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					                                                                              THE NATION’S NEWSPAPER                                                                        FY01-01

                                                                                          Choosing Wisely (or Not)
Schools urged to serve the                                          Summary: College students are making decisions about lifestyles that may have a
facts about booze                                                      long-term impact on the quality and length of their lives. The newly found
Students experience is tapped to                                    freedom and peer pressure add to the challenge of making logical decisions. The
                                                                       four articles in this case study offer information and research that can help
teach differences in social and
                                                                               college students make more informed and healthy choices.
binge drinking
By Kathleen Fackelman
                                                                    Two 20-year-old
                                                                    women take a
Binge drinkers may be                                               memory test. One
                                                                    of them abused
trying to consume their                                             alcohol. The MRI
                                                                    scan on the left is
‘fair share’                                                        her brain, the lack
                                                                    of color indicating
By Mary Beth Marklein                                               a sluggish mind.
                                                                    In contrast, the
                                                                    scan on the right

College’s party atmosphere                                          is of the woman
                                                                    who doesn’t have
inflates number of                                                  a drinking prob-
                                                                    lem. The colors
smokers                                                             show lots of brain
                                                                    activity. Not sur-                                 By Sandra A. Brown and Susan F. Tapert, University of California, San Diego

By Sherice L. Shields                                               prisingly, she does
                                                                    better on the test.                                 Cover story

Case Study Expert:                                                  Teen drinking, thinking don’t mix
Sally Deters
Residence Life Coordinator                                          Alcohol appears to damage young brains, early research finds
Iowa State University
Ames, Iowa                                                          By Kathleen Fackelman                       portrait of alcohol's impact on the
                                                                    USA TODAY                                   young brain:

                                                                       Teens who drink heavily face a slew        u Brain scans of teenagers who have
USA TODAY Snapshots®                                                of hazards, ranging from accidental         abused alcohol suggest damage to the
  College students who binge-drink                                  injuries to death by alcohol poisoning.     hippocampus, the region involved in
                                                                    If early research is verified, scientists   learning and memory. On average, the
                                                                    might add another danger to that list       young drinkers had a 10% smaller
                                                                    soon: brain damage.                         hippocampus than their peers, one
                                          Men 50%                                                               study shows.
                                                                      Preliminary studies indicate that
                             Women 39%                              heavy, regular drinking can damage           u A separate study shows that teens
                                                                    the developing brains of teens and          who are heavy drinkers perform
                                                                    young adults and perhaps destroy            poorly on memory tests.
                                                                    brain cells involved in learning and
                                                                    memory.                                       u Brain scans of young women who
                                                                                                                drank heavily as teens showed regions
                                                                      Recent scientific findings represent      of sluggish activity in the brain.
                    Source: Harvard School of Public Health Study   the first brush strokes of an emerging
                    By Karen Sloan and Keith Simmons, USA TODAY

                                                 Reprinted with permission. All rights reser ved.

  At risk: at least 3 million American teens who abuse           especially vulnerable target for alcohol.
alcohol regularly.
                                                                   The team injected young rats with a high dose of alcohol -
  People joke about the fact that alcohol kills brain cells,     - the human equivalent of drinking a 12-pack in a single
says Duncan Clark, a                                                                        night. The rats got a day off,
researcher at the University of                                                             then got another shot the next
Pittsburgh Medical Center.                                                                  day. The team continued that
''Well, in this case, the                                                                   bingeing pattern for 20 days.
implications are quite serious.''
                                                                                                     The team let the rats mature
  Clark and other scientists                                                                       into adults, then challenged
fear that teens and young                                                                          them with a memory maze.
adults who regularly get drunk                                                                     Initially, the rats did fine. But
will sustain lasting damage to                                                                     researcher         H.      Scott
the brain, which could make it                                                                     Swar tzwelder wondered
more difficult for them to do                                                                      whether the rats had sustained
well in school or at work.                                                                         a subtle brain injury, one that
                                                                                                   would show up under duress.
  Critics say it's too early to                                                                    To find out, the rats were given
blame brain damage on alcohol                                                                      a single injection of alcohol and
abuse. They say that many                                                                          placed in the maze.
teens who drink heavily also
abuse other drugs and have                                                                           That slight impairment didn't
other risk factors that could                                                                      mar the performance of rats
hurt the brain.                                                                                    that had never been given
                                                                                                   alcohol. Nor did it slow down
  But researchers say that                                                                         rats that had been given
though the work is in the early                                  By Robert Willett for USA TODAY
                                                                                                   alcohol as adults. But rats given
stages, the evidence leans                                                                         shots of alcohol as adolescents
toward a link between alcohol      Caught in a maze: H. Scott Swartzwelder says rats inject-       faltered. Again and again, those
and damage to young brains.        ed with alcohol when young suffer memory loss as adults.        rats made mistakes.

  Sur veys show that many                                                                       ''They were doing twice as
young Americans favor the particularly dangerous binge           bad as everyone else,'' Swartzwelder says.
drinking — downing four or five drinks in a row.
                                                                   Hippocampus may be hurt
  A recent survey by the Harvard School of Public Health in
Boston found that 44% of college students are binge                The team thinks that the alcohol inj ured the
drinkers, and nearly 74% said they binged in high school.        hippocampus, a brain region involved in memory and
                                                                 learning. The findings are in the August issue of Alcoholism:
  ''We have a massive alcohol problem among youth,'' says        Clinical and Experimental Research.
Enoch Gordis, the director of the National Institute on
Alcohol Abuse and Alcoholism (NIAAA), a part of the                Other research suggests that binge drinking overloads a
National Institutes of Health in Bethesda, Md. Gordis and        protein receptor on cells in the hippocampus, White says.
other experts say the new studies, although far from             When working properly, the receptors help the brain
complete, represent a warning that alcohol may target the        encode recent events. The proteins help lay down a
young brain. ''Teens who drink heavily may not realize their     memory so that it can be recalled.
maximum potential,'' Gordis says.
                                                                   Researchers think that binge drinking may lead to the
  Until recently, researchers thought the teen brain had         death of cells in the hippocampus. The loss of those brain
completed its development. Now scientists realize that the       cells may underlie the rats' poor performance on the
brain makes important strides until age 20 or 21.                memory maze, Swartzwelder says.

 Aaron White, a researcher at Duke University Medical              There's also human research suggesting that teens and
Center in Durham, N.C., and his colleagues wondered              young adults who binge are hammering the hippocampus.
whether that meant the young brain presented an

                                  Reprinted with permission. All rights reser ved.
                   Case Study: Teen Drinking
  Adults who drink heavily for 20 or 30 years are known to           Again, the implication is that alcohol harmed regions of
damage that brain region. But the injury was thought to be         the brain involved in memory. The drinking teens had
inflicted over decades of bathing the brain in toxic alcohol,      trouble remembering names — a problem that could
says Michael De Bellis, a researcher at the University of          translate to forgetting facts during a school test and might
Pittsburgh Medical Center. De Bellis and his colleagues            set the stage for spiraling underachievement, Brown says.
recruited 12 teens and young adults with serious drinking
problems. They took scans of their brains and compared               Those findings suggest that alcohol attacks the brain,
them with those of 24 kids who did not have an alcohol             although all three research teams say their results fall short
problem.                                                           of an indictment. It's almost impossible to find alcohol
                                                                   abusers who haven't used other drugs such as marijuana,
  On average, the drinkers had a 10% smaller hippocampus           they say. It could be marijuana, and not the alcohol, causing
than their peers, a ''substantial difference,'' co-author Clark    the memory difficulties, says Linda Spear, an alcohol and
says. The longer a youth had been drinking, the smaller the        drug researcher at the State University of New York,
hippocampus.                                                       Binghamton. And the MRI studies are far too small to offer
                                                                   any proof of brain damage, she says.
  The small study, which appears in the May issue of The
American Journal of Psychiatry, does not prove that alcohol,         Don't give up on youths
rather than some other factor, damages the hippocampus,
De Bellis cautions.                                                  There has been a ''rush to judgment'' on the part of the
                                                                   research community, Spear says.
  But those findings fit with another MRI study, this one of
10 young women who had abused alcohol as teens. All 10               She worries that people will write off young alcohol
had stopped drinking before the study.                             abusers as hopelessly damaged.

   The researchers used a type of MRI that snapped pictures          ''We have to be cautious,'' says Kenneth Sher, an alcohol
of the brain while the women took a test -- in this case, they     researcher at the University of Missouri in Columbia. The
had to remember the location of objects on a computer              studies to date have not conclusively proved that alcohol
screen. Compared with 10 healthy young women, the                  causes damage in the young brain. ''Yet the findings are
women with a drinking history had trouble remembering              extremely provocative,'' he says.
the locations of objects, says Susan Tapert, a co-author who
is at the University of California, San Diego.                        His research suggests that teens who drink heavily have
                                                                   trouble on cognitive tests. His findings suggest that the brain
  The scans of the 10 former drinkers show sluggish brain          is most vulnerable to alcohol's toxic assault in the teen years,
regions. The worry is that alcohol damaged parts of the            not during college.
brain involved in spatial memory. In the real world, such
damage could lead to trouble doing math or even reading a            Swartzwelder says he would bet on the theory that
map, Tapert says.                                                  alcohol harms the brain throughout young adulthood. ''The
                                                                   converging lines of evidence provide a very compelling
  And the study suggests that the brain damage, if it exists, is   argument,'' he says.
long-lasting. Some of the women in the study, who were in
their late teens and early 20s, had been alcohol-free for            At the very least, the findings should raise a red flag for
months. Yet they still showed impairment in brain function,        parents, teachers and others, Brown says. Kids with alcohol
co-author Sandra Brown says.                                       problems should get into treatment as quickly as possible,
                                                                   she says. If further research does prove brain damage from
  The San Diego team has uncovered additional signs of             heavy drinking, the injury might be reversed, she says.
thinking problems in a study of 33 teens, 15 and 16, who
had been drinking heavily for several years.                         Even if research rules out brain damage, there is concern
                                                                   that heavy drinking can lead to short-term memor y
  The researchers gave the teens a list of names and 20            impairment, Swartzwelder says. Alcohol is thought to
minutes later asked them to repeat it. The 24 members of           disrupt brain receptors that form memories, he says. So
the control group, who had no histor y of drinking,                even if brain cells don't die, a heavy dose of alcohol will
remembered 95% of the names. Those who had abused                  garble the ability to encode recent facts and events.
alcohol got 85%, Tapert says.                                      Therefore, kids who study all day and drink at night might
                                                                   have trouble getting their facts right on a test the next day.
  That's like getting a B instead of an A on a test, she says.
The researchers described their results in the February issue         Swartzwelder has a simple message for students: ''Alcohol
of Alcoholism: Clinical and Experimental Research.                 is bad for your memory.''

                                  Reprinted with permission. All rights reser ved.

                                         Health and behavior

Schools urged to serve
the facts about booze
Student experience is tapped to teach
differences in social and binge drinking
By Kathleen Fackelman                                            booze for them, Abbate says.
                                                                   He participated in a teen panel at a recent Washington,
  Teens and college-age youths often are not versed in the       D.C., meeting of Leadership to Keep Children Alcohol Free,
convention of ''social drinking,'' instead favoring a drinking   an initiative formed to educate the public about the
style in which they consume lots of drinks quickly.              dangers of underage drinking.

  A 1999 Harvard School of Public Health survey of 119             In light of recent studies that suggest a link between
U.S. colleges found that almost one-fourth of college            heavy drinking and brain damage among teens and young
students drink heavily and frequently. ''Binge drinking is on    adults, parents could find themselves in a tough spot when
the rise,'' says alcohol researcher Sandra Brown of the          dealing with the issue.
University of California, San Diego.
                                                                    ''Nobody thinks we should go out and tell teenagers to
  That's what 23-year-old Brandon Busteed recalls about          drink,'' says Robert Butterworth, a psychologist to children
college life at Duke University in Durham, N.C.                  and adolescents in Los Angeles.

  Busteed, who graduated last year, says students who              ''But we just have to be so careful when we talk about
drink often do so with the sole purpose of ''getting             these studies,'' he says. ''A while back we had one study
trashed.''                                                       that said if you drink a little bit every day, you'll live longer.''

  For many teens, the drinking begins in high school or            The back-and-forth nature of the scientific method can
even in middle school. Another survey, this one conducted        be confusing, Butterworth says, adding that future studies
by the Centers for Disease Control and Prevention, found         could reverse or modify current findings.
that one out of four ninth-graders reported binge drinking
in the month before the survey.                                    ''I do a lot of evaluations of kids,'' Butterworth says. ''We
                                                                 know that the youngsters who have the worst time are
 Alcohol flows freely at underage parties, says 17-year-old      those who have been strictly forbidden to have even a sip
Andrew Abbate of Burrillville, R.I.                              at home, and when they get some freedom, they rebel.''

  ''It's all around you,'' says Abbate, noting that at many        Busteed thinks schools should do more to include alcohol
parties alcohol is the only drink that is served. Most of the    education in the curriculum. His company, Outside the
kids he knows drink, and some of them drink heavily, he          Classroom (www.outsidetheclassroom .com), is developing
says.                                                            an online course that presents the facts on alcohol
                                                                 consumption to college students.
  Kids bring their own liquor bottle or six-pack to a party.
In some cases, legal-age siblings or other adults buy the          Contributing: Karen S. Peterson

                                Reprinted with permission. All rights reser ved.
                   Case Study: Teen Drinking

How to keep your kids                                       Where to get help
from abusing alcohol                                          For kids and young adults who have a drinking
                                                            problem, experts advise getting help right away.
                                                            For more information:
  u Make it easy for your child to talk honestly with
you about alcohol and other issues.
                                                             u The National Institute on Alcohol Abuse and
                                                            Alcoholism at 301-443-3860 or
  u Talk to your child about the risks of alcohol use,       u The National Council on Alcoholism and Drug
reasons not to drink and ways to avoid drinking.
                                                            Dependence at 800-622-2255 or
  u Keep tabs on your child's activities.

  u Encourage healthy friendships and participation
in activities that don't involve drinking.

  u Develop family rules about drinking, and
establish consequences.

  u Set a good example regarding your own alcohol

  u Know the warning signs of a drinking problem,
and get help quickly for your child.

  Parents of college kids can take these additional

  u Ask the college about its alcohol policies and

  u Find out whether the school has a reputation as a
party school.

  u Call the campus health clinic and find out
whether the school has lots of alcohol-related
incidents during the year.

  u If your child wants to join a fraternity or sorority,
ask about the group's alcohol use and ask your child
how he or she will handle situations involving alcohol.

  u Stay in touch with college students, and don't be
afraid to ask them directly about their alcohol use.

                                Reprinted with permission. All rights reser ved.

                                             Health and behavior

Binge drinkers may be trying
to consume their 'fair share'
By Mary Beth Marklein                                                  similar drops.
                                                                         ''The central theme of the social norms approach is that you
  One of the most popular approaches to curbing binge drinking         get more good behavior if you pay more attention to good
on college campuses may not be effective for most students and         behavior rather than (using) scare tactics and threats of
could even backfire on some students, a new study suggests.            punishment, which has been the more common approach,'' he
  The survey of 14,000 students, conducted in 1999 at 119
colleges in 40 states, centers on how student perceptions about          Even so, smaller studies by other researchers published in the
drinking levels affect student behavior.                               journal appear to support Wechsler's findings.

  About one college in nine has in recent years adopted a                One study involving first-year residential students at a
strategy, called the ''social norms approach,'' that aims to correct   medium-size public university in the South found that a social
misperceptions about alcohol use with education and publicity          norms campaign did not reduce drinking levels for students
campaigns.                                                             overall, and that risky behavior worsened somewhat among
                                                                       students who showed signs of being in the early stages of binge
 The premise is that students will adjust their drinking levels to     drinking behavior.
whatever level of consumption they perceive the norm to be.

  But the strategy is based on an assumption that most students
overestimate drinking levels, Harvard researcher Henry                    How big a problem?
Wechsler says. His study, published in the September Journal of
American College Health, finds the assumption inaccurate:
                                                                          College students' perceptions of the
Nearly half (47%) of college students underestimated binge                alcohol problem on their campuses
drinking levels at their schools, whereas 29% overestimated the           seems to depend on how much they
level, 13% were accurate within 10%, and 12% said they did not            drink, according to a Harvard School of
know. Binge drinking is defined as five or more drinks in a row for       Public Health study. The research defi-
men, four or more for women.
                                                                          nition of binge drinking is five or more
  Also, just 13% of college students surveyed are binge drinkers          drinks at one sitting for men, four or
who overestimate the amount of drinking — the population                  more for women. A frequent binge
most likely to benefit from a social norms approach, Wechsler             drinker had binged three or more times
says.                                                                     in the two weeks prior to the survey. A
  ''If you have a campus where a lot of students are
                                                                          non-binge drinker had consumed alco-
overestimating the amount of drinking, that's certainly fertile           hol in the prior year but had not binged
ground for this approach, but the approach isn't going to work for        in the two weeks before the survey.
all students,'' he says. It's also possible that students who
underestimate drinking levels might increase their drinking if                                         Non-binge  Frequent
they conclude they're not consuming their ''fair share,'' he says.                                      drinker binge drinker
                                                                           Major problem                    12.5%        5.6%
  Michael Haines, director of the National Social Norms
Resource Center at Northern Illinois University (NIU) in DeKalb,           Problem                          39.0%       29.3%
says he is not persuaded by Wechsler's research. He says a                 Minor problem                    33.5%       42.9%
campuswide campaign stressing that most college students
drink moderately has contributed to a 44% decline in heavy                 Not a problem                    14.9%       22.2%
                                                                           Source: Journal of American College Health
drinking at NIU since 1990, and other campuses have seen
                                   Reprinted with permission. All rights reser ved.
                   Behind the Story: A Reporter’s Notebook
                       Stories on college drinking have taken me all over the map. I've gone into fraternity hous-
                       es with sticky floors and John Belushi posters and under bleachers to count discarded
                       liquor bottles during a football game. I've spoken with parents who lost a son or daughter
                       because of alcohol, with hospital emergency room workers who are tired of pumping
                       stomachs (or worse) at midnight, and with college and fraternity leaders who are trying to
                       figure out how to address binge drinking as a legal, social and health issue -- while also
                       downplaying the problem, sometimes, to fend off negative publicity.

                       It's a complex issue with lots of questions. Do you ban alcohol or teach students to use it
                       responsibly? Do you notify parents or work out problems with a student confidentially?
 Mary Beth Marklein    Should problem drinkers be punished or offered therapy? The list goes on.
 Reporter, Life
                       My favorite stories are those about college students trying to change the campus culture.
At one school, members of the senior class vowed to stop participating in a longtime drinking ritual after a class-
mate fell down the stairs and died after chugging alcohol. One fall, I went through fraternity rush with a chapter
that had banned alcohol in their house -- and had a great time. Those examples suggest to me that students can
make a difference. And on a selfish level, those stories are a lot more fun to do!

Higher education reporter Mary Beth Marklein earned a bachelor's degree from the University of Wisconsin at
Madison and a master's in journalism and public affairs from American University in Washington, DC. She also is
an adjunct on the faculty of American University, and recently returned from a sabbatical offered by USA TODAY
at the University of North Carolina at Chapel Hill. She speaks often to college students and groups.
                    Teen Drinking Case Study

College's party atmosphere
inflates number of smokers
By Sherice L. Shields                                                u 8.5% had smoked a cigar within the past month.
                                                                      More freshmen and sophomores used tobacco than
  Almost half the nation's college students have turned to          juniors and seniors. ''This suggests that the cigar use is a
tobacco in the past year, says a report out today in the            new phenomenon entering the college population,''
Journal of the American Medical Association.                        researchers write.

  That finding and others are part of a JAMA issue devoted           Other findings:
to tobacco issues and will be conveyed at this week's 11th
World Conference on Tobacco OR Health in Chicago. Other               u Michael Thun and colleagues from the American
studies have focused on college students' cigarette use, but        Cancer Society in Atlanta dispute claims that the estimated
researchers say this is the first to look into cigar use as well.   death toll from tobacco — put together by the Centers for
                                                                    Disease Control and Prevention — was inflated because the
  Researchers studied the results of the 1999 Harvard               research didn't account for the higher proportion of
College Alcohol Survey, which focused not only on alcohol,          smokers who are from lower socioeconomic groups.
but on cigarette, cigar, smokeless tobacco and pipe use at
119 colleges.                                                         ''It quantifies and confirms that tobacco is the culprit,''
                                                                    Thun says.
  Of the more than 14,000 students who responded:
                                                                      u Florida's ''The Truth'' anti-smoking campaign has
  u 61% said they had tried a tobacco product at least              reduced the number of teen smokers in the past two years
once in their lives.                                                — a 40% decrease among middle school students and an
                                                                    18% decrease for high school students.
  u 45.7% said they had used tobacco within the past year.

  u 32.9% said they had used a tobacco product within the            USA TODAY Snapshots®
past month.

  Researchers found that students are more likely to use               Cigarette smoking drops
tobacco if they value social life more than academics,                 The average annual number of cigarettes smoked by
religion or athletics or if they engage in risky behavior such         an American adult:
as having multiple sex partners or                                     Year
  binge drinking.                                                      1991                                   2,727
                                                                       1992                                              2,647
  ''It's a gross generalization, but students who are
majoring in partying are those most likely to smoke,'' says            1993                                            2,543
lead researcher Nancy Rigotti, the director of Tobacco                 1994                                           2,524
Research and Treatment at Massachusetts General Hospital
and associate professor of medicine at Harvard Medical                 1995                                           2,505
School in Boston.                                                      1996                                          2,482

  The study also found that:                                           1997                                          2,423
                                                                       1998                                        2,320
   u 37% said they had smoked a cigar at least once in their
                                                                       1999                                     2,1361
                                                                       2000                                    2,1031
  u23% had smoked a cigar within the past year.                        1 - preliminary
                                                                       Source: USDA Economic Research Service Agricultural Outlook

                                                                                                                  By Keith Simmons, USA TODAY
                                                                For discussion
     Additional                          1. In era where students typically "live for today,” what alternative
      Resourcs                           methods of teaching should be implemented to demonstrate the
                                         long term effects of alcohol / tobacco use /abuse?

 CDC Tobacco Information Source          2. The facts about the long-term effects are not new and have been
  Information, publications and tips     presented to students throughout the elementary/high school
        on smoking cessation             period. What should we be teaching about the immediate effects
        www.cdc,gov/tobacco              that may make more of an impact?

                                         3. What consequences should students who violate a school’s alcohol
     Entertainment Industries            or other drug policies be? Is the practice of calling the student’s
        Council, Inc. (EIC)              parents or taking away their financial aid a deterrent?
      Information referral, scrip
             consultation                4. What responsibility do administrators have to change the social
            800-783-3421                 norm? What role does the educational institution need to play in
              offering social opportunities that do not involve alcohol? What
                                         would make non-alcohol events more attractive to students to
                                         attend? What is the student’s responsibility in programming for his
    National Clearinghouse for           or her own social needs?
   Alcohol and Drug Information
    Posters, brochures and videos        5. Is there a mixed message when college administrators tell students
            800-729-6686                 they need to act like adults but then tell them what our specific
                 expectations of their behavior are? Are we legislating too much or
                                         too little on those expectations?

      American Public Health
       Association (APHA)
       Information, brochures
                                                           Future Implications:
            202-789-5600                            Legal versus " illegal" recreational drugs
                              — what is on the horizon?

                                       About Sally Deters. . .
Sally Deters is Coordinator of Residence Life –Judicial Affairs at Iowa State University, where she has been
for 22 years. Deters has been active on campus by serving on campus committees to assess the climate and
program for the need of the students.

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