Treatment of alcohol intoxication at university health services: examining clinical characteristics, drinking patterns, and adherence with referral.

ABSTRACT

Objective: This study examines' demographics, clinical characteristics and drinking patterns of students presenting with alcohol intoxication at a university health service. Participants: The sample included one hundred students (50% female, 48% freshmen) treated for alcohol intoxication at university student health services. Complete medical charts were obtained for 80 students (43% female, 46% freshmen). Methods: A prospective case review was performed between September 2005 and March 2006. Results: Although males reported having more drinks before admission, drinking more frequently, and having more drinks per drinking day than females, there were no other gender differences. Freshmen comprised almost half the admissions, but there were no significant differences in drinking patterns across school years'. While only 54% of students were given follow-up referrals, 72.2% of students complied with recommended referrals. Additional assessment information included alcohol use disorders sceening scores, history of previous alcohol intoxication, problems related to use, symptoms of anxiety and depression, and use of antidepressant medication. Conclusions." These results suggest that further investigations of student characteristics and experiences prior to contact with university health services are warranted and may be necessary to the development and implementation of programs to reduce harmful alcohol consumption.

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Rates of binge drinking among college students (five or more drinks per occasion for men and four or more drinks per occasion for women) have remained relatively stable: Approximately forty-four percent of all college students report binge drinking over the course of a school year, with roughly half reporting occasional binge drinking and half reporting frequent binge drinking (Wechsler et al., 2002). The Monitoring the Future project that took place in 2005 reported similar findings. The majority (83.0%) of full-time college students reported consuming alcohol within the last year, and 40.1% of students reported drinking five or more alcoholic beverages in a row in the past two weeks (Johnston, O'Malley, Bachman, & Schulenberg, 2006). Additionally, college students reported a significantly greater number of heavy drinking episodes than their same-age peers not enrolled in college. College students were also more likely to confine their drinking to a limited number of days per week but drink in greater quantities during those days compared to non-students their ages (Johnston, O'Malley, Bachman, & Schulenberg, 2006).

Binge drinking by college students has been associated with numerous negative long-term and short-term consequences including increased incidence of health problems, risk of unintentional injury, poor academic performance, and driving under the influence (Barnett et al., 2003; Cherpitel, 1993; Wechsler et al., 2002). In addition, students who binge drink are at an increased risk for date rape, sexual assault, engaging in unwanted sexual activity, and not using adequate protection against pregnancy and sexually transmitted diseases while intoxicated (Wechsler, Lee, Kuo, & Lee, 2000; Wechsler et al., 2002). Furthermore, consequences of heavy episodic or binge drinking are not limited to drinkers themselves, but may also result in negative consequences, or "secondhand effects," for non-drinking college students. For example, students report unwanted sexual advances, engagement in physical or verbal fights, and study or sleep interruption as a result of binge drinkers' behaviors (Turner & Shu, 2004).

The use of emergency medical treatment following severe intoxication among college students has been documented by previous research (Barnett et al., 2003; Helmkamp et al., 2003; Wright, Norton, Dake, Pinkston, & Slovis, 1999; Wright & Slovis, 1996); however, fewer studies have focused on the reasons why some college students consume enough alcohol to require medical attention. While the use of alcohol by college students is widespread, and roughly half of these drinkers report binge drinking, far fewer receive medical care following acute intoxication (Helmkamp et al., 2003; Wright & Slovis, 1996). This suggests that students presenting for urgent treatment with acute alcohol intoxication may be a unique subgroup; however, little is known regarding how these individuals may differ from their binge drinking peers who do not seek medical care.

Previous studies have reported similar rates for males and females receiving treatment for alcohol-related emergencies as well as a greater frequency of admissions for college freshmen (Barnett et al., 2003; Wright, Norton, Dake, Pinkston, & Slovis, 1999; Wright & Slovis, 1996). Wright and Slovis (1996) reviewed admissions of college students to a university hospital emergency department and found an overall incidence of 3.9 students per 1,000 per year requiring medical treatment for alcohol intoxication. This rate was almost 2 1/2 times greater for first year students who had an incidence of 9.3 per 1,000 students per year. However, they found ...