As the semester draws to a close and Commencement approaches at the George Washington University, plenty of students are getting ready to celebrate. But it’s important to make informed, healthy choices around partying: Excessive alcohol use is linked with a plethora of negative health outcomes.
On National Nurses’ Day, GW School of Nursing Dean and Professor Susan Kelly-Weeder, whose scholarship focuses on high-risk behavior clusters in college populations, shared the trends she’s seeing in alcohol use among young people, the signs of problematic drinking and the things she saw during her time as a family nurse practitioner that drew her to this field.
Q: How and when did you become drawn to alcohol use in college-aged populations as an area of research?
A: I came to this research area from my days as a family nurse practitioner practicing in college health. I was working in a college health center, and on the Monday after spring break, every student patient I saw had an alcohol related injury or concern. Students who had fallen while drinking and sustained orthopedic injuries, students requesting STD workups because they had unprotected sex while intoxicated and a variety of other complaints. It was a varied and compelling list of problems, and they all had one thing in common—excessive alcohol consumption.
Additionally, as I started investigating this phenomenon, I discovered that many of my female student patients were also describing disordered eating symptoms along with their high-risk drinking behaviors and this put them at high risk for developing an eating disorder. The co-occurrence of these behaviors was novel and not well described so I decided to focus on these behaviors in order to develop interventions to assist these students in reducing these behaviors and preventing additional health problems.
Q: What are the trends around alcohol use on college campuses? What’s driving those trends, and are they likely to last?
A: College-age drinking is declining, with 2023 seeing record lows for alcohol use (55%) and binge drinking (21.9%) among college students. While consumption rates are falling, over half still consume alcohol, with binge drinking prevalent.
Key trends include rising abstinence, a shift toward marijuana usage and continued higher binge rates among students in fraternities or sororities. While males historically had higher drinking rates, recent data shows females have sometimes exceeded males in monthly drinking; however, males continue to report higher rates of binge and heavy drinking.
Potential reasons behind these trends include increased health awareness and risk perception. Young adults increasingly view alcohol as harmful—even at moderate levels. About 65% of people ages 18 to 34 now say moderate drinking is bad for health, a major shift from prior generations. We have also seen a decrease in teenage drinking—about a 40% decline in the last 10 years—so students are arriving in college with less drinking experience. We have also noted an increase in other substance uses. Some evidence suggests partial substitution, with marijuana use rising among young adults.
Another interesting finding is related to the student population. Gen Z is often described as more risk-averse, goal-oriented and image-conscious, and they may not identify with drinking to excess as previous populations have.
Q: What qualifies as problematic or excessive drinking? How can a person recognize when their own alcohol use needs attention?
A: There are several definitions of high-risk alcohol consumption, but in college-aged populations we primarily talk about binge drinking. That is defined as five or more drinks in two hours for men and four or more drinks in two hours for women. Some of the most significant indicators of excessive drinking include negative experiences while drinking, including problems with friends or partners, or missing classes or other important events due to the effects of drinking.
Roughly 20% of college students meet the criteria for having an alcohol use disorder, and about 2,000 college students (ages 18 to 24) die from unintentional, alcohol-related injuries annually. Health impacts include alcohol poisoning, accidents and injuries, aspiration and electrolyte imbalance and dehydration.
There are cognitive effects too, as alcohol impacts brain activity, and the brain of an individual in their 20s is still developing. Alcohol disrupts memory, executive function, learning and attention levels. Additionally, alcohol has a strong association with mental health concerns including anxiety, depression, suicidal ideation and attempts.
We also know that college-aged students who drink in excess are at increased risk for unprotected or unintended sexual activity, sexual assault (both victimization and perpetration), driving under the influence and experiencing violence and/or interpersonal conflict. Overall, excessive drinking in college students is associated with life-threatening risks, neurodevelopmental and cognitive harm, significant mental health consequences, academic disruption, long-term addiction and chronic disease risk.
The benefits of reducing or abstaining from alcohol use in college include improved physical health and safety, improved mental health and emotional stability, improved academic performance, success and retention. There are also community and campus-wide effects, including decreases in sexual assault and interpersonal violence, as well as decreases in property damage and disruptive behaviors.
If you're a member of the GW community struggling with alcohol use, resources are available. Visit the Division of Student Affairs substance use website to learn more.
