Transcript Acute Alcohol Intoxication

College Drinking
Gail M. Basch M.D
Department of Psychiatry
Rush University Medical Center
© AMSP 2013
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College Heavy Drinking
Transitional time
Heaviest drinking epoch
Believe heavy drinking = norm
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This Lecture Reviews:
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Definitions
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Campus drinking & problems
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Risk factors for heavy drinking
•
Prevention efforts
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Morbidity & Mortality
~2,000 student deaths/yr
~700,000 assaults/yr
~80,000 sexual assaults/yr
~2.8 million drove while intox
$62 billion/yr underage drinking
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Heavy Drinking Episodes
~45% heavy drinking/2 wks
~20% ♂ drank 10 drinks/occas
~10% ♀ drank 8 drinks/occas
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College Heavy Drinking
→ drinking problems
Clues for prevention
Clues for Rx
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This Lecture Reviews:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
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Standard Drink
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Heavy Episodic Drinking
4+ ♀ / 5+ ♂
≥5 occas/month
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Blood Alcohol Concentration
Standard drink ~12 grams alcohol
1 drink → BAC 0.015 g/dl (~15 mg%)
↑ BAC with:
♀
↓ Weight
Drink w/out food
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BAC’s Effects
Effects
BAC (mg%)
> 300
↓Vital signs, coma, death
≤ 300
Difficulty waking
≤ 200
Anger, moody, confusion
≤ 100
Sleepiness, ↓ coordination
≤ 50 (1-3 drinks)
Well-being, ↓ inhib
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Blackout
Intox →forget events
Not lose consciousness
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Alcohol Use Disorders
Abuse
Dependence
≥1
Role failure
Risk of harm
Legal problems
Use despite problems
 Dependence
≥3
Tolerance
Withdrawal
Unable to limit
Unable to cut down
 Time w/alcohol
↓ Time elsewhere
Use despite problems
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This Lecture Reviews:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
© AMSP 2013
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Heavy Drinking
45% 4+ drinks/occas past 2 wks
20% > 15 drinks/occas past 2 wks
50% ~ 1+ blackout/college
40 % ~ 1+ alcohol problem prior yr
20% students drink 72% of alcohol
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College Students vs Peers
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Specific Vulnerabilities
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Risk Higher For:
21st birthday
Single event/game day/holiday
Fraternity/sorority
Student athletes
↑Impulsivity
AUD relative
Low LR to alcohol
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BAC ↑Drink Days
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Next:
st
21
Birthday
83% drink to celebrate
~25% >21 b-day drinks
~40% blackouts
~50% highest ever drinks
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Next: Game Day Drinking
~60% drink
~7 drinks/game
↑ Impulsive
↑ Expect drunk
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Next: Fraternity/Sorority
~ 60% prior heavy drinkers
~ 80% heavy episodic drinkers
Greeks = heavier drink peers
Believe ↑ drink norms
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Fraternity/Sorority
Blackouts/Past 2 Weeks
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Next: Student Athletes
~50% heavy episodic drinkers
Leaders ↑ drink and set norms
↑↑ Drink peer group
Athlete + Greek =↑↑ drink
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Next: Impulsivity
↓Postpone reward
↑Risk taking
↓Urgency
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Family History
4x ↑ AUD risk
Even if adopted out
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Level of Response
↑↑ Drinks/occas for effects
→Join peers ↑↑ drinks/occas
→Think everyone drinks ↑↑
→↑ Stress
Use ↑ drinks to cope
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This Lecture Reviews:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
© AMSP 2013
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Peer Influence
Students fear rejection
~40% afraid to refuse
Overestimate peer/campus
↑ Drinking to match
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Inaccurate Beliefs
~65% more fun
Alcohol OD
~55% better sex Predict BAC
↓Muscle tension Alcohol + Drugs
Better Sleep
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Alcohol to Cope
Low doses → ↓ mild anxiety
2 or 3 drinks → ↑ anxiety
Drink to Rx anxiety
→ ↑↑ drink
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Prevention Programs
Student health
Dorm counselors
Orientation
Prevention campaigns
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Prevention Videos
Peer influence
Accurate alcohol beliefs
Actual campus drinking
Healthy coping
Can’t guess BAC
Alcohol + drugs dangerous
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This Lecture Reviewed:
•
Definitions
•
Campus drinking & problems
•
Risk factors for heavy drinking
•
Prevention efforts
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Acknowledgements
Marc A. Schuckit, M.D.
Department of Psychiatry
University of California, San Diego
Marcy Gregg
AMSP Scholars
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