Tips for Collegiate Drinkers

6 Ways to Moderate Consumption if Choosing to Drink in College[RC1] 

By Dr. Robert Chapman, Associate Clinical Professor, Behavioral Health Counseling Department 

 

[RC2]  It’s no secret that some college students choose to drink alcohol. Nor is it surprising that some of these drinkers either intentionally or accidentally become intoxicated and face various consequences. What might be new to some is that most articles about college drinking focus almost entirely on these consequences and suggest that they prove that all college drinking is problematic.

If “the problem” is solely collegiate drinking, then the only reasonable prevention goal is abstinence. However, this goal raises questions. Is there ever a time when students do not drink? We have focused more on the consequences after students drink than on understanding the meaning they assign to alcohol and drinking before they consume it. This understanding influences their decisions to drink—when to drink, how to drink, and what circumstances justify drinking.

So, if college drinking isn't the problem, but rather the drinking some students do is, here are a few suggestions to reduce the risk of adverse consequences if you decide to drink.

1.     Water is a commonly mentioned nonalcoholic beverage that many students report drinking. Remember that when drinking, the more nonalcoholic beverages you consume, the longer it takes between alcoholic drinks and the more time there is for the alcohol already consumed to be absorbed. Additionally, alcohol is a diuretic that draws water from body tissues. Drinking water rehydrates the body and may help reduce some hangover symptoms. Ideally, those who drink alcohol should consume an 8-ounce serving of water for each standard alcoholic beverage.

 

2.     Students tend to develop habits. Drinking a certain amount of "X” drinks in one sitting can create the illusion that “X” is moderate intake, especially if friends are also drinking “X” or “X+1, 2, etc.” Think about your usual drinking habits. Multiply your typical amount by the number of days you drink each week. Then, multiply that total by the calories per drink: 90 for light beer, 130 for regular beer, or "per shot" in a mixed drink (don't forget to include calories from mixers). The result is your total calorie intake per week, month, or year. For accurate calorie counts for 100 beers, visit http://www.beer100.com/beercalories.htm (keep in mind that 12 ounces of beer equals 350 ml).

 

3.     Track your drinking over a couple of typical weeks. Once you have a baseline, divide the number of drinks by the hours spent consuming them. The resulting number is your "drinks per hour" ratio. Once the pace has been determined, for example, "4/hr," consider if you were to have a drink every 20 minutes instead of every 15. By adding 5 minutes between drinks, you realize a 25% reduction in drinks consumed in the evening—from 4 per hour to 3. What happens if you add 15 minutes between drinks? A 50% reduction in drinking. 

 

4.     Next, explore creative ways to add those 5 to 15 minutes between drinks. Drink a nonalcoholic beverage like bottled water, or avoid standing directly next to the keg. Finally, consider the benefits of this simple change, such as fewer hangovers, improved class attendance, fewer regrets the next day, fewer calories consumed, more money saved, and more. All of this can be achieved just by adding 5 to 15 minutes between drinks.

 

5. When you have a headache, consider how much aspirin, Tylenol, or Advil you actually take. Chances are, you take two, perhaps three. So why not take 6, 10, or 15 if they work so well? Before you dismiss this as an foolish question, keep in mind that most people who drink alcohol find the effects from 1 to 3—and no more than 5—standard drinks (12-oz beer, 10-oz malt liquor, 5-oz wine, 1.5-oz spirits) during an outing. Yet they often go on to drink 6, 10, or even 15+ drinks and face the common consequences of heavy drinking. 

 

6.     I like to ask students what time they usually eat dinner. If they live on campus, most dining halls are open from 4:30 PM to 7 PM, with many students eating between 5:30 and 6:30, "just like home." Then I ask what time they usually go out when they socialize. Chances are high that most students go out after 9 PM, with many not until 10 PM or later. If there is a gap of over three hours between dinner and socializing, the student may drink on an empty stomach. Students could eat dinner later if they plan to go out and then snack before leaving and throughout the outing. 

7. "Add your harm reduction suggestion as a comment."

 

Although no tips can prevent someone determined to get drunk from reaching that goal, those who choose to drink but want to reduce the chance of adverse outcomes may find one or more of these tips helpful.

  

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 [RC1]I am uncomfortable with this title as it places the emphasis on drinking—wrong message. How about something like: 6 Ways to Moderate Consumption if Choosing to Drink

Thank you. Good suggestion, and the title is changed.

 [RC2]I suggest a different “less negative” picture. I believe a tipped “dead soldier” (empty bottle of alcohol) is inconsistent with the emphasis of the essay.

Thank you. Good suggestion and the graphic is changed.

Dr. Robert

Preventing Relapse: A Look at Marlatt's Cognitive-Behavioral Model

Relapse prevention is an important topic in the training of any counselor, irrespective of her or his ultimate specialty. That said, any consideration of relapse need at least consider Marlatt's cognitive-behavioral therapy approach – see Larimer, Palmer, & Marlatt’s 1999 article in Alcohol Research & Health, “Relapse Prevention: An Overview of Marlatt’s Cognitive-Behavioral Model.” As for a text for a relapse prevention course, I recommend Marlatt and Donovan’s edited text, Relapse Prevention, Second Edition: Maintenance Strategies in the Treatment of Addictive Behaviors  (link to book on Amazon). Be sure to review the table of contents as you will quickly see this text truly considers the subject of relapse across ALL addictive disorders.

As an aside, an important aspects of Marlatt’s consideration of relapse is the role the “abstinence

violation effect” (AVE) plays in the onset of a true relapse. The AVE is essentially the guilt that is associated with having used after a period of abstinence. It is this guilt that plays a major role in turning the “slip” into a “fall off the wagon.” Marlatt argued that before one can relapse, the recovering individual must first “lapse.” The distinction between a “lapse” and a “relapse” being that a lapse is a temporary return to use whereas the relapse is a return to the lifestyle of the active user. It is important for counselor-ed students to recognize this difference as this concept—“lapse” precedes “relapse”—coupled with CBT enables the practitioner to “act on” the lapse rather than “react to” the relapse.

I have had individuals with whom I addressed a SUD (substance use disorder) contact me in a panic the day after a lapse, filled with guilt and shame about their use. I always begin the conversation by asking what they have done with the remainder of the alcohol, weed, cigarettes or “whatever.” Frequently, they tell me that they felt so bad about the use that they flushed the weed, dumped the alcohol down the drain, or discarded the remainder of “whatever.” I then suggest that while we can discuss the use later, “right now” what I am really interested in is the fact that they appear so committed to change that they threw away $X of product. I then suggest this shows how far they have come in their recovery and that their experience is what is called a lapse rather than a relapse. Obviously there is more to this approach than a simple 3-min conversation with a client. The point is, the practitioner follows a true “solution-focused” path; by concentrating on what the client has done well, we can move further away from the AVE and its associated guilt and shame. This guilt and shame then all but ensures the lapse progresses into the proverbial “full blown relapse.” This blending of harm reduction with CBT is a very effective strategy in “true” relapse prevention.

To put some closure on these comments, there is no distinct line of demarkation between recovery and relapse. Just as the 21-year-old at 12:01 AM on her 21st b-day has not magically become better able to drink safely than at 11:59 PM, neither does someone with a substance use disorder relapse upon taking the first sip/toke/drag. Now, do not misunderstand my comments to mean that it is “okay” to use “just a little” or we should not be concerned about that sip/toke/drag etc. Clearly, we need to be sensitive to any early indicators of someone who is skating on the proverbial thin ice as regards recovery; risk is risk and those who ignore this fact will fall through that ice. That said, Miller’s admonishment that we “dance” with clients rather than “wrestle” with them suggests that we teach our students the difference between a “lapse” and a "relapse” so that as practitioners they can proffer the guidance and support necessary to get the “train back on the tracks.”

What do you think?

Dr. Robert