the battle of the binge

It’s late Saturday night on Homecoming weekend in this picturesque Midwestern college town. But in the dozens of bars just off the University of Iowa campus, the atmosphere is tranquil. There are no lines forming to enter the bars, and the pedestrian malls and sidewalks show no signs of the heavy student drinking that has characterized this town for many years.

A mile away from the downtown scene, several fraternity houses appear quiet. Only one house has an obvious party underway.

The post-football game victory celebrations--at least the ones featuring booze--have gone underground at the University of Iowa this autumn.

The change has much to do with an ambitious new program at Iowa that is attempting to curb the high rate of binge drinking among students. The programs, part of a $10-million initiative funded by the Robert Wood Johnson Foundation, are also in place at nine other U.S. colleges, including the University of Colorado in Boulder, the University of Delaware, Florida State and Louisiana State.

The stakes are high. Success, which Iowa administrators define as a gradual reduction in binge drinking rates, has the potential to do to binge drinking behavior what Mothers Against Drunk Driving did to the practice of driving under the influence of alcohol, says Laurie Leiber, director of the nonprofit Center on Alcohol Advertising in Berkeley.

Failure, however, could mean the addition of yet another well-intentioned plan to the public health compost pile.

“There really hasn’t been anyone asking the questions that MADD started asking, which is, ‘What are the predictable consequences of alcohol in our society?’ ” Leiber says. “What MADD did was simply point out that we are losing people on the road.”

Likewise, Leiber said, drinking-related deaths, such as a 1995 death in a fraternity house at Iowa, several throughout the country in 1997, and one last week at Rutgers University, “rivet people’s attention.”

The Robert Wood Johnson Foundation, a Princeton, N.J.-based philanthropy devoted to health, stipulates that the grantees must involve both the college and surrounding community to focus on the environment that leads to excessive drinking--especially access to alcohol.

The program differs significantly from other substance abuse prevention programs of the last two decades (such as DARE, “Just Say No” and others) because it deemphasizes educating youths about their personal responsibility in favor of creating an environment in which drinking to excess is frowned upon, too difficult and too risky.

“The personal responsibility approach is not going to suffice; there are too many pressures,” says University of Iowa president Mary Sue Coleman, who has been urging college presidents nationwide to address the problem. “We are talking about the environment and the culture we create that leads to something like a student’s death.”

But to critics of the program, this “environmental approach” smacks of Big Brother oversight, infringement of individual rights or even a throwback to Prohibition.

“When we tell Americans you cannot have something, they tend to reach for it,” says Janet Reis, an associate professor in community health at the University of Illinois. With funding from the alcoholic beverage industry, Reis has developed an education program for colleges, called Alcohol 101, which stresses personal responsibility. “The environment is very important. But we first have to modify individual attitudes about drinking.”

Efforts such as the Iowa program, however, spring from a growing recognition that previous efforts to curb binge drinking have been largely unsuccessful, says Richard Yoast, director of the office of alcohol and other drug abuse at the American Medical Assn., which administers the Johnson grants.

“In the past, we have tried to deal with youth who have been drinking by scolding them and punishing them without getting to the causes of why they are drinking,” Yoast said. “It’s like putting kids in a candy store, advertising the candy, and then telling them not to eat the candy. If we had wanted students to drink, we couldn’t have created any better environment in colleges than we have now.”

The statistics bear that out. A recent annual survey from Harvard University showed that bingeing rates have not changed much in recent years, with 42.7% of college students admitting to the practice in 1997. Bingeing is typically defined as five drinks in a row for men, four in a row for women.

Slightly more than half of the Harvard students who drank said they aimed to get drunk, while a recent survey from the American Academy of Pediatrics found that adolescents ages 16 to 19 said they drink to fit in and have fun.

Emphasizing the Costs of Alcohol Abuse

The time seems right to marshal forces for an assault on America’s alcohol-friendly culture, says Iowa’s Coleman.

“Just like the antismoking effort found, you can rarely have success locally when no one is paying attention nationally,” she says. “I saw a sea change when [the student drinking deaths] happened. I think people sat up and said, ‘What is going on here?’ ”

Indeed, the AMA’s initiative, called “A Matter of Degree,” is tapping into a tried-and-true public health model. Just as the antismoking campaign ultimately rejected a narrow “it’s bad for your health” tactic to discourage smoking, the Johnson grantees are emphasizing the cost of irresponsible alcohol use to society at large.

“Binge drinking affects other people and their rights to function,” says Phillip Jones, vice president for student services at Iowa. “This is the development of a social movement. We have to work on changing the social structure, the law enforcement structure and the economic structure.”

With its $770,000 Johnson grant, Iowa is attempting to do just that. Its plan, called the Stepping Up Project, unites individuals at the university and in the community to look for ways to curb binge drinking, including:

* A plan called “reclaiming Mondays and Fridays,” in which instructors are urged to avoid making fewer academic demands on students on those days just because students are less than alert after partying.

* An education effort in the city’s high schools to address bingeing.

* More campus social activities that do not feature alcohol, such as movies, concerts, speakers and street dances.

* Banning alcohol next fall in a parking lot that is popular for football game “tailgating” parties.

* Cooperation with police to encourage more patrolling of bars for underage drinkers and of neighborhoods for vandalism related to drinking.

* Persuading local bars to eliminate all-you-can-drink or other types of specials that encourage excessive drinking.

The university has already seen some progress. Iowa’s fraternities, rather than fight the restrictions, have gotten on board. The fraternities earlier this year voted to “go dry.”

“The [fraternity] chapter presidents see the danger and risks and liability that excessive drinking brings to the houses,” said Nick Mauro, president of the Intrafraternity Council at Iowa.”

Backlash Against Tightening Rules

But there has been plenty of backlash too. A survey of Iowa City residents showed only moderate support for a proposed rule to prohibit kegs on campus and a tighter nuisance ordinance that would not require a complaint from an individual before the police could address the situation.

“[Stepping Up] can’t push ordinances down their throats,” says Brian White, president of the UI student government and a member of the Stepping Up Project executive committee. “If you don’t change perceptions, it won’t work.”

It’s even hard to know whether students--many of whom have moved their parties to residences off campus--are paying attention to the efforts going on around them. Dormitory literature making students aware of their rights to a clean, quiet, alcohol-free dorm seem to have stirred little interest or opposition.

However, there has been no reaction similar to one last spring at Michigan State University, when students rioted after the university banned alcohol in an 11-acre lot popular for partying before and after football games.

Such restrictive programs run the risk of alienating the people they are trying to reach, says Illinois’ Reis.

“Choking the supply doesn’t work to the degree we would hope it does,” she says. “The environmental approach doesn’t give enough emphasis to the social influences on a young adult.”

Reis helped create and test Alcohol 101, an interactive, CD-ROM program for college students. The program is funded by the Century Council, a Los Angeles-based industry group representing brewers, vintners, distillers and wholesalers and is available free to 650 U.S. colleges and universities this year.

Alcohol 101 is intended to help students anticipate the impact of alcohol and teaches such facts as how many drinks it takes to get drunk and how long it takes alcohol to leave the body.

According to Reis, a four-year study at Illinois shows the program is successful in helping students understand the effects of alcohol--more so than in “traditional” alcohol education programs.

“Many students come to college feeling like they have heard it all and are tired of the dreaded lecture,” says Lawrence Lokman, vice president of program development for the Century Council. “Particularly at the college level, not feeling lectured to is very, very important.”

But Yoast and other skeptics say Alcohol 101 “plays into the whole idea that the only ones responsible are the students. It doesn’t look at all at the tremendous amount of advertising and promotion of alcohol to students. It doesn’t really talk much about not drinking as a major alternative. The entire [computer program] takes place in a bar. And, when I used it, the program asked, ‘Are you 21?’ I said no, and it still let me into the bar.”

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By the Numbers:

An annual study on alcohol use in colleges nationwide released last month showed binge drinking rates are remaining high.

Students who said they usually binge when drinking: 41.5%

Students who said they drank to get drunk: 52%

Students who abstained: 19.5%