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As a part of National Collegiate Alcohol Awareness Week, we will be posting thoughts from leaders in binge drinking research and prevention.

To start things off, we're thrilled to present an essay by Dr. Hugh Gusterson, Professor of Anthropology and Sociology at George Mason University, and a project director of  Understanding Teen Drinking Cultures in America His most recent book is The Insecure American.

In 1997, when I was a professor at MIT, we lost one of our freshmen to alcohol poisoning.  Scott Krueger died in his first month at MIT, while at an initiation party for Phi Gamma Delta Fraternity.  Inexperienced with alcohol and pressured to drink so much alcohol that he had an astounding .41 blood alcohol level, he complained of feeling sick.  Left alone on a bed by his would-be fraternity brothers, who went back to drinking upstairs, he choked on his own vomit, went into a coma, and died three days later.  [http://reason.com/archives/1999/11/01/binge-and-purge].

Scott Krueger might still be alive today if any one of a number of things had been different: if it were harder for underage students to buy alcohol, if fraternity initiations did not revolve around drinking games, or if MIT had not allowed freshmen to live off campus.  He would also probably still be alive today, even if none of those things were different, had he or the fraternity residents been a little better educated about alcohol.  For example, he would probably have staggered on with nothing but a very bad hangover the next day if the brothers of Phi Gamma Delta had known that you put someone who is throwing up on their side, so they do not choke on their own vomit, and keep watch over them.

I thought of Scott Krueger recently as I was taking my son to his pediatrician.  While enduring the interminable wait for a doctor, I studied the leaflets in the examination room.  There were leaflets on puberty, diet, the HPV vaccine, depression, and other issues, but nothing on alcohol.  When I asked the pediatrician why not, she was surprised by the question.

Together with my George Mason colleague, David Anderson, I have spent considerable time of late talking to teens about alcohol in focus groups around the country.  We have been trying to find out what teens think about alcohol, how they acquire it, and how they use it when adults are not around.  One of our strongest findings is that teens are often remarkably ignorant about the ABCs of alcohol and that this ignorance, combined with teens’ natural predilection to believe they are somehow immune to the mortality that afflicts the rest of us, can lead them into very dangerous situations.  You might think that parents, schools or older siblings would have transmitted to young teens some elementary facts of alcohol literacy, but time and again we found teens left to discover such facts for themselves through trial and error.  And trial and error can be a dangerous and inefficient way to learn.

Here are some facts about alcohol that most readers will take for granted although many teens are unaware of some or all of them when they first drink:

  • That you get drunk more quickly on liquor than on beer or wine
  • That you get drunk more quickly on an empty stomach
  • That alcohol is best sipped rather than swigged
  • That alcohol is not immediately metabolized, so you should wait before downing more of it
  • That mixing alcohol with caffeine can dangerously mask the subjective awareness of intoxication
  • That mixing drinks can upset your stomach
  • That taking Tylenol with alcohol can damage your liver
  • That someone throwing up and passing out should be put on their side and watched

In an ideal world teens would all obey the law and would not seek to acquire alcohol until they reached the legal drinking age; and they would also lead such rich and stimulating lives that there would be little appeal in getting drunk in dank basements with, in some cases, people they hardly know.  We do not live in that ideal world.  Instead we live in a world where teens are interested in new experiences, even if they are illegal; where adult warnings of danger are often mistrusted as so much hyperbolae; and where alcohol is attractive for its ability to relax teens who may be anxious as they learn to navigate the complex social cross-currents of their peer groups.  In this world “getting wasted” can become a pleasurable activity.

We should work toward the ideal world.  But, in the meantime, it would be a wise precaution to make sure teens have some basic information about the different kinds of alcohol that exist and how they are metabolized by the body.  For reasons I do not understand, many parents are not communicating such information to their children.  That means schools should step into the breach – not, as some now do, with sensationalist once-a-year programs about the dangers of drunk driving, but with programs to impart factual information in such a low-key way that teens do not feel propagandized.

There are two ways in which schools might go about this sort of alcohol education.  One would be to have a stand-alone curricular module as part of health education.  In my view, this is the less effective educational strategy since it is set apart from the parts of the curriculum that matter for GPAs and SAT scores, so teens will treat it as decorative rather than substantive instruction.  It also puts a frame around the endeavor of alcohol education that lets teens know they are being told something for their own good, and teens hate being told things for their own good.  Still, it is better than nothing.

More effective would be to embed alcohol education in the general curriculum so that students scarcely notice they are getting it.  This is, if you like, analogous to the way product placement works on television, and product placement is seen by advertisers as more effective than a stand-alone ad for a product precisely because the message is not set aside with a frame around it that says “we will now try to persuade you to buy this.”  Skillful educators could embed alcohol education in classes in chemistry (how the molecules work and interact with others); biology (how the body metabolizes alcohol); history (the eighteenth amendment); literature (while reading Who’s Afraid of Virginia Woolf, say); or social studies.  I myself teach a university undergraduate class on drug policy that is ostensibly neutral about the merits and demerits of various substances, but I make sure that, without noticing it, students casually learn a great deal about how drugs act upon the body and why certain drugs are particularly addictive.  For example, while we are ostensibly discussing why certain demographic groups have been particularly drawn toward methamphetamine, students learn without realizing it why methamphetamine is such a nasty drug.

Experiments along these lines in high schools could save lives.  They certainly could not make the situation any worse than it is now.