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College Students at Risk During Alcohol-Related Blackouts

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Duke Health News 919-660-1306

DURHAM, N.C. -- A survey by Duke University Medical Center
researchers suggests that college students are engaging in
significantly risky behaviors during alcohol-related memory
"blackouts." The researchers further note that female students
may be at greater risk during a blackout than their male
counterparts.

The survey results appear in the most recent issue of the
Journal of American College Health, published in February 2003
(but dated November 2002).

According to the researchers, the survey findings offer
important insights into the experiences college students are
having with alcohol -- the most popular drug on American
college campuses.

Nearly three-fourths of all respondents (74.2 percent)
reported consuming alcohol in the two-week period prior to the
survey. Of those, nearly one in 10 (9.4 percent) had
experienced at least one blackout during that same time period,
while 40 percent reported having experienced at least one
during the previous year.

"This study shows that the common assumption that blackouts
only happen to alcoholics is wrong," said Aaron White, Ph.D.,
assistant research professor of psychiatry at Duke and lead
author of the study. "It is very possible for social drinkers,
such as the students we surveyed, to experience blackouts if
they overdo their consumption of alcohol. The study suggests
that college students are much more familiar with blackouts
than many people, including us, assumed."

Using an e-mail survey, the researchers collected data from
772 undergraduate college students at Duke University during
the spring 2001 semester. The student group surveyed was evenly
divided among freshmen, sophomores, juniors and seniors, and
between males and females. All students included in the survey
were aged 18 years or older. The survey was a 19-point
questionnaire designed to acquire information on demographics,
drinking habits, family history of problems with alcohol,
frequency of blackouts and the types of events the students
later learned they had participated in during the blackout
episode.

The researchers acknowledge that while they are pleased with
the survey response and sample size, they only examined
students from one university. While they expect that the sample
of Duke students is likely representative of a broad
cross-section of American college students, they stress that
larger studies need to be completed before statements can be
made about blackouts among college students as a whole.

During a blackout, an individual is capable of participating
in salient, emotionally charged events but will have no
recollection of what has occurred. Many students in the study
indicated that they later learned they had engaged in a wide
range of risky activities during their blackout -- such as
having unprotected sexual intercourse, vandalizing property or
driving a car -- which could have led to serious health or
legal consequences.

White stressed that due to the high level of intoxication
needed to experience a blackout, other psychological processes
may also be impaired.

Impairments in judgment, decision-making, and impulse
control could lead an individual to make potentially hazardous
choices during blackouts. The researchers believe that more
information about why blackouts occur and the potential dangers
associated with them need to be part of any standard
alcohol-awareness training for students. Such training, they
said, would be most effective if made available as early as
possible upon a student's arrival on campus.

"We want to provide students with information that will help
them make good, informed decisions regarding their use of
alcohol," said White. "It is important for students to know
what blackouts are and what factors seem to increase the risk
of blackout occurrence so that they can be avoided."

The total number of blackouts experienced by students
appears to correlate with lower grade point averages and other
indicators of problem drinking, the researchers said.
Additionally, they learned that while female students tend to
drink less heavily than their male counterparts, they were just
as likely as males to experience blackouts -- and that, they
say, could put females at greater risk for a variety of
consequences.

Alcohol disrupts information processing in a variety of
brain regions, including the hippocampus, which plays a
critical role in the formation of memories of facts and events.
The researchers suspect that consuming large amounts of alcohol
quickly might increase the chances for a blackout because it
leads to a rapid increase in the person's blood alcohol
content. This catches the brain circuitry underlying memory
formation unprepared to deal with an onslaught of alcohol. When
blood alcohol levels rise slowly, people seem to be less likely
to experience blackouts even if they eventually become
intoxicated. The researchers speculate that this might be due
to a small degree of tolerance that develops during consumption
of alcohol and could help protect the brain from blackouts.

"In college, in general, young people are living
independently for the first time in their lives," said H. Scott
Swartzwelder, Ph.D., clinical professor of psychiatry at Duke,
a senior research career scientist with the U.S. Department of
Veterans Affairs and a study co-author. "With new freedoms,
many adolescents go into an experimental mode which could
include experimenting with alcohol and heavy drinking. Alcohol
consumption is often viewed as a rite of passage for young
adults and has become widely accepted throughout American
culture, but people should be aware that the culture of
drinking is quite different than it was some years ago. Many
students today drink specifically to get drunk. This increases
the risk of all sorts of consequences, including
blackouts."

According to the researchers, e-mail surveys have become
more popular in recent years as a method of researching the
habits and behaviors of college students because computers and
e-mail have become mainstream tools for all college campuses.
Students are comfortable using both computers and e-mail as a
form of written communication, and e-mail surveys offer
anonymity and a quick way to respond, they said.

"These study findings are very important because they
support a large literature suggesting that students are
consuming large quantities of alcohol and that they will suffer
consequences," said Fulton T. Crews, Ph.D., director of the
Center for Alcohol Studies at the University of North Carolina,
Chapel Hill. "Brain damage incurred during adolescence may
become significant later in life as the processes of aging
reduce the reserve capacity of individuals. Degenerative
problems may become more prominent as people get older. So the
risks of these types of episodes are not only the risks of
trauma and harm during the blackout, but could include
long-term consequences to health later in life."

David W. Jamieson-Drake, Ph.D., director of institutional
research, office of the provost, Duke University, also was an
investigator on the study.

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