(This is an example of what I’ve been working on in my internship this summer.  This piece is intended as a training/consulting resource for folks who will have my job in the future.  The cited resources are available in a monster annotated bibliography I finished yesterday. )

Henry Wechsler has shaped the way American college alcohol consumption is understood more than any other individual. His role as lead researcher and spokesperson for the Harvard College Alcohol Survey (CAS) has given him access to a volume and quality of data that was unprecedented. (The CAS has an n in excess of 40,000, and took administered surveys in 1993, 1997, 1999, and 2001.) Wechsler’s choice on subject and the ways in which he has approached presenting and publicizing his findings has galvanized attention of the sort that little academic research does.

The most ubiquitous of Wechsler’s contributions has been his redefinition of binge drinking. While he makes the point that others had done so before, Wechsler’s use of the 5/4 standard (five standard drinks for men, four for women, in a single setting) to define binge drinking has changed the way to term is defining by American culture at large. Prior to Wechsler, binge drinking was commonly thought of as a several day period of intense drinking, a bender, or a particularly sustained bought of partying. The difference between these two definitions is substantial.

Wechsler’s reason for using the 5/4 standard is that it serves as a logical cut point for correlations between drinking volume and the incidence of academic, social, and legal problems. Once a generic college student drinks at or above the 5/4 level on a consistent basis, she is statistically far more likely to skip classes, achieve lower grades, engage in unprotected sex, be injured, and a host of other troubles frequently associated with American undergraduate life. While the specifics of the CAS’s data and conclusion can be disputed, most notably on the grounds that correlation does not automatically imply or clarify causation, the general idea that for the American college student consistently having 5/4 or more drinks in an evening is problematic has become a matter of consensus.

The debate around the CAS is rather focused on two issues: the cause of systemically problematic drinking amongst American college students, and the most effective means of altering drinking behavior. I will take up the later first. Wechsler, in his many academic articles and in his popular book Dying to Drink, focuses on the cultural conditions that promote drinking in college. In Dying to Drink (p. 132) he writes “But alcohol itself creates addiction…” Therefore Wechsler focuses much of his attention of alcohol distributors, the ways in which their advertising appeals to and creates an image of college drinking, and on the laws and policies which allow this image to propagate and thrive. He advocates holistic approaches that bring town and gown together, creating alcohol-free living and social arrangements on campus while at the same time making the acquisition of alcohol, especially cheap alcohol, difficult. Wechsler also encourages parental involvement, education, and role modeling.

Wechsler has been a vocal critic of the social norms approach for changing college drinking. Pioneered and popularized by sociologist H. Wesley Perkins, the social norms approach is also predicated around the influence culture at large has on how college students drink. The dominant image of college drinking might be epitomized by MTV’s longstanding Spring Break series, insofar as college represents a union of freedom and carelessness likely to never again be afforded. Therefore, in the interest of fun now and no regrets later, every opportunity to party must be seized. The social norms approach does not engage with the cultural trope of college as the best years of one’s life, instead focusing on highlighting the differences between popular perceptions of student behavior and student self-reports. Surveys have fairly consistently found that college students overestimate the frequency and vociferation of their peers’ partying, and the social norms approach assumes that if good data is gathered which contradicts those popular misperceptions, and if it is disseminated in effective ways, that the intractable influence of conformity will cause student partying to readjust. If students believe that “most students” drink a given amount, they will be more likely to drink about that amount more often.

Wechsler has been a loud and consistent critic of the social norms approach, noting that its implementation at various schools has often been funded by alcohol producers, and that it gives tacit approval to underage college drinking. Wechsler may well be correct that social norms approaches normalize college drinking, at least moreso than the approaches which he favors, but any argument on these matters comes down to effectiveness. If a program is designed to reduce the amount or frequency or drinking or drinking-related and caused problems, evidence of a change is the sole arbiter. On these grounds, both the social norms approach and the enforcement and programmatic changes favored by Wechsler have been a mixed bag. Some schools have reported results from social norms programs that have been highly (statistically) significant. Other schools have not. Some schools and communities have funded more police enforcement, taxed alcohol, and restricted liquor licenses. The success of these and other ideas has been mixed, depending on what example one chooses to peruse.

I suggest that the importance of Wechsler’s work is less in the debate he has sparked about how to prevent harmful and excessive college drinking, a state of affairs for which Wechsler deserves much credit. The vicissitudes of these arguments can only be understood well by examining the primary sources (which are included elsewhere on the J drive). Instead, perhaps the grandest truth revealed by the CAS and its aftermath has been giving America a clear picture of just how much it cares, worries, even fetishizes the college experience. Perhaps this very weightiness is one of the most problematic influences on college drinking.

Wechsler opens the first chapter of Dying to Drink with an anecdote about Cupid Week, a ritual at a Northeastern college. There “…brothers of one fraternity take their shyest new member, get him completely wasted, and dress him up as Cupid. Then two brothers hold him up as he stumbles across campus. For every girl that he kisses the fraternity donates a dollar to the American Heart Association. The event draws hundreds of onlookers, both drunk and sober…” (p. 3) It is not clear to me why, out of all the many lurid incidents of which the books first eighty pages almost solely consists, Wechsler chose this one. What does seem clear, given the nature and abundance of debauchery in the books first section, is that Wechsler is very concerned about getting his audiences attention. Yet, it all seems like a bit too much. Wechsler could have made his point with much less material. It seems possible that, as a culture, we find college drinking to be a too interesting subject.

This is not a trait irrevocably carved into the American mind. Cultural anthropologist Dwight Heath, in his book Drinking Occasions, discusses that while most (but not all) world cultures managed to discover alcohol, and that most imbue the drinking of alcohol with emotional and cultural significance, a great deal of what we assume to be the necessary and inevitable behavior that accompanies alcohol consumption is merely an American cultural artifact. Even Wechsler’s opinion that “alcohol creates addiction” is complicated by cross-cultural research. Heath documents several examples of cultures whose typical drinking patterns far exceed the 5/4 rule, with no evidence of the ensuing ills which in contemporary American college life seem almost inevitable. College drinking is then a socially constructed entity, and while may seem to be no great revelation, the important thing to note is that because cultures exist because of the people who make them up, we are the ones doing the construction in the first place.

Some thinkers and researchers have advanced alternatives models. Psychologist Stanton Peele, in his The Meaning of Addiction: An Unconventional View, advocates that addiction be viewed strictly as a behavior. While behaviors are determined in a matrix which includes cultural, social, and genetic factors, behaviors are also eminently changeable. Peele writes that a successful theory of addiction “…must account for why a drug is more addictive in one society than another, addictive for one individual and not another, and addictive for the same individual at one time and not another.” (p. 72) The question of to what extent addiction may or may not be relevant for what percentage of college drinkers in besides the point. The vital question is why alcohol is, statistically and otherwise, so much more problematic for modern American college students than almost any other group.

This is a useful guiding question for anyone working in the field of drug and alcohol treatment to keep at the forefront of their daily practice: what role does alcohol play in the life of this client? Rather than undertaking a historical and archeological investigation that would produce an interpretation of what alcohol use means that could then be placed onto a client, better to formulate a new interpretation for each, from the bottom up. This will ensure a client-centered approach, which is one method that irrespective of the subject or setting has proven to be effective in the helping professions. Anthropologist Andrew Sherratt has written (as a part of the collection Consuming Habits) that “…the performance of the process of enjoyment…” (p. 3) is the most relevant diagnostic and analytic factor to use when examining drug use. It also seems to be one factor which binds human drug use, trans-historically. Finding how enjoyment functions and is achieved for each college student gives insight not only into the role of alcohol in that person’s life, but into the role of alcohol in college as a whole.

In the end Wechsler, Perkins, and even Peele have much in common. All say that alcohol use cannot make sense outside of a certain context. All say that this context determines how alcohol is used in a given place, at a given time, and by certain people. All say that ultimately meaningful change in alcohol use must emanate from a shift in culture. The open question is and remains how to best facilitate such a change, in daily practice.