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Think when you drink: The new norm?

The fall of 1997 was a sorrowful semester for the Commonwealth's public colleges and universities, when alcohol-related accidents claimed the lives of five students statewide.

Among those who died was University student Leslie Ann Baltz, said Susan Bruce, director of the University's Center for Alcohol and Substance Education, commonly know as CASE.

Baltz, left unattended with a blood alcohol content of .27, died from severe head injuries after falling down stairs. Her death came little more than a year after the University lost Elizabeth McGowan, who slept through a fire at her home with a BAC of .25.

The second alcohol-related death of a University student within little over a year prompted University students, faculty and administrators to reevaluate alcohol awareness around Grounds.

The reassessment coincided with recommendations from a statewide alcohol task force created by Richard Cullen, who was Virginia's attorney general at the time.

"Every public school had to put together a document that listed [under each] recommendation what the school was currently doing and what they planned to do," Bruce said.

In the fall of 2002, each participating college and university submitted a five-year update report to the Virginia Attorney General's Office, she added.

Within the past six years, the University has seen both the expansion of existing alcohol abuse prevention programs, as well as the initiation of new programs. Through CASE, the Elson Student Health Center and the Alcohol and Drug Abuse Prevention Team, the University offers several resources to educate students on making safe decisions regarding alcohol.

Finding Solutions

The founding of ADAPT through the Office of the Dean of Students in the spring semester of 1999 was a major student-initiated effort at counteracting alcohol abuse.

"A group got together because of growing concerns about alcohol and drug use and decided that there needed to be a student group," ADAPT chair Kathy Radd said.

ADAPT's services range from presentations to fraternities, sororities and athletic teams to week-long campaigns to promote safe drinking. The interactive presentations cover a variety of subjects, including social norms, alcoholism, high-risk drinking and drunk driving, Radd said.

One major ADAPT program is the annual Alcohol Awareness Week, which takes place the week before the University's last home football game.

One goal of Alcohol Awareness Week is to persuade students not to participate in the "fourth-year fifth" tradition.

ADAPT works with fourth-year class trustees to promote Fourth-years Acting Responsibly, a drive to collect pledges from students that they will not consume a fifth of liquor during the last home football game, Radd said.

The Peer Health Educator's Fourth-year 5k Run, offered through the Student Health Center's Office of Health Promotion, also takes place the morning of the last home football game to discourage the drinking tradition, Health Promotion Coordinator Alison Beaver said.

In a similar week-long campaign, ADAPT conducts Safe Spring Break Week during the week preceding Spring Break to promote safe drinking habits and responsible choices.

Another ADAPT-sponsored initiative is the 21st birthday card with a moderation message. ADAPT sends out birthday cards one to two weeks before students' birthdays that contain an insert encouraging them to drink in moderation.

Based on surveys administered in 2001, students indicated that they consumed less alcohol on their birthdays as a result of the birthday cards, Radd said.

"I personally was surprised by that statistic," she said. "It's such a small project, but it's something we can to do to reach out to people so they can be safer on their 21st birthdays."

ADAPT currently is working with the University Housing Division to establish "Wellness Housing," to which students could apply and pledge to be substance free and adhere to an overall healthy lifestyle by eating right and exercising regularly.

ADAPT conducts weekly walk-in hours on Thursdays at 3 p.m. in room 187 in Newcomb Hall, during which students can seek advice on alcohol and drug issues.

"Since we are their peers, students might feel more comfortable talking to us," Radd said. "We can help them and point them in the right direction for counseling or [Alcoholics Anonymous] meetings."

Another source of advice or counseling is the Counseling and Psychological Services division of the Student Health Center, which provides alcohol assessments for students.

People call CAPS with concerns for themselves, friends or family and to find out about consultations, said Richard Heisterman, director of consultation services and substance use clinician.

Whereas CASE and ADAPT focus on cultural factors and the Office of Health Promotion focuses on health factors, CAPS concentrates on the clinical and psychological factors influencing alcohol and substance use, Heisterman said.

"The key wildcard is psychology," he said. "We do risk assessment based on social environment and family history and look at individual risk factors that may affect students."

Making a CASE

Another major change that took place over the past six years was the relocation of Institute for Substance Abuse Studies from the department of psychiatric medicine to the Office of the Dean of Students. The institute was renamed CASE after the move.

One of CASE's major initiatives within the past six years was a University adaptation of the national Prime for Life program, which the University renamed Choices, Bruce said.

The program, offered on a monthly basis, consists of two, two and half hour sessions during which participants are instructed through lectures, power point presentations and videos. Although Choices is open to all University students, most participants are "indicated" or "high-risk individuals" and have been sanctioned by the University Judiciary Committee or are otherwise encouraged to attend for alcohol-related problems, Bruce said.

Data collected from pre-program and post-program questionnaires during the 2002-2003 academic year, indicated that a majority of participants were both drinking less and experiencing fewer negative drinking-related consequences, she said.

In addition to Choices and collaborative efforts with ADAPT, CASE is involved with promoting low-risk alcohol behavior within the Greek system.

In 2001, the U.S. Department of Education gave CASE a $257,000 grant specifically for use within the fraternity and sorority culture

Upon receipt of the grant, CASE faculty met with representatives from all four Greek Councils -- the Inter-fraternity Council, the Inter-Sorority Council, the Black Fraternal Council and the Multicultural Greek Council -- to discuss possible uses of the grant money, Bruce said.

One of the major projects stemming from the funding is the Small Group Social Norms Program, which is modeled off of a program developed at Washington State University, she said.

CASE faculty train fraternities and sororities from any council to administer a one-page social norms survey, gather data from the survey and conduct a presentation for their respective chapters.

"The nice thing about the program is that we provide the training and students within the chapters are doing the presentations, as opposed to someone external to the group," Bruce said. "It's a much more personalized presentation -- each group is looking at its own norms."

Drinking Norms

The survey is an abbreviated version of the much longer social norms survey, part of the University-wide Social Norms Marketing Campaign offered through the Student Health Center's Office of Health Promotion.

Prior to the 2002-2003 academic year, the campaign was geared primarily towards first-year students, but has since broadened its scope to include upperclassmen, said Social Norms Marketing Coordinator Jennifer Bauerle.

The Web-based, random sample survey gauges student drinking behavior through questions ranging from how many alcoholic drinks students consume per week to the types of negative consequences students experience as a result of consuming alcohol, she said.

The statistics are published in two different series of posters, "The Stall Seat Journal" for first-year students and "Hoo Knew" for upperclassmen.

Although social norms marketing was criticized as ineffective in a recent Harvard University, University data has shown that over the years students have reported fewer negative consequences of drinking.

"We can't say 'Yes, social norms marketing causes this,' but we can show there is some correlation between our program and a decrease in negative consequences of drinking," Bauerle said. "For me, that is my litmus test for whether or not our programs are working."

Negative consequences can include anything from a hangover to unprotected sex to a trip to the emergency room, she said.

"Our goal is to keep students healthy and safe so they can come to the University and learn, not just in an academic setting, but so they can be ready for all experiences that college brings," she added.

Data collected over the past five years by the Student Health Center indicates fewer students have visited the emergency room for serious alcohol-related injuries or sickness, Director of Student Health Dr. James C. Turner said.

"I know based on the research we have done at the University that the number of drinks students consume on a weekly basis has dropped significantly over the last five or six years," Turner said. "The negative consequences have dropped from what students are self-reporting and very serious consequences have dropped in the emergency room as well."

The Student Health Center started collecting emergency room data on students with alcohol-related problems in 1998 or 1999, after growing concern that students avoided using the emergency room for fear of parental or police notification, he said.

"We've actually spent a fair amount of time trying to reassure students that if they use the emergency room for any reason, the University, their parents or police are not notified," Turner said.

The only exception to this is the rare instance that a student's life is in danger, he added.

Since University health officials have increased efforts to encourage students to use the emergency room, the total number of alcohol-related visits has increased. Whereas the emergency room used to see 100-115 alcohol-related visits per year, the average has increased to 150-160 per year, Turner said.

"The trend is there are more visits for alcohol-related problems like minor cuts, bruises and sprains, but fewer visits for serious problems such as alcohol poisoning and serious head trauma," he said.

Despite criticism over the effectiveness of social norms marketing, Turner said he is convinced that the University's campaign has contributed to the positive changes in student drinking trends.

"Our students are smart -- they receive the information in a positive way and make smart decisions as a result," he said.

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