9 No. 2
Out of Control
Alcohol abuse and academic life at Emory
Use and Abuse
Select Recommendations from the President's Task Force on Alcohol and Other Drugs
"Faculty members generally are more aware of what’s going on with students than the rest of us are. They see the impact more closely in terms of class absences, emotional trauma because of assault, and grades suffering."
"In Italy someone who is out of control because of alcohol is considered the lowest of the low as far as bad public behavior is concerned. Drunkenness is disgusting. American youth are always associated with drunken behavior, and they go from drunken to destructive."
An Image of Ethics
The response of the human brain to moral conflict
Neuroethics and Moral Progress
Toward an understanding of ethics decisions
Emory Indicators: Research impact on neuroscience
On a warm Saturday night last October, a steady stream of drunken undergraduates stumbled into Emory Hospital’s emergency room—casualties of the semi-formal dance. Even ten-year veteran emergency medicine physician Kate Heilpern, associate professor and acting chair, Department of Emergency Medicine, who has pretty much seen it all at inner-city emergency departments, was dismayed.
“I was struck by the number of students, many of them underage, who were remarkably intoxicated and who had been binge drinking,” says Heilpern. “Usually a friend or classmate brought them in, and they were so incredibly drunk that it was surprising. They were mixing types of alcohol and drinking obscene quantities—chugging down a pint of vodka or mixing beer with grain alcohol punch, and they had dangerous levels of alcohol in the bloodstream. It was disconcerting.”
Many had to rely on friends to help them stand. A few bled from injuries related to drinking. One, with a deep forehead laceration, had walked into a doorjamb and required a CT scan. Heilpern also marveled at the students’ laissez faire attitude, as if to say none of this is unusual. And it isn’t.
That college students drink is hardly news. They’ve always made alcohol and (by the mid-twentieth century) drugs their allies. What has changed is their relationship with earthly spirits, the truly mind-numbing amounts that are routinely consumed on and off campus, and the blasé attitude about being staggeringly hammered and staggeringly sick from it.
“The severity of substance abuse issues is growing exponentially. I’m seeing people who, with the quantities of alcohol they use, shouldn’t even be able to walk,” says Virginia Plummer, coordinator of alcohol and other substance abuse prevention services for Emory Student Health Services. “Students report consuming from twenty to forty standard drinks of alcohol in a night. For them even considering cutting back means going to twelve, ten, or eight.”
Faculty: how close?
These issues are increasingly asserting themselves in the classroom. Students are coming to their professors to say that they are struggling with alcoholism. Hangovers interfere with academic work. But to what degree should faculty be involved with their students’ extra-extracurricular activities?
Plummer suggests that, in addition to directing at-risk students to Emory Student Health Services and the Counseling Center, faculty can harness the leverage of their position. “Grades and career are very important to students and their parents, and that’s where faculty carry weight,” she says.
“I don’t mean ponderous or disciplinary weight, but if they’re willing to draw boundaries in an open way, they can have a great impact.” Warning a student well in advance that he is heading for low marks may be enough to alter behavior among true binge drinkers. But for those suspected of being alcoholics, she emphasizes the need for compassion and urges faculty to do their best to avoid shaming students. “Shame comes with this, so people who need the most help are often the most reluctant to reach out. They’re scared of their parents and faculty. Yet it’s the faculty who are the doorway to where they may, for the first time, share that they have a problem.”
Faculty have a responsibility to identify students with drinking issues, then nudge them toward help, agrees John Ford, senior vice president for campus life. Telltale signs include a sudden drop in academic performance, falling asleep in class, or belligerence. “It’s not unthinkable to actually walk a student to the [counseling] center,” says Ford. “But I would be very careful to say that beyond recognition and referral or leading them by the hand, faculty should not get involved in counseling students themselves. That’s where I would draw the line. I don’t think that’s the role of faculty.”
That line can leave some feeling stymied, however. Jim Roark, Samuel Candler Dobbs Professor of History, recalls a student whose attendance suddenly dropped off after a strong start. He shot off an e-mail and asked if all was well. The young man visited Roark and confessed that he was an alcoholic—a fact he’d thus far misconstrued as heavy binge drinking. “He was twenty years old, clearly shaken and scared,” says Roark. He sought counseling and took other positive measures, such as moving out of his fraternity. But he left Emory, and Roark never found out what happened afterwards.
“I felt powerless,” he says. “What do you do other than encourage them, and give them a hug?”
The consequences of extreme drinking reach well beyond the drinker and are profoundly associated with incidents of interpersonal violence, sexual assault, depression, suicide, classroom absenteeism, academic and professional failure, and motor vehicle accidents, as noted in the final report of the President’s Task Force on Alcohol and Other Drugs, released last March. In addition to characterizing the extent of the problem, the three-person task force identified “strategies for reducing and preventing high-risk use of alcohol and other drugs at Emory University.”
First-year students are particularly susceptible to the lure of alcohol. Many have already partied hard during summer break, but the number who binge drink jumps significantly during the first semester “Something happens to freshmen,” says task force member Michael Huey, executive director, Student Health and Counseling Services, and clinical assistant professor of family and preventive medicine. “These are kids who studied hard in high school. Our data show that they didn’t party as much as other high school seniors while trying to get into college. Then, eight to ten weeks after arriving on a college campus, their rate of high-risk drinking has nearly doubled. Something about college makes people drink in a dangerous manner.”
So, apparently, does traveling abroad. For six weeks each summer, Judy Raggi-Moore, director of the Italian studies program and a senior lecturer, leads twenty to thirty Emory students through her native Italy. She has little choice but to immerse herself in students’ lives, and she’s grudgingly accepted that, against all obstacles, and regardless of how often she admonishes them to respect the customs of their host country, most of her students will find a way to drink.
“Despite the fact that it’s 11:00 at night and they have to get up at 6:30 and still have to prepare for the next day’s assignment, they will not give up going to drink. They won’t. They can’t. They have to drink,” she says. “Many American students in Italy drink heavily and become obnoxious.
“Some European cultures consider drunken behavior absolutely inexcusable and disgusting. In Italy, you can scream and shout and get angry at people. It isn’t considered noteworthy. But someone who is out of control because of alcohol is considered the lowest of the low.” Drunk Americans often go hand-in-hand with property damage, Raggi-Moore adds, and European hotel and restaurant managers often refuse reservations from American study abroad programs.
At the root of what’s been called an epidemic among college students are the usual suspects: explosively decompressive freedom laced with disorienting isolation, grade pressure, and a desperate need to fit in. Alcohol is the source for some. And the race for college admittance demands more of today’s students than of any previous generation. Just to get into Emory requires, in addition to stellar grades and test scores, an extraordinary résumé of extracurricular activities and achievements.
Students perhaps feel license to cram as much socialization, relaxation, and partying into a few short years as possible, Huey suggests. Some students have told Plummer that they’ve heard enough about the dangers of alcohol and drugs; now it’s their turn to make their own choices, and some decide to “drink as heavily as I can and smoke all the pot I can” for the next four years. Parties become a contest to “top what they’ve already done,” says Plummer, and they elevate drinking to a competitive sport. Intellectually, students are aware of the risks but seem unwilling to personalize them. “They share with me that they have friends who went into rehab or died because of alcohol. It scares them, but they don’t think that it will happen to them.”
No amount of sermonizing can persuade them not to drink, says Dan Adame, associate professor of health education in the Department of Health, Physical Education, and Dance, who coordinates the required first-year health class. “I don’t tell people not to drink, I don’t moralize, I try very hard not do that. That’s not my place,” he says. “My place is to teach [students] what we know about alcohol and drug use, so you can decide if you want to do it or not. If I can at least get you to consider what you’re doing, I’ve done my job.”
Alcohol abuse and mental health top the list of issues among student affairs administrators, says Ford. He believes that Emory’s drinking problem is less serious than those of the most heavily drinking campuses. “We’re somewhere in the middle. That makes our situation fixable, and I’m encouraged,” says Ford. “We’re not bursting at the seams with horrific alcohol abuse problems that hit the newspaper on a regular basis, as happens at some campuses. We have room to improve, but those improvements are doable.”
A change in Emory’s culture is mandatory, says Huey. “We need to decide what type of place Emory is, and if we care enough about each other that we don’t let each other drink or take drugs to the point where it destroys academic careers or harms ourselves or other people in the community. A lot of people have said you’re never going to change that. That college is a rite of passage and students have done this for generations, so why should this one be different? I don’t believe that. One year from now, 25 percent of the student body is gone, the next year 50
percent, and two years after that 100 percent. So why couldn’t things be 100 percent different four years from now? We have the advantage of having a community that reselects itself every year. They can choose to come here or not. I think the culture at Emory can change.”—S.F.