TRYING harder doesn't always pay off; more effort doesn't always produce better results. A study released by Harvard University's School of Public Health last week suggests that increased efforts to curb college students' binge drinking may be backfiring. If this is the case, universities should reevaluate the effectiveness of programs designed to combat binge drinking.
The study, based on surveys of over 14,000 undergraduate students at 119 four-year colleges in 39 states, revealed that binge drinking is on the rise. Almost one fourth - 23 percent - of students admitted to "frequent binge drinking," defined as three episodes of more than four drinks in the previous two weeks. This is up from 21 percent in 1997 and 20 percent in 1993. The number of students who had engaged in binge drinking at all in the two-week period remained constant at 44 percent.
This means that the proportion of moderate drinkers is going down, while that of frequent binge drinkers is rising. At the same time, the proportion of nondrinkers is increasing. It is now 19 percent, compared to 15 percent in 1993.
A larger increase in frequent binge drinking took place between 1997 and 1999 compared to that between 1993 and 1997. This is disturbing, especially when coupled with an increase in nondrinkers, because this period is one in which universities have increased their efforts to combat binge drinking. The same researchers also surveyed university administrators, and found that over 97 percent now have education or prevention programs in place at their schools. For example, the University's Alcohol and Drug Abuse Prevention Team (ADAPT) and Peer Health Educators (PHE) aim to educate students about alcohol abuse, and prevent abusive behavior and its health risks.
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This is not what substance abuse prevention programs should accomplish. While one of their goals is to increase the number of people who don't abuse alcohol, this isn't a desirable end if it comes at the cost of increasing the number of severe abusers. Frequent binge drinkers - those who abuse alcohol often - are at the highest risk for injuries or death from alcohol. And that's what these programs are supposed to be preventing in the first place.
The middle ground - that of the moderate binge drinkers - certainly isn't a problem-free zone. But it's a much better place to be than the frequent binge drinker category. Substance abuse prevention programs should be geared towards moving students from frequent binge drinking to moderate binge drinking, and towards convincing binge drinkers to drink less altogether.
This is understandably a difficult task, for these programs are fighting against firmly entrenched traditions of alcohol abuse on college campuses. Prevention programs should endeavor to decrease alcohol abuse gradually - without increasing it among a portion of students at the same time. This isn't what's happening now.
There isn't any conclusive evidence that the alcohol education and prevention programs are directly responsible for the increase in frequent binge drinkers. Establishing such a causal link would be virtually impossible. But it's a plausible explanation of the shifts in drinking behavior.
Such programs confront students directly about their drinking habits. They force students to define themselves at a time in which they are prone to avoid doing so. One's college years are a period of experimentation and self-discovery, and most students drink during this process - more than four out of five, according to the Harvard study.
Programs that put students into categories based on their alcohol consumption rush the self-definition process. These confrontations demand that students decide how they feel about alcohol before they are ready to do so.
It's possible that these experiences push students toward the extremes of drinking behavior by encouraging students to define themselves as one of the extremes: binge drinkers or nondrinkers. If this is the case, and frequent binge drinking is increasing as a result, these programs are failing.
Granted, this is one possible explanation among many. But the possibility that overly ambitious reform programs are doing more harm than good is worth examining. Before universities devote resources to alcohol abuse prevention programs, they need to be sure that they are at least not increasing alcohol abuse.
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