Substance abuse during young adulthood often occurs in the context of the college experience. Many making the initial foray into higher education find themselves at a crossroads of sorts as they navigate from being a recent family dependent toward newfound autonomy. Experimenting with alcohol is one way many college students test the bounds of their newly acquired independence.
In a recent national survey, 60% of college students aged 18-22 reported past-month alcohol use, and nearly 2/3 of this group binge drank during that timeframe.1 Other studies show that 20% of college students currently meet the criteria for an alcohol use disorder.1 College binge drinking can lead to serious consequences such as sexual assault, unprotected sex, injuries, academic problems, driving-related accidents, alcohol poisoning, and even death.2
Binge drinking is defined as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 g/dl (or higher), which corresponds, in most cases, to 4 or more alcoholic beverages for women and 5 or more drinks for men within 2 hours.1,2 People who engage in binge drinking 3 or more times in a week are considered frequent binge drinkers, whereas those who engage in the behavior less frequently are known as occasional binge drinkers.2
In the U.S., a standard drink contains about 14 grams of pure alcohol. Standard drink sizes vary according to the type of alcohol but are typically:1
Statistically, 32-44% of college students report binge drinking.2 Males are much more likely to binge drink than women, with 43% percent of male and 32% of female college students reporting they binge drank during a 2-week period.3 Freshmen are also more likely to engage in this type of drinking behavior, with 1 out of 4 students developing heavy drinking habits in their first year of college.4
In particular, binge drinking is most common among those in sororities and fraternities and is less prevalent among college students who live at home with their families.1
Other factors contributing to binge drinking in college include:3
The first few weeks of freshman year can be a vulnerable time for binge drinking and alcohol-related consequences because of academic and peer pressures that often come at the beginning of the semester.1 Potentially compounding the problem, co-occurring mental health issues such as trauma, depression, and anxiety disorders may also be more present in those who are more likely to abuse alcohol.4
College students tend to binge drink in certain settings, such as:1.3
Problem or binge drinking that worsens and becomes a compulsive, uncontrollable set of behaviors is known as alcohol use disorder (AUD), also referred to as alcohol addiction. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), “AUD is a chronic relapsing brain disease characterized by compulsive alcohol use, loss of control over alcohol intake, and a negative emotional state when not using.”6 Problematic binge drinking behavior, when caught early enough and managed appropriately, can be prevented from progressing to full-blown AUD.
Some of the warning signs of AUD might include:6
If you’ve displayed or experienced 2 or 3 of the above signs and symptoms in the past year, you may meet criteria for diagnosis of a mild alcohol use disorder. If you’ve had 4 to 5 symptoms, you may have a moderate disorder, and 6 or more indicate a severe AUD.
However, simply labeling college binge drinkers as substance abusers or addicted to alcohol isn’t always entirely accurate since drinking behavior that would normally be considered alcohol abuse is often seen as socially acceptable in college. Yet frequent binge drinkers are similar to alcohol abusers in their tendency to deny they have a problem or to minimize the extent of their drinking, and roughly 20% of college students do meet the criteria for AUD (8% alcohol abuse, 13% alcohol dependence).3 Students who binge drink in college are also more likely to abuse other substances.5
When alcohol is consumed in large quantities during a single sitting (a binge episode), death can occur as a result of the ensuing “poisoning” of vital brain stem reflexes such as those that control your respiratory drive and gag reflex—potentially culminating in markedly suppressed breathing or airway blockage (i.e., choking).3 Binge drinking is associated with acute cardiotoxicity (e.g., inflammation/injury of the heart muscle), and may, over time, result in damage to the liver, kidneys, and other major organs, leading to severe long-term health consequences. In fact, liver disease stemming from alcohol abuse was a factor in 1 in 3 liver transplants in the United States in 2009.8 Chronic conditions are rare in young adults, but alcohol users who binge in this age group report significantly more medical conditions than non-drinkers, such as appetite changes, weight loss, and sleep problems.9
In addition to compromising physical health, frequent college binge drinking often results in behavioral problems and compromised academic performance.7 After a long night of binge drinking, students may miss classes the next day or be too hungover to perform well. Statistically, 1 in 4 students suffer academic problems from drinking, which can stem from missing class, performing poorly on tests, falling behind, or just earning lower grades.8 Students who binge drink are often at a higher risk of being put on academic probation.3
College athletes are frequently categorized as heavy episodic drinkers, the effects of which can lead to probationary periods or being cut from the team.4 These consequences can be emotionally difficult to deal with if the student was on a full scholarship or their identity was based on their athletic status.
Binge drinking can take a toll on students’ mental and emotional well-being too, causing episodic depression, cognitive impairment, and legal issues for driving while under the influence of alcohol. An average of 2.7 million college students between the ages of 18 and 24 drive under the influence of alcohol yearly; alcohol-related violations, such as DUIs and DWIs, may cause serious legal consequences and financial burdens that contribute to emotional and mental turmoil.3 Sadly, between 1.2% and 1.5% of college students reported attempting suicide within the past year in connection with drinking or drug use.3
Socially, excessive binge drinking can lead to fights with friends and family members and create other problematic interpersonal issues. Generally, freshmen are housed in dorms and have roommates; binge drinking can cause issues if one roommate is disturbed due to the other person’s disruptive behavior caused by alcohol abuse. College rape attributed to binge drinking and blackouts can have dire effects on someone’s emotional state.3 In such instances, receiving help immediately after the incident is critical. However, alcohol-related college sexual assaults are generally underreported, making it difficult to gauge the true extent of the problem.3
When a person regularly uses or abuses alcohol, physical dependence can develop as the brain comes to rely on the substance. Once the body has adapted to the consistent presence of alcohol, if the person tries to quit drinking, withdrawal symptoms may arise in its absence.
Alcohol withdrawal carries many serious risks, which makes supervised detox treatment very important. Qualified professionals can monitor your symptoms and respond quickly to seizures and other dangerous effects of withdrawal. Not everyone experiences alcohol withdrawal the same way due to their individual physiological makeup, but close supervision can reduce any potential dangers that may arise.
Certain factors that may affect how you detox from alcohol include:10
Fortunately, finding help to safely detox from alcohol is fairly easy on most college campuses. Social service agencies, university health centers, and counseling centers are good resources to explore. Many young adult inpatient and outpatient rehab centers also provide detox services if you think you might need more long-term treatment.
After properly detoxing, you may consider regularly attending peer support groups, such as Alcoholics Anonymous (AA), where you can talk to others who have gone through the process to get clean and are actively working to stay sober.