Wednesday, April 4, 2007

Dying to Drink: Confronting binge drinking on college campuses

By Henry Wechsler & Bernice Wuethrich:
ISBN# 1-57954-583-1

Reviewed by Robert Chapman, Ph.D.

(This review also appears in the January 2003 issue (Volume 2 #3) of The Report on Social Norms, published by Paper-Clip Communications (866 295-0505). Published here by permission.)

There are few topics of more import in higher education than the role of alcohol in contemporary collegiate life. And if collegiate drinking is a topic of significance, then Henry Wechsler is certainly on the “short list” of influential voices on this subject. But being on this list and being one of the most frequently cited authorities by the media is not exactly synonymous with being a seer.

Dying to Drink, co-authored with Bernice Wuethrich, is Dr. Wechsler’s latest offering on the subject of high-risk collegiate drinking, or what he has deemed “binge-drinking” (i.e., 4 or more drinks in a row for women or 5 or more drinks in a row for men.) It is an exhaustive review of the myriad alcohol-related threats faced by today’s college students. From its thorough review of media perceptions regarding collegiate drinking, through the role of “big alcohol” in aggressively marketing to underage drinkers, to proffering an unfortunately subjective list of recommendations, this tome is relentless in its intent to deliver America a wake-up call regarding the pandemic currently raging in higher education.

As a treatment and prevention specialist who has dedicated his professional career to addressing problems associated with alcohol abuse, I recognize the concerns cited by the authors and do not take issue with their facts. But I do question their myopic view of the issue and their “out-of-hand” rejection of several promising practices currently being employed to address it.
The information cited in Dying to Drink (D to D) justifies the authors’ admonishment to assertively address the problem. However, its description as extrapolated from these facts is suspect. For example, the book dust jacket states: “Perhaps more chilling even than the cold facts and figures are the personal confessions gathered from Wechsler’s survey and Wuethrich’s independent interviews.” What the dust jacket does not mention, however, is that approximately 25% of students account for approximately 67% of the alcohol consumed in college. Thus, to only interview “these” students or others affected by “these students” does not provide an accurate picture of “all” college students.

If the extent and definition of the problem are suspect, so are the recommendations, which are at best dated and already made by others. Many of them have been available to the public on the web site of the Higher Education Center (HEC) since well before publication of this book. For example, D to D calls for schools to explore “social alternatives” to high-risk social outlets, but as early as 1997 the HEC has been advocating for “alcohol-free” and “late night” programming as key parts of a comprehensive package of environmental strategies to curb high-risk drinking. Similarly, D to D dismisses social norms programs as “soft-selling the message” while paraphrasing a classic social norms tag line that “a majority of students want a change in the tenor of campus life” to justify its call for “tougher enforcement” of campus policy. A chart on page 217 even outlines percentages showing that a majority of students support such environmental strategies as “cracking down on underage drinking” and “enforce rules more strictly.” These are the identical recommendations made by the HEC in its comprehensive collection of environmental strategies to curb collegiate high-risk drinking and in its endorsement of social norms campaigns as promising tools for the collegiate preventionist’s toolbox.

The Audience

Dying to Drink is written to a very specific and receptive audience, namely the parents of current and future college students. As such, ANY publication that is likely to reach this population has an obligation to present the entire story. Unfortunately, this work does not pursue this objective.

I have cited many of the facts delivered here myself. Unless, however, they are couched in the reality of the “rest of the story” (as Paul Harvey used to say), they are meaningless at best and incite unwarranted fear and reactionary responses at the worst. The “six o’clock news syndrome” does nothing to further the development of proactive steps designed to impact the real problem of alcohol abuse by some students. Unfortunately, this book stops short of providing an objective view of that problem. Rather, it breeds shortsighted responses that tend to “react to” problems rather than “act on” them. Just as a technician who neglected to include a ruler or other reference point in the photograph of evidence found at a crime scene could seriously compromise the photograph’s usefulness to a criminologist, so does the absence of reference points call into question the snapshot this book provides of higher education.

We know from the very first College Alcohol Study conducted by Dr. Wechsler in 1993 that while significant numbers of students reported consuming 5+ drinks in a row if male and 4+ drinks in a row if female, the majority did not. The most recent CAS, conducted in 2001 found that less than a quarter of students reported drinking in this fashion 2 or more times in a 2-week period prior to being surveyed. Another 19% reported that they had consumed no alcoholic beverages at all in the previous 12 months. I would not suggest that a quarter of our students drinking 5 or more drinks 2 times in 2 weeks is not a problem. But to read D to D, is to wonder if the authors are ignoring the fact that most students in their studies are not the contemporary collegians portrayed on the 6 o’clock news and T.V. tabloids. The quote prominently displayed on the book’s dust jacket seems to applaud this very inaccuracy: “That college students drink to get drunk is no myth. It is the simple truth….(sic) But being statistically normal doesn’t make [binge drinking] right, and it certainly doesn’t make it safe…” (sic). Yet the authors’ own data indicate that “binge drinking” is NOT “statistically normal.” Again, my point is not to deny the extent of high-risk drinking by today’s collegians. Rather, the facts that indicate we SHOULD BE concerned need to be considered in the context of what ALL students are doing.

The Problem

While there is a significant alcohol problem on our college and university campuses, this book does NOT provide an objective overview of what students are doing with alcohol in college. As noted above, Dr. Wechsler’s own College Alcohol Study statistics indicate that it is not even what most students are doing.

The traditional argument says that “if even one student is drinking too much” or “even one student is drinking under age” it is a problem. Similarly, I do not take issue with the authors’ claim that “if 23% of college students” are consuming 5 or more drinks in a row 2 or more times in the previous 2 weeks, we should go to whatever lengths necessary to curb this alarming trend. But to present this as the gist of the story is not good science.

If the “out of context” presentation of facts is of concern, so is the “out of hand” dismissal of current prevention and intervention strategies. The authors’ almost parochial rejection of social norms programs as being based on “unproven assumptions” and “soft selling the message” reminds me of someone who is blinded to the truth by a dogged adherence to dogma. Rather than explore social norms as science, D to D banishes the approach—implying that the prevention model is the contrivance of “big alcohol”—and all but impugns the integrity of its proponents.

This summary rejection of social norms programs as “disturbing” and without evidence strikes me as curious. As a Harvard trained PhD Social Psychologist I would expect that Dr. Wechsler’s familiarity with the robust social psychology literature of the last 50 years on “social influence and conformity” would have been sufficient to adopt a “wait and see” posture regarding the current investigations into the efficacy of social norms campaigns, especially in light of their promising results. This social psychology research, dating back to the early 1950’s, suggests that the views of others exert a significant social influence on the views of the individual. This influence can be sufficient to someone to abandon personal opinions in favor of those reported by others. Every reader of this review is likely to recall a situation where a personal position was altered in order to adopt one more perceived to be more in tune with that of one’s social group.

It would seem that the Substance Abuse and Mental Health Services Administration (SAMHSA) has also found reason to support social norms programs as worthy of consideration as a prevention strategy of promise. Recently added to its “model programs” web site is a report supporting the use of social norms, an excerpt of which states: “The Social Norms Media Marketing Campaign is the primary component of Challenging College Alcohol Abuse…Results show that negative consequences of alcohol and other drugs (AOD) use and positive perceptions of alcohol use decreased significantly. Heavy drinking decreased by 29 percent, as did AOD-related crimes” (see

The Future

I do not know what science will ultimately prove regarding social norms and other promising approaches to reducing high-risk drinking in college. As a practitioner I find the logic of contemporary prevention strategies to be compelling. Approaches to reducing high-risk student behavior such as social norming, environmental management, motivational-interviewing and harm-reduction should be investigated and funding provided to underwrite these investigations. We need look no further than the changes of the last 40 years regarding social perceptions of normative behavior with regards to cigarette smoking or reductions in drinking and driving fatalities to get a sense of how vulnerable public perceptions of normative behavior can be.

My experience is that there is no “silver bullet” or “one-size-fits-all” approach to solve any social problem. Most successful interventions involve a concerted effort mounted by a variety of individuals who collaborate to achieve a common goal. While the prevention field is indebted to Dr. Wechsler and his colleagues for placing the issue of high-risk collegiate drinking on the front page where it belongs, unfortunately D to D is sorely lacking as a call to collaborate on a solution.

Despite all this, this book is worth reading by higher education professionals working to prevent high-risk drinking, if for no other reason than “to demonstrate how not to do something.” I would, however, caution parents that Dying to Drink is not representative of the views of all who are concerned about the problem. Likewise, many of the recommendations proffered have been advocated for some time by some of the very same agencies accused by the authors as ‘sleeping with the enemy.’ Thus, if you choose to read this book, please also take the time to find out “the rest of the story.”

Note: for a comprehensive overview of “what’s what” in higher education’s attempt to address collegiate high-risk drinking I would recommend visiting the web site of the Higher Education Center at . To learn more about the social norms approach visit

Robert Chapman, Ph.D., is the Pennsylvania Regional Coordinator for the Network of Colleges and Universities Committed to the Elimination of Alcohol & Drug Abuse and Related Violence. He can be reached at:

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