What percentage of medical students meet the criteria for diagnosis of a mild alcohol use disorder?

College alcoholism affects millions of students every year. The college years are some of the most popular times to experiment with alcohol. Roughly 80% of college students – four out of every five – consume alcohol to some degree. It’s estimated that 50% of those students engage in binge drinking, which involves consuming too much alcohol in too little time.

Many young adults admit to drinking alcohol even before they enter college. After graduating high school and moving out on their own, college students want to experience their newfound freedom and independence. The availability of alcohol at sporting events and social activities is often tempting to students. What may start out as one drink can quickly turn into two, three or more. Drinking week after week causes the body to start building a tolerance to alcohol. This means it will require you to drink more in order to get the same high.

Frequent heavy drinking greatly increases your chance of developing an alcohol use disorder (AUD), which can cause serious physical and emotional damage. While some side effects are temporary and go away within a matter of days, others can affect you for years to come. That’s why it’s crucial to seek help at the first warning sign of a drinking problem. The specialists at an alcohol treatment center are able to provide top-notch care and assistance for those who have quit drinking. Contact a treatment provider today to find out more about rehab facilities and how they treat alcoholism.

Online Counseling for Alcohol Addiction

Over 3 Million people have turned to BetterHelp for professional online therapy.

Take the quiz and get matched with a therapist.

College Students And Binge Drinking

A large percentage of college students consume alcohol by binge drinking. Binge drinking is defined as when a person consumes an excessive amount of alcohol in a short timeframe. For men, binge drinking involves drinking five or more alcoholic beverages in two hours. On the other hand, binge drinking for women is considered four or more drinks within a two-hour time period.

The high-risk period of binge drinking for college students is during the first six weeks of their freshman year. Many of these students fall into peer pressure and begin drinking soon after the first day of classes. Alcohol use is commonly viewed as the “college experience” that students desire. They want to fit in and make new friends, so they keep drinking without thinking about the potential consequences involved.

Within the last couple of decades, college students have started consuming more hard liquor than beer. Rather than drinking to socialize, an increasing number of young adults are drinking to get drunk. Since liquor has one of the highest alcohol percentages by volume, it takes fewer drinks to feel its effects. The end goal for some is to drink as much as possible or black out. These outcomes are extremely dangerous and can possibly lead to life-threatening effects, such as alcohol poisoning.

Reach out to a treatment provider for free today for immediate assistance.

Consequences Of Heavy Drinking In College

Nearly every college student has been impacted by alcohol use during their academic career – even if they have never drank themselves. For instance, a person can witness a friend’s drinking pattern worsening over time, gradually taking over their life. Heavy drinking affects more than just an individual; it can destroy anything in its path, including friendships and relationships.

Alcohol-related problems begin to arise when an individual drinks excessively and puts their health – and the health of others – at risk. Several consequences associated with heavy drinking in college are:

Performing Poorly In Classes

Excessive alcohol consumption can take a toll on a student’s academics. Drinking may even become a priority over attending classes, completing homework and studying for exams. An estimated one in every four college students admit to having poor grades or other academic problems because of their drinking behavior.

A lack of effort in school can make a difference in whether a student passes or fails a class. It can cost thousands of dollars to retake a course or change majors due to bad grades. In addition, failing classes will push back a student’s graduation, taking more time and money to complete the degree program.

Risking Injury

Drinking can increase a person’s risk of injury, ranging from minor cuts to broken bones or concussions. The higher someone’s blood alcohol content (BAC) level, the greater the chance of getting injured. Each year, close to 600,000 college students unintentionally injure themselves due to heavy drinking. Injuries can involve bruising, fractures, muscle sprains and other similar issues.

For those who struggle with depression or anxiety, alcohol consumption can cause life-threatening effects. Students who face extreme mental instabilities are most at risk of attempting to commit suicide or other acts of self-harm. Alcohol can significantly alter a person’s mind, which can make them act irrationally.

Becoming A Victim Of Assault

Alcohol is known to lower a person’s inhibitions and therefore, makes them more vulnerable to physical or sexual assault. Close to 700,000 students between the ages of 18 and 24 are assaulted by a student who had been drinking prior to the offense.

Another serious crime linked closely to alcohol use is sexual assault. All too often, perpetrators prey on victims who have been drinking. Victims are sometimes too incoherent to fight back or pass out before knowing what happened. Sexual assault can have a lasting effect on someone emotionally and physically, including getting a sexually transmitted disease (STD), having an unwanted pregnancy, or causing lasting psychological damage.

Committing Criminal Activities

When someone is under the influence of alcohol, their actions may be entirely different from how they would normally behave. This involves committing a crime, no matter how minor it may be, that a person wouldn’t have committed if they were sober. Highly intoxicated college students usually partake in vandalism, property damage, driving under the influence and other criminal activities.

Sometimes though, alcohol-related crimes can be extremely serious and put other people in danger. Harmful criminal activities involve battery, kidnapping and homicide. College students who commit crimes while intoxicated can face legal punishments such as fines, probation, suspended license and jail time.

Developing Health Issues

The effects of heavy drinking do not always happen immediately. It may take months or even years for some effects to occur. Nearly 150,000 college students develop some type of alcohol-related health problem every year. This may include liver damage, high blood pressure, inflammation of the pancreas and other health complications.

College students who participate in frequent drinking activities are also more likely to develop a dependency on alcohol later in life. Although alcoholism typically results from years of drinking, it can also happen during periods of heavy and frequent drinking during college. Bad drinking habits in college can evolve into other issues, like alcoholism, in the future.

College Drinking Statistics

Roughly 20% of college students meet the criteria for having an alcohol use disorder (AUD). Close to 60% of college students between the ages of 18 and 22 admitted to drinking in the past month. Of those, nearly two in every three engaged in binge drinking. A little less than 2,000 college students ranging from 18 to 24 years old die from unintentional, alcohol-related injuries each year.

Online Counseling for Alcohol Addiction

Over 3 Million people have turned to BetterHelp for professional online therapy.

Take the quiz and get matched with a therapist.

Find a Treatment Program Today

There are many safe and effective ways to treat a college student’s drinking problems. More rehab facilities are introducing treatment programs tailored specifically to young adults.

Speak with a treatment provider today and get started on your recovery plan.

Editor’s note: The opinions expressed by the author do not necessarily reflect the opinions of the AAMC or its members.

Medical students are known for being highly accomplished — but some experience significant challenges as well, including misuse of substances such as alcohol and marijuana.

A 2016 research report by the Mayo Clinic published in Academic Medicine analyzed over 4,000 medical student surveys and found that nearly one in three respondents met diagnostic criteria for alcohol dependence or alcohol use disorder. On a national level, this translates to medical students using alcohol at roughly double the rate of age-matched peers not in medical school. In some studies, large subgroups of medical students — up to 70% — reported consuming more than five drinks in one sitting, while nearly one in four students reported cannabis use, with men reporting higher use than women.

Not surprisingly, those who experience higher levels of burnout, depression, and low mental or emotional quality of life have a greater risk of problematic substance use. Unhealthy ways of dealing with the chronic stress of medical education as well as strong family history and genetic susceptibility to substance use disorders also play a role.

Interestingly, some studies have found that excessive alcohol use among medical students had limited impact on their performance during the clinical years of training. However, that ability to function at a high level in school may ultimately backfire, as students may delay seeking treatment.

The COVID-19 pandemic no doubt exacerbated all of these trends. In particular, the social isolation and stress of coping with an inordinate amount of illness and death caused significant deterioration in students’ mental health. Anxiety and depressive symptoms have exacerbated, while feelings of stress and isolation have spiked.

As students resume in-person learning and have more face time with peers, guidance on how to nonjudgmentally initiate conversations about concerning substance use may be helpful.

As a medical student myself, I have seen several students struggle with substance use and yet, I have not known how to help. Responses to a query on Facebook to my medical student peers found that many feel the same.

So, I spoke to Jonathan Avery, MD, director of addiction psychiatry at Weill Cornell Medicine and co-editor of Medical Student Well-Being: An Essential Guide, for advice. Here’s what he told me.

Familiarize yourself with the warning signs of substance use disorder and available resources in your medical school and community

Some medical schools incorporate content on general warning signs of concerning substance use into their curriculum. There are also many fact-checked websites that students can access on their own, or they can speak to mental health professionals if preferred. Knowledge of these signs is important to distinguish recreational substance use from heavy use bordering on the side of dependence to use disorders and functional impairment that is impacting patient care.

Also, prior to conversing with peers, familiarize yourself with what services your medical school offers. Some schools outline their policies and programs on intranet pages and in student handbooks accessible online. For example, NYU Grossman School of Medicine lists availability of voluntary and confidential services through the medical school’s Student Health Service as well the university’s Section on Tobacco, Alcohol, and Drug Use Education. University of California, Los Angeles David Geffen School of Medicine similarly outlines resources available through Counseling and Psychological Services (CAPS), a multidisciplinary student mental health center.

Indiana University School of Medicine has programs that allow students to get trained in mental health first aid, which serves as a bridge between initial help offered to a person and appropriate longitudinal treatment. The training helps students identify risk factors and warning signs of concerning substance use (and other mental health disorders), learn a 5-step action plan to help someone experiencing a crisis, and familiarize themselves with other evidence-based professional and self-help resources.

Sometimes handbooks also list resources that are in the community beyond the immediate perimeter of the medical school campus. For example, NYU SOM lists programs available in the New York City area including Alcoholics Anonymous, Marijuana Anonymous, and the National Drug and Alcohol Treatment Referral Routing Service. There are also resources available through Physician Health Services in partnership with local medical societies. For example, Harvard Medical School’s student handbook refers to a program offered by the Massachusetts Medical Society.

But many schools have insufficient information in student handbooks. In fact, a recent study in JAMA Psychiatry found that only a minority of schools’ policies met the AAMC’s published guidelines on developing comprehensive frameworks regarding medical student substance use. In these scenarios, students could contact their respective school’s Office of Student Affairs as a starting point and ask for options available for peers (while maintaining anonymity as needed).

Check in with the person directly

Avery acknowledges that peer conversations around substance use are in a “nebulous territory” and can often be “extremely dicey.” What makes them especially tricky is the murkiness underlying true recreational use and misuse (and conflating that prematurely with a disorder diagnosis), if the use is at work versus elsewhere, and if patients are at risk. “The stakes are of course higher when it involves patient safety,” he says.

The best starting point is to have a casual check-in with the person, preferably outside of work. You can say that you’ve been worried about them and wanted to see how they were doing. Ask how things are going and/or if anything is bothering them. Text messaging might be easier for some, while others may prefer a face-to-face conversation. Some people may feel singled out when inquired about a visible change, and respond better to a general conversation where concerns around substance use are subtly folded in. Evaluate the dynamics of the situation, check with the peer’s friends for advice if needed, and act accordingly. “A casual check-in can create a welcoming environment and not come across as a criticism or attack,” Avery says.

Have a conversation when everyone is level-headed

Avery emphasizes that being “cool and level-headed” is critical to having this conversation. “Make sure that you yourself are calm so that you can be nonjudgmental and create a safe space for your peer,” he says. Being impaired or altered yourself may impact the tone of the conversation and turn adversarial very quickly.

Don’t lecture, be an advocate

When talking to a peer about their concerning substance use, don’t lecture them. Ensure that you establish rapport as an ally and an advocate who cares about them. Contextualize by sharing what you’ve noticed and/or heard from other classmates and that you’ve been meaning to check in, and introduce them to the various resources. “Make sure that your observations and facts are accurate,” Avery emphasizes. If you say something that is untrue, the entire conversation will most likely backfire.

Don’t badger

Many people with concerning substance use — whether it is recreational or bordering on dependence or disorder — don’t perceive their use as concerning and may not feel ready to talk about it. They can get defensive and lash out instead. “Don’t take the bait and just let it go,” Avery says. Also, if they’re not volunteering any information or appear to be shutting down or have unconscious denial defenses, don’t badger. But if they are receptive, let them know what their options are and that you would love to be there for them if they need anything.

You are their peer, not their doctor

Avery feels that people are often “quick to diagnose substance use disorders with insufficient knowledge and/or data.” There are specific definitions for what qualifies as a use disorder compared to just concerning use, tolerance, or dependence. “Don’t say that you think your peer has an alcohol use disorder or cannabis use disorder or something else,” he says. Instead, say that you’ve been worried about them and wanted to check in.

Despite the best of intentions, these conversations can be extremely sensitive. But while it is hard to predict who will be receptive and who won’t, they are still conversations worth having and may allow people to know what options they have to address their substance use challenges before things spiral out of control.

Lala Tanmoy (Tom) Das is a student in the Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program in New York City. Follow him on Twitter @TanmoyDasLala.