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Unformatted text preview: In this chapter you
will explore Confessions of a COLLEGE STUDENT... ‘‘ ’’ SHELLY SANDERS, 20
Midwestern State University is a great time to explore. It’s an opportunity to
exercise your mind and expand your horizons. Unfortunately, for too many students it becomes an opportunity to stop exercising their bodies and begin expanding their waistlines! Because the college environment might be new to you, you
could forget to take care of yourself.
Many students can handle the transition to college easily, using various
coping mechanisms. Others drink too much or smoke too much. Some overeat or develop an eating disorder such as bulimia or anorexia. Some become
so stressed that their anxiety overwhelms them. Some ignore their sexual
health and then have to deal with a sexually transmitted infection or an unplanned pregnancy.
This chapter explores the topic of wellness, which is a catchall term for
taking care of your mind, body, and spirit. Wellness means making healthy
choices and achieving balance. It includes reducing stress in positive ways,
keeping fit, maintaining good sexual health, and taking a sensible approach
to alcohol and other drugs. In the fall of 2007, according to a survey conducted by the American College
Health Association, about one third of college students reported that stress had negatively affected either an exam grade or a course grade.1 When you
are stressed, your body undergoes rapid physiological, behavioral, and emotional changes. Your rate of breathing can become more rapid and shallow.
Your heart rate begins to speed up, and the muscles in your shoulders and
forehead, at the back of your neck, and perhaps across your chest begin to
tighten. Your hands might become cold or sweaty. You might experience gastrointestinal symptoms such as an upset stomach. Your mouth and lips might
feel dry and hot, and you might notice that your hands and knees begin to
shake or tremble. Your voice might quiver or even go up an octave.
A number of psychological changes also occur when you are under stress.
You might experience changes in your ability to think, such as confusion,
trouble concentrating, inability to remember things, and poor problem solving. Emotions such as fear, anxiety, depression, irritability, anger, or frustration are common, and you might have trouble getting to sleep at night or
wake up too early and not be able to go back to sleep. Stress has many sources, but two seem to be prominent: life events and
daily hassles. Life events are those that represent major adversity, such as the
death of a parent, spouse, partner, or friend. Researchers believe that an accumulation of stress from life events, especially if many events occur over a
short period of time, can cause physical and mental health problems. Daily
hassles are the minor irritants that we experience every day, such as losing
your keys, having three tests on the same day, quarreling with your roommate, or worrying about money.
The College Readjustment Rating Scale is a life events scale, adapted
from Holmes and Rahe’s Life Events Scale and modified for traditional-age
college students. Complete the scale in the box on the next page. If you find
that your score is 150 or higher, you have experienced a great deal of stress
over the past year. You might consider what help you need or skills you must
learn to be able to cope effectively.
On this scale, each event, such as one’s first term in college, is assigned a
value that represents the amount of readjustment a person has to make in life as
a result of change. In some studies, people with serious illnesses have been found
to have high scores on similar scales. People with scores of 300 and higher have
a high health risk. People who score between 150 and 300 points have about
a 50-50 chance of a serious health change within two years. People who score
150 and below have a one in three chance of a serious health change.
If your score is high enough to indicate potential health problems, it
would benefit you to pay special attention to the stress reduction and management techniques discussed in this chapter and to select and implement
some strategies to reduce your stress.2
Adapted with permission from T. H. Holmes and R. H. Rahe, “The Social Readjustment
Scale,” in Carol L. Otis and Roger Goldingay, Campus Health Guide. New York: CEEB, 1989. 2 The best starting point for handling stress is to be in good physical and
mental shape. When your body and mind are healthy, it’s like inoculating
yourself against stress. This means you need to pay attention to your diet,
exercise, sleep, and mental health. There is a clear connection between what you eat and drink, your overall
health and well-being, and stress. Eating a lot of junk food will add
pounds to your body and reduce your energy level. And when you
can’t keep up with your work because you’re sluggish or tired, you
might experience more stress. One dietary substance that can be
directly linked to higher stress levels is caffeine.
In moderate amounts (50 to 200 milligrams per day), caffeine
increases alertness and reduces feelings of fatigue, but even at this
low dosage it can make you perkier during part of the day and more
tired later. Consumed in larger quantities, caffeine can cause nervousness, headaches, irritability, stomach irritation, and insomnia—
all symptoms of stress. Many people who have heart conditions have
been told to avoid caffeine, since it tends to speed up heart rates. How
much caffeine do you consume? Total your caffeine on the basis of the
figures in Table 16.1.
If the amount of caffeine is excessive (this will vary with individuals,
so monitor such things as inability to sleep and when you are most alert
t and most tired), consider drinking water in place of caffeinated drinks, or
choose decaf coffee or a caffeine-free soft drink.
Exercise is an excellent stress management technique, the best way to stay
fit, and a critical element of any worthwhile weight loss program. While any
kind of recreation benefits your body and spirit, aerobic exercise is the best
for stress management as well as weight management. In aerobic exercise,
you work until your pulse is in a “target zone” and keep it in this zone for at
least thirty minutes. You can reach your target heart rate through a variety
of exercises: walking, jogging, running, swimming, biking, or using a stair
climber. What makes the exercise aerobic is the intensity of your activity.
Choose activities that you enjoy so you will look forward to your exercise
time. That way, it’s more likely to become a regular part of your routine.
Besides doing wonders for your body, aerobic exercise keeps your mind
healthy. When you do aerobic exercise, your body produces hormones called
beta-endorphins. These natural narcotics cause feelings of contentment and
happiness and help manage anxiety and depression. Your mood and general
sense of competence improve with regular aerobic exercise. In fact, people
who undertake aerobic exercise report more energy, less stress, better sleep,
weight loss, and an improved self-image. Think about ways to combine activities and use your time efficiently. Maybe
you could leave the car at home and jog to class. Try going to the gym with a
friend and asking each other study questions as you work out on treadmills.
Park at the far end of the lot, and walk to classes. Take the stairs whenever possible. Remember that exercise does not have to be a chore. Find something you
enjoy doing, and make it part of your daily schedule. Many campuses have recreation departments that offer activities such as intramural sports, rock climbing, aerobics classes, and much more. The most important thing about exercise
is that you stay active and make it part of your day-to-day life. Getting adequate sleep is another way to protect yourself from stress.
According to the National Sleep Foundation, 63 percent of American adults
do not get the recommended eight hours of sleep per night. Lack of sleep can
lead to anxiety, depression, and academic struggles. Researchers at Trent
University in Ontario found that students who studied all week but then Wired WINDOW stayed up late partying on the weekends forgot as much as 30 percent of the
material they had learned during the prior week. Try the following suggestions to establish better sleep habits:
If you can’t sleep, get up and do something boring.
Get your clothes and school materials together before you go to bed.
Avoid long daytime naps.
Try reading or listening to a relaxation tape before going to bed.
Get exercise during the day.
Sleep in the same room and bed every night.
Set a regular schedule for going to bed and getting up. Modifying your lifestyle is yet another approach to stress management. You
have the power to change your life so that it is less stressful. Teachers, supervisors, parents, friends, and even your children influence you, but ultimately, you control how you run your life. Lifestyle modification involves
identifying the parts of your life that do not serve you well, making plans
for change, and then carrying out the plans. For instance, if you are stressed
because you are always late for classes, get up ten minutes earlier. If you get
nervous before a test when you talk to a certain pessimistic classmate, avoid
that person before a test. Learn test-taking skills so you can manage test
Relaxation techniques such as visualization and deep breathing can help
you reduce stress. Learning these skills is just like learning any new skill. It
takes knowledge and practice. Check your course catalog, college counseling center, health clinic, student newspaper, or fitness center for classes that
teach relaxation. You’ll find books as well as audiotapes and CDs that guide
you through relaxation techniques. Your stress level plays a key role in your overall mental health. Here are
several additional things you can do to improve your level of stress and your
Reward yourself on a regular basis when you achieve small goals.
Remember that there is a reason you are in a particular situation. Keep
the payoff in mind.
Laugh. A good laugh will almost always make you feel better.
Get—or give—a hug.
Pray or meditate.
Practice a hobby.
Get a massage.
Practice deep breathing. According to the American Psychological Association, depression is one of
the most common psychiatric disorders in the United States, affecting more
than 15 million adults. College students are at especially high risk for depression as well as suicide. The National Institutes of Health report that depression is diagnosed more
often in women than in men. Depression is not a weakness; it is an illness that
requires medical attention. You will find that many college students suffer
from some form of depression. The feelings are often temporary and may be
situational. A romantic breakup, a disappointing grade, or an ongoing conflict with a friend or roommate can create feelings of despair. Although most
depression goes away on its own, if you or a friend have any of the following
symptoms for more than two weeks, it is important to talk to a health care
Feelings of helplessness and hopelessness
Feeling useless, inadequate, bad, or guilty
Self-hatred, constant questioning of one’s thoughts and actions
Loss of energy and motivation
Weight loss or gain
Difficulty going to sleep or excessive need for sleep
Loss of interest in sex
Difficulty concentrating for a significant length of time The Centers for Disease Control and Prevention (CDC) report that students
ages 15 to 24 are more likely than any other age group to attempt suicide.
Most people who commit suicide give a warning of their intentions. The following are common indicators of someone’s intent to commit suicide:
Recent loss and a seeming inability to let go of grief
Change in personality—sadness, withdrawal, apathy
Expressions of self-hatred
Change in sleep patterns Change in eating habits
A direct statement about committing suicide (“I might as well end it all.”)
A preoccupation with death
If you or someone you know threatens suicide or displays any of these
signs, it’s time to consult a mental health professional. Most campuses have
counseling centers that offer one-on-one sessions as well as support groups
for their students. Finally, remember that there is no shame attached to high
levels of stress, depression, anxiety, or suicidal tendencies. Unavoidable life
events or physiological imbalances can cause such feelings and behaviors.
Proper counseling, medical attention, and, in some cases, prescription medication can help students cope with mental health issues. “You are what you eat” is more than a catchphrase; it’s an important reminder of the vital role diet plays in our lives. You’ve probably read news
stories about how there are more and more obese young people than ever before in our history. The CDC reports that the rates of obesity have more than
doubled in the United States since 1990: In 1990 an estimated 11.6 percent of
U.S. citizens were obese; in 2007 an estimated 25.6 percent
were classified as obese. One expert, Dr. James Hill, Director
of Human Nutrition at the University of Colorado, predicts,
“If obesity is left unchecked, almost all Americans will be
obese by 2050.” Many people attribute this situation to
the explosion of fast-food restaurants, which place flavor
and low prices before health. A Tufts University researcher
found that 60 percent of college students eat too much
saturated fat, which increases the risk for heart disease.
Also, most of us do not consume enough fiber and whole
grains. As a result, we are more likely to have long-term
health problems, such as diabetes, heart disease, and
cancer. So what can you do about your eating habits? It’s
not easy at first, but if you commit to a new eating regimen, you will not only feel better, you’ll be
healthier and probably happier. Your campus might
have a registered dietitian available to help you make healthy changes in your diet. Check with your student health center.
Meanwhile, here are some suggestions:
Restrict your intake of red meat, butter, white rice, white bread, and
sweets. “White foods” are made with refined flour, which has few nutrients. Instead, go for fish, poultry, soy products, and whole wheat or
multigrain breads. Remember that brown bread is not necessarily whole
wheat. Check the label.
Eat plenty of vegetables and fruits daily. These are important building
blocks for a balanced diet, and they contain lots of fiber (to help fight off
cancer and heart disease). Instead of fruit juices, which contain concentrated amounts of sugar, opt for the actual fruit. When you sit down to
eat any meal (including breakfast), make sure you have at least one fruit or
vegetable on your plate.
Avoid fried foods—french fries, fried chicken, and so forth. Choose
grilled or broiled meats instead. Avoid foods with large amounts of fat
and sugar, such as doughnuts.
Keep your room stocked with healthy snacks, such as fruit, vegetables,
yogurt, pretzels, and graham crackers.
Eat a sensible amount of nuts and all the legumes (beans) you want to
round out your fiber intake.
Watch your portion size. Avoid “super-sized” fast-food items and allyou-can-eat buffets.
Eat breakfast! Your brain will function more efficiently if you eat a
power-packed meal first thing in the morning. Eating breakfast can also
jump-start your metabolism. If you are not normally a breakfast eater,
try eating just a piece of fruit or half a bagel. You will notice a big difference in your energy level during your early morning classes. Avoid
sugar-coated cereals. Go for healthier options that are loaded with
Always read the government-required nutrition label on all packaged
foods. Check the sodium content (sodium will make you retain fluids and
increase your weight and possibly your blood pressure) and the number
of grams of fat. Strive for a diet with only 20 percent fat.
Figure 16.1 shows the Healthy Eating Pyramid, designed by Walter
Willett, Chairman of the Department of Nutrition at Harvard’s School of
Public Health. The Healthy Eating Pyramid puts exercise and weight control
at the base, recommends eating whole-grain foods at most meals, and encourages eating vegetables “in abundance.” This pyramid emphasizes eating
lots of plant oils, such as olive, canola, and soy, and gives fish and poultry a
higher profile than red meat, which you should eat sparingly. Use sparingly Multiple Vitamins for Most Red
Sweets Dairy or Calcium
Supplement, 1–2 times/day
Fish, Poultry, Eggs,
0–2 times/day Nuts, Legumes, 1–3 times/day
Alcohol in Moderation
(unless contraindicated) Vegetables
Whole Grain Foods
(at most meals) Fruits, 2–3 times/day
Plant Oils, including olive,
canola, soy, corn, sunflower,
peanut, and other vegetable oils Daily Exercise and Weight Control People have been joking about the “freshman 15” forever, but it’s no joke
that new college students tend to gain weight during their first term. Nutrition
experts at Tufts University reported that the average weight gain is 6 pounds
for men and about 4.5 pounds for women during the first year of college.
Increased stress, lifestyle changes, new food choices, changes in physical activity, and alcohol consumption can all cause weight gain. Try eating smaller
meals more often, getting regular exercise, keeping a food journal (to keep
track of what you are actually consuming), and being realistic about dieting. An increasing number of college students are obsessed with their bodies and
food intake. This can lead to conditions such as anorexia, bulimia, or binge
eating disorder, all of which affect women disproportionately more than
men. Anorexia is characterized by self-induced starvation, extreme preoccupation with food, and a body weight less than 85 percent of a healthy
weight. Bulimia is characterized by cycles of bingeing (eating large amounts
of food) and purging by vomiting, abusing laxatives and/or diuretics, exercising excessively, and fasting. People with a binge eating disorder do not purge
the calories after the binge. Individuals with binge eating disorder tend to eat
secretively and are often clinically obese.
Some of the signs and symptoms of an eating disorder are as follows:
Intense fear of gaining weight
Restricting types of food, such as those containing any kind of fat
Weighing less than 85 percent of recommended body weight based on
height, or failure to make appropriate weight gain during a period of
growth Stopping or never getting a monthly menstrual period
Seeing one’s body as fat, even though it is underweight
Secrecy about food and denial of a problem with eating
Anyone who is struggling with an eating disorder should seek medical attention. Eating disorders can be life-threatening if they are not treated by a health
care professional. Many colleges and universities have eating disorder case management teams to help individuals on campus. Contact your student health center for more information, or contact the National Eating Disorder Association
(http://www.nationaleatingdisorders.org or 1-800-931-2237) to find a professional in your area who specializes in treatment of eating disorders. Numerous studies report that about 75 percent of traditional-age college students have engaged in sexual intercourse at least once.
Whether or not you are part of this percentage, it can be helpful to explore your sexual values and to consider whether sex is right for you at this
time. If it is the right time, you should choose a good birth control method
and adopt some strategies for avoiding sexually transmitted infections (STIs)
and unplanned pregnancies. What matters most is that you take care of yourself and your partner. The problem of STIs on college campuses has received growing attention in
recent years as epidemic numbers of students have become infected. In general, STIs continue to increase faster than other illnesses on campuses today,
and approximately 5 to 10 percent of visits by U.S. college students to college
health services are for the diagnosis and treatment of STIs. The belief that
it won’t happen to you and you can’t catch these sorts of infections is inaccurate and potentially more dangerous than ever before. If you choose to be
sexually active, particularly with more than one partner but even if there is
only one, exposure to an STI is a real possibility.
STIs are usually spread through genital contact. Sometimes, however,
STIs can be transmitted through mouth-to-mouth or mouth-to-genital contact. There are more than twenty known types of STIs; Table 16.2 lists those
that are most common on college campuses.
As you can see from the table, many of the STIs have similar symptoms
or no symptoms at all. Many women show no symptoms and are therefore
considered asymptomatic. Most health care professionals recommend that
women who are sexually active be screened for all of the possible STIs during
their yearly pap smear. These screenings are not part of the regular annual
exam and must be specifically requested.
Not all STIs are curable. This means that medications will help alleviate
the symptoms, but the virus will stay in an individual’s system. Sexually transmitted infections that are left untreated can progress to pelvic inflammatory
disease, which is now thought to be the leading cause of infertility in women. One particularly common STI is the human papillomavirus (HPV). In fact,
the CDC estimates that currently 20 million people in the United States are
infected with HPV. HPV is a sexually transmitted infection that is closely linked to
cervical cancer. Gardasil, a vaccine that became available in 2006, provides protection against four types of HPV that cause 70 percent of cervical cancer cases.
For more information about this vaccine or to receive the three injection series,
contact your college or university health services or local health care provider. If you are sexually active, it’s important that you talk with your partner about
ways to protect against sexually transmitted infections and unwanted pregnancy.
Communicating with your partner about safer sex can be difficult and even
embarrassing initially, but this communication can make your relationship stronger and more meaningful. The national organization Advocates for Youth offers
these suggestions to help make this conversation easier and more effective:
Use “I” statements when talking. For example, you might say, “I feel that
abstinence is right for me at this time,” or “I would feel more comfortable if we used a condom.” Be assertive! Do not avoid talking about sex
because you fear your partner’s reaction.
Be a good listener. Let your partner know that you hear, understand, and
care about what he or she is saying and feeling.
Be patient with your partner and remain firm in your decision that talking is important.
Understand that success in talking does not mean getting your partner to
agree to do something. It means that you both have said what you honestly
think and feel and that you have both listened respectfully to one another.
Avoid making assumptions. Ask open-ended questions to discuss relationship expectations, past and present sexual relationships, contraceptive use, and testing for STIs.
Do not wait until you become sexually intimate to discuss safer sex with
your partner. In the heat of the moment, you and your partner might be
unable to talk effectively.
You can avoid STIs and unwanted pregnancies by avoiding sex entirely.
Apparently, 25 percent of college students choose this option, according to
national research. For many people, masturbation is a reasonable alternative
to sex with a partner.
If you’re in the remaining 75 percent, you’ll be safer (in terms of STIs) if you
have only one partner. Yet you might feel that you’re at a point in your life when
you would prefer to have multiple relationships simultaneously. Whether you’re
monogamous or not, you should always protect yourself by using a condom.
In addition to being a contraceptive, the condom can help prevent the
spread of STIs, including HIV. The condom’s effectiveness against disease
holds true for anal, vaginal, and oral intercourse. The most current research
indicates that the rate of protection provided by condoms against STIs is
similar to its rate of protection against pregnancy (90 to 99 percent) when
used correctly and consistently for each and every act of intercourse or oral
sex. Note that only latex rubber condoms and polyurethane condoms—not lambskin or other types of “natural membrane” condoms—provide this
protection. The polyurethane condom is a great alternative for individuals
who have allergies to latex. Use only a water-based lubricant (such as K-Y
Jelly) to keep the condom from breaking. Sexually active heterosexual students have to take steps to prevent unwanted
pregnancy. Planning is the key. What is the best method of contraception?
It is any method that you use correctly and consistently each time you have
intercourse. Table 16.3 compares the major features of some of the most
common methods of birth control. You should be aware that the actual cost
of some of these methods will vary depending on where you live and the kind
of medical insurance you have. The costs listed in Table 16.3 will give you a
general idea of how the costs of the various methods compare. Always discuss birth control with your partner so that you both feel comfortable with the option you have selected. For more information about a
particular method, consult a pharmacist, your student health center, a local
family planning clinic, the local health department, or your private physician.
The important thing is to resolve to protect yourself and your partner each
and every time you have sexual intercourse.
What if the condom breaks or you forget to take your birth control pill?
Emergency contraception pills can reduce the risk of pregnancy. According
to Planned Parenthood Federation of America, if the pills are taken within
72 hours of unprotected intercourse, they can reduce the risk of pregnancy by
75 to 89 percent. Most campus health centers and local health clinics are now
dispensing emergency contraception to individuals in need. Emergency contraception does come with side effects, such as nausea, vomiting, and cramping. In rare cases, serious health complications can result from emergency
contraception. Be sure you ask your provider what symptoms to watch for. In this section our purpose is not to make judgments, but to warn you about
irresponsible use of some substances that can have a major negative impact
on your college experience and your life: alcohol, tobacco, prescription drugs,
and illegal drugs. While you’re in college, you will likely be exposed to the
reckless use of one or more of these substances. We hope that this information will help you think twice and avoid the trouble that can come from substance abuse. Even if you don’t drink, you should read this information because 50 percent
of college students reported helping a drunken friend, classmate, or study
partner in the past year.
A number of surveys have confirmed that your peers aren’t drinking as much
as you think they are, so there’s no need for you to try to “catch up.” Most students’ estimates of how much the average college student drinks are twice as
high as the actual statistics. In the final analysis, it’s your decision to drink or not
to drink alcoholic beverages, to drink moderately or to drink heavily, to know
when to stop or to be labeled as a drunk who isn’t fun to be around. Between
10 and 20 percent of people in the United States become addicted to alcohol at
some point in their lives. Alcohol can turn even people who don’t drink into
victims, such as people who are killed by drunk drivers or family members who
suffer from the behavior of an alcoholic. Over the course of one year, about 20
to 30 percent of students report serious problems related to excessive alcohol
use. You might have heard news reports about college students who died or
were seriously or permanently injured as a result of excessive drinking. Just one
occasion of heavy or high-risk drinking can lead to problems.
How alcohol affects behavior depends on the dose of alcohol, which is
best measured by blood alcohol content, or BAC (see Table 16.4). Most of
the pleasurable effects of alcoholic beverages are experienced at lower BAC levels, when alcohol acts as a behavioral stimulant. For most people, the stimulant level is around one drink per hour. Usually, problems begin to emerge
at doses higher than .05, when alcohol acts as a sedative and begins to slow
down areas of the brain. Most people who have more than four or five drinks
on one occasion feel “buzzed,” show signs of impairment, and are likely to be
higher risks for alcohol-related problems. However, significant impairment at
lower doses can occur.
How fast you drink makes a difference, too. Your body gets rid of alcohol at a rate of about one drink an hour. Drinking more than one drink an
hour might cause a rise in BAC because the body is absorbing alcohol faster
than it can eliminate it.
Professionals can estimate BAC from your behavior. When someone is
stopped for suspicion of drunk driving, police might videotape the person
completing a series of tasks such as walking on a line and tipping his or her
head back or touching the nose with the eyes closed. The degree of impairment
shown in these tests can be presented as evidence in court. At BAC levels of .025 to .05 a drinker tends to feel animated and energized. At a BAC level of around .05 a drinker can feel rowdy or boisterous.
This is where most people report feeling a buzz from alcohol. At a BAC level
between .05 and .08, alcohol starts to act as a depressant. So as soon as you
feel that buzz, remember that you are on the brink of losing coordination,
clear thinking, and judgment. Driving is measurably impaired at BAC levels
lower than the legal limit of .08. In fact, an accurate safe level for most people
might be half the legal limit (.04). As BAC levels climb past .08, you will
become progressively less coordinated and less able to make good decisions.
Most people become severely uncoordinated with BAC levels higher than .08
and might begin falling asleep, falling down, or slurring their speech.
Most people pass out or fall asleep when the BAC is above .25.
Unfortunately, even after you pass out and stop drinking, your BAC can
continue to rise as alcohol in your stomach is released to the intestine and
absorbed into the bloodstream. Your body might try to get rid of alcohol
by vomiting, but you can choke if you are unconscious, semiconscious, or
Worse yet, at BAC levels higher than .30, most people will show signs
of severe alcohol poisoning, such as an inability to wake up, slowed breathing, a fast but weak pulse, cool or damp skin, and pale or bluish skin. People
exhibiting these symptoms need medical assistance immediately. If you ever
find someone in such a state, remember to keep the person on his or her side
with the head lower than the rest of the body. Check to see that the airway is
clear, especially if the person is vomiting or if the tongue is blocking the back
of the throat.
There are many home remedies (such as coffee, water, or cold showers)
for helping to sober someone up, but none has been proven to work. Time is
the only remedy because your liver can metabolize only one ounce of alcohol
per hour. Harvard University has developed the following guidelines for helping an intoxicated friend:
Never leave a drunk person alone.
Keep the person from driving, biking, or going anywhere alone.
If your friend wants to lie down, turn the person onto his or her side to
prevent the inhalation of vomit.
Don’t give the person any drugs or medications to try to sober him or her up.
You can’t prevent the alcohol from being absorbed once it has been consumed, so giving a drunken person food will not prevent or reduce intoxication but can increase the risk of vomiting.
Do not assume that a drunk person is just “sleeping it off” if he or she
cannot be awakened. This person needs urgent care.
We know that many students have been subjected to what they might
regard as exaggerated scare tactics by well-intentioned educators. However,
there are many compelling warning indicators related to heavy drinking.
Think about the following statistics and their possible application to you and
your friends. The effects of heavy drinking are nothing less than a tragedy for
many college students:
1,700 college students between the ages of 18 and 24 die each year from
alcohol-related unintentional injuries, including motor vehicle crashes. 599,000 students between the ages of 18 and 24 are unintentionally injured each year while under the influence of alcohol.
More than 696,000 students between the ages of 18 and 24 are assaulted
each year by another student who has been drinking.3
Heavy, or binge, drinking is commonly defined as five or more drinks for
males and four or more drinks for females on a single occasion. Presumably,
for a very large person who drinks slowly over a long period of time (several
hours), four or five drinks might not lead to a BAC associated with impairment. However, research suggests that in many cases the BAC of heavy drinkers exceeds the legal limit for impairment (.08).
The academic, medical, and social consequences of heavy drinking can seriously endanger a person’s quality of life. Research based on surveys conducted by the Core Institute at Southern Illinois University (http://www.siuc
.edu/~coreinst) provides substantial evidence that heavy drinkers have a significantly greater risk of adverse outcomes. Among other problems, the Core data
identify heavy drinking with increased risk of poor test performance, missed
classes, unlawful behavior, violence, memory loss, drunk driving, regretful behavior, and vandalism, compared with all drinkers and all students. At the same
time, college health centers nationwide are reporting increasing occurrences of
serious medical conditions—even death—resulting from excessive alcohol use:
Alcohol poisoning causing coma and shock
Respiratory depression, choking, and respiratory arrest
Head trauma and brain injury
Unwanted or unsafe sexual activity causing STIs and pregnancies
Anxiety attacks and other psychological crises
Worsening of underlying psychiatric conditions such as depression or anxiety
If you engage in heavy drinking for so long that your body can tolerate
large amounts of alcohol, you might become an alcoholic. According to the
medical definition, someone is alcohol-dependent or alcoholic if he or she
exhibits three of the following symptoms:
1. A significant tolerance for alcohol
2. Withdrawal symptoms such as “the shakes”
3. Overuse of alcohol
4. Unsuccessful attempts to control or cut down on use
5. Preoccupation with drinking or becoming anxious when you do not have
6. Making new friends who drink and staying away from friends who do
not drink or who do not drink to get drunk
7. Continued heavy drinking despite experiencing alcohol-related social, academic, legal, financial, or health problems
3 R. Hingson et al., “Magnitude of Alcohol-Related Mortality and Morbidity among U.S.
College Students Ages 18–24: Changes from 1998–2001.” Annual Review of Public Health,
26 (2005): 259–79. 12 Drinks per week 10
0 D or lower C
Grade point average A Through its College Alcohol Study (CAS), the Harvard School of Public
Health has found that consuming alcohol at binge levels has a negative effect
on academic performance, social relationships, decision making, and health.
Binge drinking is also associated with risky sexual behavior such as having
unplanned or unprotected sex as well as antisocial behavior such as vandalism and getting in trouble with the police.
The College Alcohol Study also finds that a student’s alcohol use affects
others in the immediate environment. Roommates and neighbors complain of
Disruption of sleep or study
Verbal, physical, or sexual violence
Visits from the police4
Since the early 1990s, surveys conducted by the Southern Illinois
University Core Institute have found a consistent negative correlation
between grades and the number of drinks per week—and not just for
heavy drinkers. Findings are similar for two-year and four-year institutions
(see Figure 16.2). —
Tobacco use is clearly the cause of many serious medical conditions, including heart disease, some forms of cancer, and lung ailments. Over the
years, tobacco has led to the deaths of hundreds of thousands of individuals.
4 H.Wechsler and T.F.Nelson, “What We Have Learned from the Harvard School of Public
Health College Alcohol Study: Focusing Attention on College Student Alcohol Consumption
and the Environmental Conditions that Promote It.” Journal of Studies on Alcohol and Drugs,
July 2008: 481–90. The University of Michigan’s Monitoring the Future Survey published by
the National Institute on Drug Abuse estimates that rates of smoking have
declined among college students and were at 20 percent as of 2007.5 But
one concern about college students and smoking is “social smoking.” This
term describes smoking by students who do so only when hanging out with
friends, drinking, or partying. Most college students feel they will be able to
give up their social smoking habit once they graduate, but after four years of
college, some find that they are addicted to cigarettes. Although a small percentage of college students use smokeless tobacco,
one “dip” delivers the same amount of nicotine as three to four cigarettes.
Smokeless tobacco contains twenty-eight known cancer-causing substances
and is associated with the same level of health risk as cigarette smoking.
Although smoking is more prevalent among men than among women,
according to the American Lung Association,6 the differences are narrowing,
and the rates of smoking-related cancers in women are rapidly approaching
or surpassing rates in men. One explanation as to why women smoke is the
enormous amount of pressure on young women to stay thin. While there is
some evidence that smoking increases metabolism and suppresses the appetite, the problem of being two or three pounds heavier cannot begin to
compare to the dangers of smoking. It has been noted that on the average,
female smokers have their first heart attack nineteen years before nonsmoking females do.
Chemicals in tobacco are highly addictive, making it hard to quit.
Although young people might not worry about long-term side effects, increased numbers of respiratory infections, worsening of asthma, bad breath,
stained teeth, and the huge expense should be motivations not to start smoking at all. Smoking and the use of hormonal birth control can be a deadly
combination. A study conducted at Boston University School of Medicine
showed that women who smoke and use hormonal birth control are nearly
ten times more likely to have a heart attack than are women who don’t smoke
and don’t use hormonal methods of birth control. A final reason for smokers
to quit is the cost (see Table 16.5).
Many institutions and local hospitals offer smoking cessation programs
to help individuals who are addicted to nicotine to quit smoking. Contact
your campus health center for more information about taking this step toward quitting.
5 L.D. Johnston, P.M. O’Malley, J.G. Bachman, and J.E. Schulenberg, Monitoring the Future:
National Survey Results on Drug Use, 1975–2007. Volume II: College Students and Adults
Ages 19–45 (NIH Publication No. 08-6418B). Bethesda, MD: National Institute on Drug
American Lung Association, Quit Smoking: Smoking and Women Fact Sheet. http://www
.lungusa.org/site/c.dvLUK9O0E/b.33572. Researchers at the University of Michigan reported in 2008 that 11.2 percent
of college students have used prescription stimulants for nonmedical purposes at some point and 6.9 percent have used them in the past year. Three
classes of prescription drugs are the most commonly abused: opioids, central
nervous system depressants, and stimulants. Some individuals might engage
in “doctor shopping” to get multiple prescriptions for the drugs they abuse.
Opioids include morphine, codeine, and such branded drugs as
OxyContin, Darvon, Vicodin, Demerol, and Dilaudid. Opioids work by
blocking the transmission of pain messages to the brain. Chronic use can
result in addiction. Taking a large single dose of an opioid can cause a severe
reduction in your breathing rate that can lead to death.
Taken under a doctor’s care, central nervous system depressants, such
as Valium, Librium, Xanax, and Halcion, can be useful in the treatment of
anxiety and sleep disorders. The flip side is that exceeding the recommended
dosage can create a drug tolerance, and the user will need larger doses to
achieve the same result. If the user stops taking the drug, the brain’s activity
can rebound and race out of control, possibly leading to seizures and other
Stimulants, such as ephedrine, Ritalin, and Dexadrine, enhance brain activity, causing an increase in alertness, attention, and energy accompanied by
elevated blood pressure and increased heart rate. Legal use of stimulants to
treat obesity, asthma, and other problems has dropped off as their potential
for abuse and addiction has become apparent.7
Ritalin is prescribed for a condition called ADHD (attention deficit/hyperactivity disorder) but is gaining recognition on college campuses as a
“cramming drug.” This prescription drug costs only about 50¢ per tablet but
sells on the street for as much as $15. College students are using Ritalin to
stay awake for long periods of time to study for exams. Many students think
7 Adapted from Prescription Drugs: Abuse and Addiction. Bethesda, MD: National Institute
on Drug Abuse, part of the National Institutes of Health, a division of the U.S. Department of
Health and Human Services, 2009. that since it is a prescribed drug, it must be harmless. The U.S. Department
of Education’s Higher Education Center for Alcohol and Other Drug Abuse
and Violence Prevention lists the following as possible adverse effects from
abusing Ritalin: nervousness, vomiting, changes in heart rate and blood pressure, dependency, fevers, convulsions, headaches, paranoia, hallucinations,
Another class of drugs that is of concern in the college setting is anabolic
steroids. When most people think of steroids, they think about collegiate
and professional athletes. But it is important for all college students to know
and understand the dangers of these synthetic substances. According to the
National Institute on Drug Abuse, steroids are taken orally or injected into
the body in cycles that last weeks or months. Steroid abuse has many major side effects, including liver tumors, cancer, jaundice, fluid retention, high
blood pressure, kidney tumors, and severe acne. Most anabolic steroid users
are male and therefore have gender-specific side effects, including shrinking
of the testicles, reduced sperm count, infertility, baldness, development of
breasts, and increased risk for prostate cancer. Abusers also put themselves at
risk for contracting HIV or other blood-borne viruses from using or sharing
The abuse rate for steroids is fairly low among the general population. The
2007 Monitoring the Future Survey found that 1.9 percent of young adults
ages 19 to 28 reported using steroids at least once during their lifetimes. Just
over half a percent (0.6 percent) reported using steroids at least once in the
past year, and 0.3 percent reported using steroids in the past month.8
Drugs that can be purchased without a prescription are generally safe
when taken according to directions on the bottle or package. But never take
more than the recommended dose without consulting your physician.
Drugstores and health food stores also carry many supplements in pill
or liquid form that are labeled “natural.” This label does not mean that the
product has been tested, is safe, or is worth your money. The Food and Drug
Administration (FDA) does not regulate supplements as they do food or other
medication, so it is very important to do thorough research and to consult
your physician before starting any over-the-counter regimen. Illegal recreational drugs, such as marijuana, cocaine, methamphetamine,
MDMA (ecstasy), and heroin, are used by a much smaller number of college
students and far less frequently than alcohol. Yet these drugs are significant
public health issues for college students. The penalties associated with the
possession or use of illegal drugs tend to be much more severe than those associated with underage alcohol use.
Athletic departments, potential employers, and government agencies
do routine screenings for many of these illegal drugs. Future employability,
athletic scholarships, and insurability could be compromised if you have a
8 L.D. Johnston, P.M. O’Malley, J.G. Bachman, and J.E. Schulenberg, Monitoring the Future:
National Survey Results on Drug Use, 1975–2007. Volume II: College Students and Adults
Ages 19–45 (NIH Publication No. 08-6418B). Bethesda, MD: National Institute on Drug
Abuse, 2008. positive drug test for any of these substances. A brief summary of five of the
most prevalent drugs follows.
The effects of marijuana can linger for three to seven days, depending on the smoker and the potency of the drug. Chronic use of marijuana
can lead to a lethargic state in which users might tend to forget about current
responsibilities (such as going to class). Long-term use carries the same risks
of lung infections and cancer that are associated with smoking tobacco.
MDMA, commonly known as ecstasy, is a synthetic (humanmade) drug, in contrast to drugs that are derived from plants, such as marijuana and heroin. Many young people believe that MDMA is safe and offers
nothing but a pleasant high for the $25 cost of a single tablet (“How bad
can it be if it’s that cheap?” is one rationalization); however, the reality is
far different. Taken orally, the effects of MDMA last approximately four
to six hours. Many people will take a second dose when the initial dose begins to fade. Some tablets contain drugs in addition to MDMA, including
amphetamine, caffeine, dextromethorphan, ephedrine, and cocaine. MDMA
significantly depletes serotonin, a substance in the brain that helps regulate
mood, sleep, pain, emotion, and appetite as well as other behaviors. It takes
the brain time to rebuild the serotonin needed to perform important physiological and psychological functions. Of great concern is MDMA’s adverse
effects on the pumping efficiency of the heart. Heavy users can experience
obsessive traits, anxiety, paranoia, and sleep disturbance. One study indicates
that MDMA can have long-lasting effects on memory.9
Numerous reports have suggested a rise in heroin use among college students. A highly addictive drug with the potential to be more damaging and fatal than other opioids, heroin is the most abused and most rapidly
acting of this group. One of the most significant—and surest—effects of
heroin use is addiction. The human body begins to develop tolerance to
the drug on first use. Once tolerance is built up, the abuser must use more
of the drug to achieve the same intensity. Within a short time, users must
take the drug more and more often to alleviate the symptoms of addiction.
Eventually, they don’t get much of a high from the heroin but take the
drug simply to avoid the discomfort of withdrawal. Heroin can be injected,
smoked, or snorted. Injection is the most efficient way to administer lowpurity heroin. However, the availability of high-purity heroin and the fear
of infection by sharing needles have made snorting and smoking the drug
more common. Some users believe that snorting or smoking heroin will not
lead to addiction. They are 100 percent wrong.
Chronic users of intravenous drugs can develop collapsed veins, infection
of the heart lining and valves, abscesses, and liver disease. Users are also at
risk for pulmonary complications, including various types of pneumonia. In
addition to the effects of the drug itself, users who inject heroin or share needles put themselves at risk of contracting HIV, hepatitis B and C, and other
9 Excerpted from Ecstasy: What We Know and Don’t Know About MDMA: A Scientific
Review. Bethesda, MD: National Institute on Drug Abuse, part of the National Institutes of
Health (NIH), a division of the U.S. Department of Health and Human Services, 2001. blood-borne viruses. A heroin overdose is known to cause slow and shallow
breathing, convulsions, coma, and possibly death.
Cocaine produces an intense experience that heightens senses. A
cocaine high lasts only a short time; then the good feelings are gone. During
the crash, the user might feel tired and unmotivated and find it impossible to
sleep. Cocaine is highly addictive. In some instances, users have died of cardiac arrest while taking the drug. Some users are shocked into quitting when
their nasal septum (the wall of cartilage separating the two nostrils) begins to
develop holes caused by cocaine use.
Methamphetamine, often abbreviated to “meth,” is
particularly dangerous because it costs so little and is so easy to make. Much
of it is produced in makeshift labs in homes or college residences, which
means not only that the quality varies from batch to batch but also that it’s
virtually impossible to know what else is in the mixture.
The drug can initially produce euphoria, enhanced wakefulness, increased
physical activity, and decreased appetite. Prolonged use can lead to binges,
during which users take more meth every few hours for several days until they
run out of the drug or become too disorganized to continue. Chronic abuse
can lead to psychotic behavior, characterized by intense paranoia, visual and
auditory hallucinations, and out-of-control rages that can be coupled with
extremely violent behavior. Researchers have found that many former meth
users have experienced long-term brain damage, and it is unknown whether
the damage can ever be reversed. Where to go FOR HELP . . . Chapter REVIEW . . .
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This note was uploaded on 05/02/2010 for the course US/101 AAGI0NMRC4 taught by Professor Kathybaucum during the Spring '10 term at University of Phoenix.
- Spring '10