One in every five frequent heavy episodic drinkers can be diagnosed with alcohol dependence
BOSTON (June 11, 2002) -- A new study shows that six percent of college students meet criteria for a diagnosis of alcohol dependence (also referred to as alcoholism), and 31 percent meet the clinical criteria for alcohol abuse. The study found that more than two of every five students report at least one symptom of these conditions, putting them at increased risk of developing a true alcohol disorder. Previous studies on college drinking have concentrated on the type, frequency and amount of alcohol consumed. This is the first study to assess the actual extent of alcohol diagnoses among college students.
“Heavy drinking is most often regarded as a behavior problem only,” said John R. Knight, Principal Investigator of the study and an Assistant Professor of Pediatrics at the Harvard Medical School. “Our study indicates that many students who drink heavily are at high risk of true mental disorders – alcohol abuse and dependence. Alcohol dependence especially may become a lifelong illness, and more should be done to recognize and help students at risk.”
The findings were released today by researchers at the Harvard School of Public Health College Alcohol Study (CAS) (www.hsph.harvard.edu/cas). The article appears in the May 2002 issue of the Journal of Studies on Alcohol.
Researchers based their findings on survey responses from more than 14,000 students at 119 4-year colleges. The survey included questions that correspond to criteria set by the American Psychiatric Association to diagnose alcohol disorders, the most severe of which is alcohol dependence (alcohol abuse is a less advanced, although still serious disorder).* The diagnostic guidelines can be found in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
Heavy episodic drinkers (often called binge drinkers), and especially frequent heavy episodic drinkers, are at increased risk of alcohol disorders. Heavy episodic drinkers are defined as men who had five or more—or women who had four or more—drinks in a row at least once in the two weeks before the students completed the survey questionnaire. Frequent heavy episodic drinkers have consumed these amounts at least three times in the previous two weeks.
Alcohol industry organizations and some alcohol educators have questioned the five/four measure as too low to be considered heavy episodic drinking. However, the study shows that drinking at this level is associated with a much higher risk of alcoholism. For instance, one in every five frequent heavy episodic drinkers was classified with alcohol dependence (alcoholism), compared to one of every 20 students in the overall student population.
“The findings that so many students are diagnosable as alcohol dependent or alcohol abusers indicate that the drinking levels of too many students are dangerously high. Any attempt to downplay college drinking flies in the face of the facts,” said Henry Wechsler, Ph.D., Principal Investigator of the CAS.
Students who attend colleges with heavy drinking environments are more likely to be diagnosed with abuse or dependence. Male students are at greater risk than females. Nearly one in 10 college men under age 24 met a 12-month diagnosis of alcohol dependence compared to one in 20 college women under age 24.
Despite the prevalence of true alcohol disorders on college campuses, few students report seeking treatment. Only six percent of students with alcohol dependence reported that they had sought treatment.
“For years colleges have offered alcohol education programs. However, our findings show that colleges must not only strengthen prevention programs, but also set up programs to identify high risk drinkers early on and ensure the availability of treatment,” Knight said.
The researchers recommend that student judicial and health service organizations implement early identification programs, and that colleges take additional steps to increase the skills and awareness of students, resident hall and advising personnel about alcohol disorders.
“Furthermore, unless colleges and their surrounding communities reduce the easy access to cheap alcohol, we can expect colleges to produce a continuing stream of alcohol-addicted young people,” Wechsler said.
* The study defined an alcohol abuse diagnosis as a positive response to any one of the four abuse criteria and the absence of dependence. It defined a dependence diagnosis as a positive response to any three or more of seven dependence criteria.
Frequencies of specific abuse criteria were:
- 27.2 % for alcohol use in hazardous situations
- 26.7% for alcohol-related school problems
- 12.4% for recurrent interpersonal problems
- 3.3% for recurrent legal problems
Frequencies of dependence criteria were:
- 17% for symptoms of tolerance
- 15% for drinking more or longer than initially planned
- 8% for drinking despite physical or psychological problems
- 7% for spending a lot of time on drinking-related activities
- Less than 2% for symptoms of withdrawal
The citation for the article in this release is the following: “Alcohol Abuse and Dependence among U.S. College Students” John R. Knight, M.D., Henry Wechsler, Ph.D., Meichun Kuo, Sc.D., Mark Seibring B.S., Elissa R. Weitzman, Sc.D., and Marc A. Schuckit, M.D. Journal of Studies on Alcohol. 63:3 263-270, May 2002.