The Stanton Peele Addiction Website, April 1, 2000
A National Failure at Moderation
"Efforts to curb excessive drinking on college campuses fall short," newspaper headlines screamed. Henry Wechsler, director of the College Alcohol Studies Program at the Harvard School of Public Health, has been studying binge drinking on U.S. campuses since 1993. By 1999, he found, the percentage of student who frequently binged had not declined, but increased, as had the number of abstainers.
This split or alternation between abstinence and binge drinking is an old one. It is characteristic of cultures which view alcohol as a tempting evil. From this perspective, drinking must be avoided. However, once tasted, it cannot be resisted.
This contrasts with those cultures (most notably Mediterranean, Jewish, and Chinese), where alcohol is seen as an ordinary part of religious or social celebrations. As one researcher described drinking in New York's Chinatown: "The children drank, and they soon learned a set of attitudes that attended the practice. While drinking was socially sanctioned, becoming drunk was not. The individual who lost control of himself under the influence of liquor was ridiculed and, if he persisted in his defection, ostracized."
The continuing high rate of bingeing on campuses is particularly disturbing given the tremendous efforts devoted to campus alcohol education programs. Wechsler's reaction: "My disappointment is, given all the action on college campuses to deal with this problem. . ., the fact that it has stayed so remarkably stable shows what a difficult problem it is."
Of what do these educational programs consist? Primarily, they aim to eliminate all drinking on campus. That is, rather than encouraging moderation, the message is that alcohol is bad. These programs cite statistic after statistic about the dangers of drinking drunk driving, risky sex, cirrhosis.
But listing only negative consequences from drinking became more difficult when epidemiologic studies of large populations discovered that drinking also often conveys benefits. Long-term studies of 85,000 nurses conducted at Harvard, and of a half million adults age 30 and older conducted by the American Cancer Society, found that moderate drinkers lived longer on average than nondrinkers. Since the vast majority of the drinkers surveyed drank lightly or moderately, these benefits hold for most adult drinkers.
But American public health does not do well at conveying the idea that drinking is a double-edged activity, one with potential benefits as well as real dangers, and that moderation is the distinguishing feature between the two. Take American high school students. Each year, seniors are surveyed by the University of Michigan about their drinking practices and attitudes.
In 1999, three quarters of the seniors had drunk alcohol over the previous year. Disturbingly, more than half had gotten drunk a third had been drunk in the prior month. But what is strangest about this cohort is their views on drinking. Although they frequently drink to excess, they condemn such drinking 64% say they disapprove of adults who "Have five or more drinks once or twice each weekend."
Remarkably, however, even more (69%) disapprove of adults who "Take one or two drinks nearly every day." Yet this is exactly the type of drinking which leads to the fewest negative outcomes, and which is most likely to extend a drinker's life span!
American education programs seemingly fail to convey the complexities of alcohol's effects. Consider the reactions to the revelation that binge drinking continues unabated on college campuses. In a parallel effort to the Harvard college drinking research, the Robert Wood Johnson Foundation has been addressing binge drinking at 10 universities.
The result of the Johnson Foundation efforts? More abstinence and more bingeing. Rather than seeing this bifurcation as problematic, Richard Yoast, director of the program, claims the program has been positive. Dr. Yoast noted with approval that the number of students who were abstaining on the targeted campuses had almost doubled since 1993, while the rates of heavy drinking were rising more slowly than the national average.
Mary Sue Coleman is president of the University of Iowa, which is part of the Johnson Foundation study. Remarking on continuing binge drinking at her school, Dr. Coleman vowed to stop serving alcohol at her own pre-football game brunches.
Were her guests getting drunk? It seems unlikely. But, like many other Americans, Dr. Coleman sees all drinking as problematic. Somehow, the United States finds it hard to escape its temperance roots and to steer a middle course with alcohol.