Deadly drinking incidents hide hopeful trends

This spring, students at the University of Minnesota are going to get a postcard in the mail telling them that Fred is Dead. Who's Fred?

Fred is anyone who dies from acute alcohol poisoning because no one around him called 911 after he passed out.

A small campus survey last year proved that simple message got the point across: Students who saw the postcard said they would be more likely to call for help if someone passed out. Now the university's Boynton Health Service plans to use Fred to spread the message further.

The Fred is Dead campaign is just one example of growing evidence -- often hidden behind relentless headlines about binge drinking and alcohol-related deaths on campuses -- that trends are quietly changing for the better. Or at least they're not getting worse.

Both drinking and binge drinking rates are flat among college students and declining among adolescents. Laws are stiffer. Brain researchers now know that alcohol affects young brains differently than older ones. Health officials say there's more going on to minimize the harm from drinking -- like that stupid-simple message to call 911 for Fred.

"Slowly the culture is changing, like turning a massive battleship," said David Golden, director of marketing and communications for Boynton. "My hope is that sometime students themselves will turn on the alcohol industry the same way they turned on the tobacco industry."

No one says excessive teen and young adult drinking is not a problem. In Minnesota it has been an especially painful reality in the past year.

No worse than mom and dad

The good news is that underage drinking and binge drinking are no worse than they used to be.

"There is no evidence we are seeing a big spike in heavy drinking behavior," said Toben Nelson, an assistant professor of epidemiology at the University who studies drinking trends. "If anything, it's flat."

In 1980, 90 percent of college students said they had used alcohol in the previous year. In 2006, the rate was 82 percent, according to the annual national survey of drinking and drug-use habits by the Monitoring the Future Project at the University of Michigan.

Binge drinking trends were similar. In 1980, 44 percent of college students said they'd had five or more drinks at one sitting in the previous two weeks, compared to 38.3 percent in 1996 -- the lowest rate -- and 40.2 percent in 2006.

A problem of extremes

But experts say those numbers may mask a problem that is getting worse. Evidence shows that among the minority who binge drink is a smaller group of super binge drinkers.

"There's a polarization," said Aaron White, an assistant research professor at Duke University who studies student alcohol use. "There are more and more students not drinking. And more and more students drinking heavily." Among students who say that sometimes they have at least 5 drinks at a sitting are some who have 15 or 20, he said. "Those are the kids who are dying," he said.

They may also be the kids who started young. Research shows those who start drinking at age 14 are far more likely to become dependent.

Vulnerable brains

Though much of that research is in rats, not teenagers, it shows that drinking can cause significant neurological injury in young brains, far more than in adult brains. In fact, it suggests that early heavy drinking may undermine the brain's ability to protect itself from alcoholism.

It does the most harm to the forebrain, the area used for reasoning and judgment, which does not fully mature until sometime in early adulthood. It also affects the area used for learning and memory.

Alcoholic teenagers perform poorly on tests of verbal and nonverbal memory, researchers say. And they have trouble focusing their attention and using spatial skills needed for things such as reading a map.

White said his research on Duke students found that half of those who drank reported having memory blackouts.

"That means waking up in the morning not able to remember places you went or things that you did," he said. "That can range from brushing your teeth to having sex. A lot of sexual assaults occur during a blackout."

While the drinking culture may be entrenched, enforcement has been ramping up -- though students say it has a ways to go.

Drinking is "a part of college life," said Chloe Schrab, 22, a U of M senior from Hartford, Wis., who worked on the Fred is Dead campaign. "It's dangerous behavior, but it's not going to change."

Change, she said, should instead be focused on education, safety and responsibility -- like calling 911 when a friend passes out, even if it means a ticket for underage drinking.

Penalties for providing alcohol to underage drinkers are getting tougher and are more often enforced, said Traci Toomey, an associate professor of epidemiology at the university who studies alcohol prevention.

But alcohol remains "incredibly accessible," said Michelle Lindeman, 19, a university sophomore from Glendale, Wis. Underage students always have older friends and siblings who buy them alcohol, and bars are not always vigilant in catching fake IDs, she said. Changing that "would take a bar getting shut down for letting underage students drink," she said. "It has to be serious."

Raising the liquor tax would raise prices and reduce consumption, just like it does on tobacco, he said.

Or, local governments could do what Mankato did. At the urging of Mankato State University, as of Jan. 1, the city outlawed all-you-can-drink specials at local bars.

That alone increases the odds that, at least in Mankato, Fred might not be dead.