Alachua County Medical Society Speech - April 12, 2005
High Risk Drinking: A Call for United Action
Presented to Alachua County Medical Society
Opening
Thank you for inviting me here today.
As you may know, I've recently marked my first anniversary in Gainesville. It's been an exciting year of challenges and growth, pomp and circumstance, hiring a football coach....All normal stuff!!
And, now that the dust has settled...
I want to focus on some issues I've come to understand are critically important and require a community effort to address.
One thing that has become clear to me is the manner in which alcohol is used, and sometimes abused, in this community is a serious problem. It is something I feel we need to address together. What we need is a long-term, sustained effort involving the entire community to address the problem of high risk drinking.
It would be impossible to overstate the severity of this problem. The pathology of alcohol abuse degrades life for college students across the nation, and the negative consequences are also apparent in our community. No other health and safety issue poses such a grave present and potential threat to the well being of our students.
Individuals who drink excessively are hurting themselves and others at a rate that is unacceptable.
The short-term tragic consequences of high risk drinking are numerous, and the number of students affected nationally, are many. Among them:
- ASSAULT ... SIX HUNDRED THOUSAND college students each year are assaulted by someone who had been drinking,
- SEXUAL ASSAULT and DATE RAPE ... SEVENTY THOUSAND college students were victims of alcohol-related sexual assault or date rape.
- DEATH ... FOURTEEN HUNDRED college students die each year in alcohol-related incidents.
I want to acknowledge that not all of these high risk drinkers are over 21. Underage drinkers (and the majority of our college students are under 21) are especially vulnerable to the consequences of alcohol use.
Alcohol is a factor in the LEADING causes of death among teenagers: automobile crashes, suicide, homicide and fatal injuries.
Too many students in our community, drinkers and non-drinkers alike, have experienced first-hand the tragic consequences of excessive drinking.
- Alcohol has been a contributing factor in FIVE deaths of University of Florida students in the fifteen months I have been affiliated with UF.
- We estimate that alcohol was a factor in 80 PERCENT of the sexual assaults our students reported last year.
- 97 PERCENT of the criminal cases handled by UF Student Legal Services last year were alcohol related.
And, for many young people, the harmful affects of alcohol follow them long after college.
I don't have to tell this group about the longer-term physiological consequences of this behavior on the individual – damage to the liver, the pancreas, the brain –but there are social consequences as well: loss of productivity, problems maintaining relationships, and other factors that reduce the quality of life our graduates might otherwise enjoy.
Even most lay people, those NOT in health related fields, are aware of the problems associated with alcohol.
Unfortunately, I don't think most, here in Gainesville, realize how serious a problem it has become in our local community. Some to whom I've spoken about alcohol consumption at the university think I'm making too much of this issue... that it is simply a normal rite of passage for college students. Others have adopted a persistent, fatalistic attitude, and regard it as unsolvable.
It is probably true that alcohol always will be a factor in college culture and university communities. Alcohol is so ingrained in the values, behaviors and beliefs of college students that drinking pervades every aspect of college life for drinkers and non-drinkers alike. In fact, on some campuses across the nation, the culture of college has become a culture of drinking.
However, that does not absolve us of the responsibility to intercede when the situation degenerates. So far as responsible alcohol consumption goes, it IS a matter of degree.
The number of young people who engage in high risk drinking behavior is growing, as is the number of people who suffer the negative consequences of that behavior.
When HOW MUCH becomes TOO MUCH, it is incumbent upon us to critically evaluate the situation and develop strategies to address it.
First, I want to be clear about what and who I'm talking about when I'm talking about high risk drinking. I want to emphasize that I'm NOT talking about ALL or even most students who drink. I have no intention of attempting to force a state of prohibition for any student who is over 21, and who makes responsible choices.
Though ANY amount of alcohol used irresponsibly by ANY person can cause problems, there are two populations of alcohol users that pose the greatest threat to themselves and others.
I've already identified underage drinkers as a vulnerable population. At the University of Florida, more than 72 percent of underage students surveyed said they had consumed alcohol in the last 30 days. That these students choose to drink when they are not legally permitted to do so is a problem, but perhaps a greater problem is that these students and, likely, teenagers even younger in our community, have easy access to alcohol.
The other population that is a great cause of concern is excessive drinkers. We define excessive drinkers as those who consume 5 OR MORE drinks in a row.
Among excessive drinkers, alcohol consumption reaches, or has the potential to reach, dangerous, potentially toxic, levels. Some of these students consume so much alcohol, so quickly, that they run the risk of experiencing the effects of alcohol poisoning, namely blackouts, ...........or even death.
It is excessive drinkers who are the greatest danger to themselves, who cause the greatest amount of disruption for non-drinking students, who encounter the greatest number of legal problems, including property damage, driving under the influence, and assault.
Not all of our students drink excessively. In fact, almost a third of our students choose not to drink at all. Unfortunately, more than half admit that they have engaged in excessive drinking at some point. And that rate is on an upward trend.
This is one upward trend at the University of Florida that we must reverse.
Now, having described the nature and severity of this problem, I can tell you that we believe we can change the culture of high risk drinking among college students in our community.
As the national numbers clearly demonstrate, we are not the only community facing this problem. Among members of the National League of Cities, Mayors of small communities with large universities consistently rank high-risk drinking among the top problems facing their communities.
Already, some of these communities have taken action, and have successfully reduced the negative consequences of high risk drinking. These successful programs have improved the quality of life both on campus and in the surrounding community.
Can this be done in our community? I believe it can.
Successful programs have two things in common: The first is that leaders in these communities set a goal of changing the CULTURE of excessive drinking in their communities.
They found that by changing the ENVIRONMENT in which drinking takes place, they can significantly inhibit high risk behavior and its consequences.
The second common factor is that they formed a broad-based, community-wide coalition to develop and implement the program.
Several successful programs were directed and documented by the American Medical Association's Office of Alcohol and Other Drug Abuse.
The programs were based on the 2002 findings of the N-I-A-A-A – that's the National Institute on Alcohol Abuse and Alcoholism -– which is a part of the National Institutes of Health.
This research found that factors at three different levels contribute to a culture of high risk drinking. They found that to change that culture, programs must be implemented at all three levels: the individual level, the campus level and the community level.
Already at the University of Florida, we've taken steps to create an environment on campus that discourages excessive drinking. We have programs that are tailored to counteract the individual and campus-level factors associated with the likelihood of excessive drinking.
What We're Doing
Individual level
The top individual-level factors known to influence alcohol use include
- Biological and genetic predisposition,
- Personality,
- Belief systems, and
- Expectations regarding alcohol use.
Obviously, we cannot change most of these factors. However, because we know that the first few weeks of college life are critical to forming healthy habits, we target the new students with educational campaigns to counter erroneous expectations and perceptions about alcohol.
For example, studies have shown that students will drink at the level THEY PERCEIVE is normal for their campus, even if that perception is FALSE. So, if they come to campus believing that their peers are excessive drinkers, they are more likely to drink excessively.
Faced with correct information about college norms, these same students often change their behavior. Recently, the University of Florida kicked off an educational campaign to let students know that abstinence and moderate drinking are the norm for this campus.
(pause)
Campus environmental factors known to influence alcohol use or mitigate its effects include consistent enforcement of alcohol policies, providing alcohol-free entertainment alternatives and careful monitoring of events likely to promote excessive drinking.
- At the University of Florida, we have long-standing policies that inhibit access to alcohol on campus, and sanction those who violate those policies
- There is no longer an "in-and-out" option at Ben Hill Griffin Stadium. If you leave, you cannot return
- In joint effort with the Regional Transit Authority, our Later Gator transportation service gives students free rides home from downtown after the bars close.
- Every Friday night, instead of going to bars, 1200 students attend all-night, alcohol-free Gator Nights Entertainment in the Reitz Union.
- There are no alcohol sales at athletic events. And, today, we are announcing that the University of Florida is the first major, public university in Florida and in the Southeastern Conference to join the national Campaign for Alcohol-Free Sports TV.
This coalition of 227 college and universities is committed to discouraging any connection between alcohol and the positive values and experiences related to sports. The University of Florida will have no advertising involving alcohol in any of its local programming.
We have begun a comprehensive review of all our policies to make certain our practices are consistent with our desire to have a positive culture as far as alcohol is concerned. You may have heard that last Friday the University suspended a syndicated radio program offered by our local commercial radio station, Rock 104. There could be other actions as we proceed with the policy review.
We've had some success with these programs, but it's not enough.
Research conducted in other college communities shows that the effectiveness of programs ON CAMPUS depends, to some degree, upon conditions OFF CAMPUS.
There are several environmental factors that successful programs elsewhere addressed.
Though they vary to some degree from community to community, the environmental factors include how aggressively alcohol is marketed, the number and amount of free and reduced-price drink specials, concentration of drinking establishments, how well servers are trained, and enforcement of state and local regulations, including access to alcohol by underage drinkers.
To identify factors and implement a successful program in OUR community will require the active participation of a broad coalition of local residents, associations and business owners.
I've promised that during my tenure as president, I would work to enhance our town-gown relationships. I can't think of an issue that puts more of a strain on our town-gown relations, nor one that presents a greater opportunity for town-gown collaboration.
To get us started, we've formed a Community Alcohol Coalition. Members include
- Students
- Faculty
- Administrators
- Elected officials
- Law Enforcement officers
- Health experts, and
- Other leaders in our community.
Members will serve on one of three committees to study
- Access to, and Promotion of, alcohol
- Our Culture and Environment, and
- Enforcement of alcohol policies and laws.
But, to succeed in addressing this problem, I need your help and the help of groups like the Alachua County Medical Society. I need and welcome your thoughts on this issue, and your participation on the committees we've formed.
A final point for tonight is my perspective on the proposal to extend bar closing hours. I would hope the deaths of five students in fifteen months would convince ANYONE we have a problem with high risk drinking in this community. I hope you are convinced, as I am, that we must act now, and as a community, to determine which environmental factors contribute to this dangerous situation.
One of the environmental changes under consideration is a Gainesville city commission proposal to lengthen bar hours as a safety measure. The rationale is that if the closing time for bars is extended by one hour, patrons will have an hour between their last drink and closing time. There is another theory that patrons will drift out over the last hour, thereby staggering their departures.
While I commend the city commission for focusing on this problem, I think it comes down to this: for every additional hour a bar is open, there is another hour for students to drink. For this reason, I don't support a change in closing time.
It is my hope that the commission will give serious thought to this problem and decide not to change the existing policy or take any action that provides yet more opportunities for those who abuse alcohol.
Thank you for allowing me to layout, today, what I see as the most critical health and safety issue facing our community. I look forward to hearing your thoughts and hope to have your assistance as we move forward.
Bernie Machen
Sources
Alcohol and Other Drug (AOD) Date: University of Florida and the Gainesville Community. Data provided by Gator Well Health Promotion Services.
Task Force of the National Advisory Council on Abuse and Alcoholism, National Institutes of health, U.S. Department of Health and Human Services. Available at: www.collegedrinkingprevention.gov.
American Medical Association (October 2003). A matter of degree advocacy initiative. A project of the Robert Wod Johnson Foundation. The national program office of A Matter of Degree at the American Medical Association.
Gardner, John N. & Jewler, A. Jerome (2000). Your college experience: Strategies for Success, 4th ed. Wadsworth. (Text used in University of Florida First Year Florida freshman college skills course).
Office of the Vice President for Student Affairs (input and information from Dr. Patricia Telles-Irvin, VP, and from linked websites)
Office of the Vice President for University Relations (input from Vice President Jane Adams)