andrew Treno, PhD, a research scientist at PRC. The project includes five components: mobilization to support the project, community awareness, alcohol server training, underage drinking law enforcement and intoxicated patrons law enforcement. Along with members of community based organizations, the project researchers handed out informational pamphlets and held community meetings to raise awareness about alcohol-related problems. They organized neighborhood committees to mobilize residents. They also provided training at bars and stores selling alcohol to prevent selling alcohol to intoxicated patrons and to minors. Project members worked with local police to increase enforcement efforts related to selling alcohol to minors and intoxicated persons. The researchers used these interrelated strategies to change the neighborhood environment with regard to the way alcohol is sold and served. Following the implementation of these strategies, there was a significant reduction in the number of assaults reported by police and a reduction in calls for emergency medical services resulting from assaults and motor vehicle crashes. There was also a significant reduction in sales of alcohol to people who appeared to be minors. No significant changes were found in service of alcohol to patrons who appeared to be intoxicated. Researchers compared these outcomes to the situation prior to the program and to comparison neighborhoods that did not receive the program. The Culprit? Alcohol Over rising concerns about the role that so-called date rape drugs like GHB, ketamine or Rohypnol play in sexual assault, a number of campaigns have been developed to inform women about the dangers of leaving their drinks unattended in social settings. But a recent study from researchers at Wrexham Maelor Hospital in the United Kingdom say women should be more concerned about the alcohol in their drinks. The researchers added that most patients presenting to the emergency department, claiming that their drink has been spiked, will test negative for drugs of misuse. "Our study showed a much higher detection rate of alcohol, which is likely owing to the timing of the sample taken. The patients' symptoms may well have been the result of excess alcohol. A number of these patients probably had their drinks spiked with alcohol, but this is difficult to determine. Claiming that their drink has been spiked may also be used as an excuse by patients who have become incapacitated after the voluntary consumption of excess alcohol." The researchers says that awareness campaigns should emphasize how excess alcohol consumption makes people more vulnerable to assaults and injury. They conclude: Most patients allegedly having had a spiked drink test negative for drugs of misuse. The symptoms are more likely to be a result of excess alcohol (Emergency Medicine Journal, February 2007).