Then, in the early 2000s, the infamous Aberdeen Street party—held in the student ghetto of Kingston, on the Saturday night of Homecoming weekend—began to draw crowds. By 2005 I was both the mother of a Queen’s student and a senior journalist at Maclean’s, Canada’s national newsmagazine. My job: overseeing all coverage of postsecondary education.
September 2005
It’s Saturday night of Homecoming weekend, and I am struggling to make my way up Aberdeen Street, cell phone clutched in one hand, notebook in the other. This was supposed to be the party to end all parties. It’s a mob scene: porches overflowing, crowds swarming front lawns, pouring onto the streets, already crunchy with broken glass. Wall-to-wall people. It’s only 10 p.m. and I can barely move.
Nicholas tells me he’s in a dark house across the street. I strain to find the location, being jostled and shoved at every turn. “Just keep clear of the windows,” I tell him. “They’re lobbing beer bottles at anything and everything.” “We have the lights off,” he tells me. “I think we’re going to head back to campus—this is no fun.”
Every few minutes, you can hear the smash of glass. Police in riot gear are at one end of the street, preparing for the worst. I run into George Hood, vice principal, advancement: he is appalled that I am here. “This is all I need: Ann Dowsett Johnston reporting for Maclean’s.” He looks exasperated, tired, frantic. The crowd is building, seething. Vacant-eyed girls clutching bottles sway behind tall boyfriends in leather jackets. One girl is being treated for cuts to her feet. There’s shoving, pushing; at one point, I am being carried by the crowd. The air is electric, giddy even. There is frenzy, fear. Anything could happen.
As it turned out, the mob overturned a car, setting it on fire. Police estimated there were between five and seven thousand people on Aberdeen Street that night. Mounted police tried to herd students onto lawns, with little to no success. An ambulance was blocked and police were pelted with beer bottles. The university staged a high-profile concert, hoping to distract students from the main event—to no avail. In the end, Queen’s canceled its fall Homecoming weekend, with the principal declaring: “The Aberdeen Street party poses a very real threat to personal safety. It is absolutely essential that the reputation of Queen’s be recognized as being based on quality, not on parties on Aberdeen Street.”
Then, in 2010, tragedy: two Queen’s students died in alcohol-related incidents, both falling to their deaths. In September, first-year engineering student Cameron Bruce, eighteen, fell out of a residence window. In December, nineteen-year-old Habib Khan crashed through a library skylight. When the coroner’s report was released in May 2011, it called on the university to “address its culture of drinking.”
Now, Queen’s has decided to reinstate its Homecoming event. “I know if it goes well this fall [of 2013], we’re good,” says Shindman. “But if it doesn’t? Well, the perception will be that the students’ sense of entitlement is real.” She remains critical of the extreme drinking culture. “I might be concerned about a friend who drinks six nights a week, and they will say: ‘Everyone else does it.’ I am flabbergasted when a person blacks out, and then is proud of it. They’re putting themselves in danger, and it’s celebrated! Culturally, we are not good at recognizing the problems with drinking. We waited until enough people died before we acted on mental health on campus. We need to not do the same thing with alcohol. We need to be proactive, rather than reactive.”
Let’s take a look at what’s happening on campuses in the United States. The percentage of college students who binge drink—using the measure of five drinks in two hours for men, four for women—has been edging up in the past decade, nearing 45 percent. Consistently, this consumption level is higher than that of noncollege peers. Drinking is one thing. Combining alcohol with energy drinks is another. This habit—which produces the wide-awake drunk—has fueled many students’ ability to drink harder and longer.
Each year, more than 3.3 million Americans between the ages of 18 and 24 drive under the influence. And in that same age group, an estimated 1,825 Americans die from alcohol-related causes. Alcohol is involved in nine out of ten campus rapes. Meanwhile, one in three college students meets the criteria for an alcohol use disorder. Hospitalizations for alcohol overdoses increased 25 percent for those aged 18 to 24 between 1999 and 2008.
“There is no doubt that more young women are binge drinking,” says Andrew Galloway, Toronto interventionist and vice president of GreeneStone Yorkville treatment center. “We were all binge drinkers in university. Ninety percent of us toned it down. What happens to the ten percent who don’t? Every young person who hears me speak thinks, ‘This won’t happen to me.’ And a handful always end up in my office.” As a generation, will this group slow down as they age? Says Sharon Wilsnack: “I am not sure they are going to ‘mature’ out of it. When I got into this field in the early eighties, there wasn’t this huge epidemic of female drinking. Heavy alcohol use, like smoking, used to be such a male prerogative.”
Thomas Workman, with the American Institutes for Research in Washington, D.C., has worked on college drinking issues for years. “With flavored vodka, the drinking of female college students became much deadlier,” he says. “It is so easily abused. I still see quite a number of student deaths and egregious injuries and sexual assaults, ones that don’t get publicized. Women in adolescence confuse notoriety with popularity. The fear of being the girl who will sit alone in her room and not be seen is pervasive. Somewhere, our culture has told girls that they need to be recognized—invisibility is the enemy. We see this scenario over and over. We have done a terrible job of helping young women situate themselves socially.”
When he was working at the University of Nebraska, Workman got fraternities to recognize the downside of inviting first-year female students to their parties. “She is your greatest liability,” Workman told them. “She can’t drink well. She’s your next trip to the emergency room.”
Workman is still haunted by the case of nineteen-year-old Samantha Spady, a Nebraska student at Colorado State University who died of alcohol poisoning at a fraternity house in September 2004. Spady was an honors student and a homecoming queen—a small-town all-American girl who graduated as president of her class in high school. Early on a Sunday morning, after eleven hours of drinking and party-hopping that ended with her swilling too many shots of vanilla-flavored vodka, Spady was unable to stand by herself. According to various accounts, she had consumed up to forty drinks, including beer, the vodka, possibly some tequila shots; she may have participated in some drinking games. One thing is for certain: she was placed on a couch in a cluttered storage room to sleep it off. When she was discovered that evening, her blood alcohol level was 0.436 percent. Spady’s parents started a foundation in her memory, one to educate on the dangers of alcohol poisoning. But as Workman says, “You need more than ‘a hair-holding friend.’ The fundamental question remains: ‘Why on earth was she drinking so much?’”
So, how do you change a campus culture?
I asked that question of Rob Turrisi, professor of biobehavioral health and prevention research at Pennsylvania State University. Turrisi challenged me: “I am not sure that is the right question. How do you change the culture? You don’t allow students who drink—and no campus is going to go there! Seriously, to change the culture? You’d have to change the culture of North America.”
Turrisi looks at the problem differently. “You need to ask: what problem can I solve? I would ask: How many dollars are we spending on residence life, health clinics, cleanup after tailgate parties? How much is being spent in the community, fixing property damage, medical expenses, extra policing at events? Most campuses are putting Band-Aids on this problem, doing what the campuses around them are doing. Assessment might lead me to a different goal: perhaps fewer emergency room visits. If that’s the case, it might be cheaper to do more triaging in a downtown facility where students are drinking.
“The administrations at most universities
have been placed in a situation where they have to be a major part of the solution,” says Turrisi. “Many don’t have the ability—and I say this in the most positive way—to solve what is a major health problem. They were teachers, researchers, working in cell division or literature, really bright people. But nowhere in their professional development did someone give them the tools to handle this, and most of them are ill-equipped.”
According to Turrisi, between 30 and 40 percent of students arriving on campus are already regular drinkers. Generally speaking, there are four types of drinkers: light or nondrinkers; weekend drinkers, who don’t binge; weekend drinkers who get drunk; and heavy drinkers who have a specific weeknight they designate as a party night. Once they arrive at college, more often than not their drinking escalates. The light drinkers become moderate drinkers, moderate drinkers become heavier drinkers, heavy drinkers become heavier still. Says Turrisi: “On weekends, this last group is sort of Lord of the Flies—ish.” These tend to be part of what Turrisi calls the “twenty-fifty” gang. Twenty percent of the population causes 50 percent of the problems: emergency room visits; blackouts; multiple repeated consequences of drinking.
Parents have a large influence as to whether their son or daughter will be in this “twenty-fifty” group: if they are loving but model heavy drinking once in a while and allow their sons and daughters to drink, their children are four times more likely to be in this group as those whose parents model moderate drinking and do not provide alcohol. Of course, there are parents who try the protective strategy of allowing kids to drink occasionally—often cited as the European model. Turrisi shakes his head: “If you allow your kids to drink once in a while, it’s neutral at best—not protective.”
Turrisi has developed a twenty-five-page handbook for effective parental interventions concerning drinking, best delivered the summer between going to high school and going to university. Says Turrisi: “This is a critical time for parents to parent. You are teaching self-regulatory skills to a person whose brain has not yet fully formed—and the logical, self-regulatory abilities are still developing.” Turrisi says parental interventions are slightly more effective with females than males, and most effective if parents use the handbook: “It’s a little more involved than just having a conversation.”
Having that interchange could have multiple benefits, not the least of which is helping young women avoid sexual assault. For young women involved in binge drinking, the risk of sexual assault is relatively high. According to a recent study in the Journal of Studies on Alcohol and Drugs, a quarter of young women in their freshman year said they had been sexually victimized. The more they drank, the higher the likelihood of sexual assault.
Ultimately, Turrisi believes that more needs to be spent on evidence-based approaches. Nothing surpasses the proper introduction of Brief Alcohol Screening and Intervention for College Students (BASICS), a prevention program for heavy-drinking individuals who have experienced alcohol-related problems. “You have to be very good at it to administer it well, and it takes eight weeks to be trained properly. It’s good, and it works if done well. But it’s time-consuming. This intervention will help students who get into trouble, but it won’t change the culture.”
To learn about BASICS, I turned to Brian Borsari, associate professor at Brown University’s Center for Alcohol and Addiction Studies. He explains: “It’s a targeted motivational intervention for students who are starting to experience consequences from their drinking: ‘This is your behavior. Is this really your ideal self?’ Unless you get a student to see their drinking behavior is in conflict with larger values, there is no room for change. These could be their values as a friend—they may insult friends when they drink; as a son or daughter; as a citizen, breaking the law; as a future employee, with damning photos on Facebook. It’s a collaborative interaction in which the student is crafting their own reasons and means for changing their drinking—which is much better than ‘You can’t,’ ‘You should,’ ‘You must.’ You reframe things as a choice.”
One of the most exciting initiatives on the postsecondary scene is the National College Health Improvement Program (NCHIP). In 2011, Dartmouth College then-president Jim Yong Kim founded NCHIP and chose as its inaugural project the Learning Collaborative on High-Risk Drinking. Multidisciplinary teams from thirty-two universities and colleges across North America—including Yale, Stanford, Princeton, and Northwestern—embraced a model of rapid-cycle change to address the high-risk campus drinking culture. This initiative is unprecedented in both its scope, its dedication to evidence-based practices, and its commitment to move things fast. “This is improvement work, trying to take drinking down a couple of notches, with teams measuring as they go,” says NCHIP director Lisa Johnson. “The cultural change is too large to shoulder alone.” Forty percent of the universities have seen a reduction in emergency room visits by their students; half the schools are collecting data on a monthly basis; 65 percent implemented new brief motivational interviewing initiatives; 69 percent are surveying their students more frequently; 80 percent have implemented initiatives across campus. Says Johnson: “Have we licked this problem and figured it out? No way. It’s only through sustained measures that we can make a difference.”
At member institution Northwestern, five hundred students receive alcohol-related citations each year, for everything from underage drinking to vandalism in the dorm. According to Dr. Michael Fleming, professor of psychiatry and behavioral science at Northwestern’s Feinberg School of Medicine, there is not one American campus that can be cited as taking a comprehensive approach to campus drinking. His 360-degree solution: “I’d screen everybody for high-risk drinking. I’d add late-night programming, offering alternatives to drinking. Dr. Turrisi’s parental program is important because parental conversations work. And I’d create a community coalition: reduce the density of alcohol outlets, the number of bars offering drink specials.”
Still, Fleming is optimistic about the direction things are taking. “People are finally acknowledging that campus drinking is a problem. That’s a big step. Campuses are putting resources into it. There is a lot of evidence as to what works. Campuses are collecting data: real-time stuff. This is encouraging. But like smoking, it’s going to take twenty years. This is a systems-level generational change.”
PART TWO
On the Edge of the Big Lonely
7.
Searching for the Off Button
DRINKING TO FORGET, DRINKING TO NUMB
The central question isn’t “What’s wrong with this woman?” It’s “What happened to this woman?”
—NANCY POOLE
Why do we drink? To celebrate, yes. Relax, reward. Of course.
Ask most girls and women with a serious drinking problem, and you will get none of these answers. What you will get is this—present or past tense notwithstanding: I drink to numb. I drink to forget. I drink to not feel. I drink not to be me.
Abuse and traumatic stress play a major role in this reality. A Canadian study involving six treatment centers found that 90 percent of women interviewed reported childhood sexual abuse or adult abuse histories in relation to their problematic drinking. Meanwhile, the majority of young people—aged sixteen to twenty-four—in the Youth Addiction and Concurrent Disorder Service at Toronto’s Centre for Addiction and Mental Health (CAMH) have histories of traumatic stress (90 percent of the females, 62 percent of the males), as well as sexual abuse.
Dr. Pamela Stewart, a psychiatrist at CAMH, puts it this way: “Typically, men drink to heighten positive feelings or socialize. Women are more likely than men to drink to get rid of negative feelings.” She says that cumulative childhood trauma leads to depression and mood disorders, PTSD, and substance abuse. “Trauma is the elephant in the room. A person can present as anxious or depressed, but it can be unresolved trauma. Almost everyone with severe trauma will do something to regulate the symptoms, and in the short term, drinking does. And once you see substance abuse, you get a much
higher prevalence of PTSD—ninety-one to ninety-four percent.”
In the American Civil War, what we now call PTSD was known as “soldier’s heart.” In the First World War, it was known as “shell shock.” Others knew it as “combat fatigue.” “Historically,” says Stewart, “we would look at trauma after each world war, and then it would be forgotten. But the Vietnam vets refused to let it slip away.”
I first came across PTSD in a most personal way: I was diagnosed with it in rehab by an elegant Harvard-trained psychiatrist with a gentle manner and deep, knowing eyes. I remember having to ask what it stood for: post-traumatic stress disorder, he said, taking his time with me.
I remember being skeptical. In the tiny library, I found a book: Seeking Safety: A Treatment Manual for PTSD and Substance Abuse, by Lisa Najavits, a lecturer at Harvard Medical School and professor of psychiatry at Boston University School of Medicine. Taking the book back to my room, I had one thought: I want to meet this Lisa Najavits. Later, I would find the work of the wonderful Bessel van der Kolk and Judith Herman, author of the groundbreaking Trauma and Recovery. And of course, Gabor Maté: In the Realm of Hungry Ghosts. I wanted to meet them all: I had so many questions. I still do.
Journalism as therapy: it’s how I’ve untangled a lot of my own story—depression, alcoholism. I figured if I could interview Najavits, I could test the good doctor’s theory. But my first attempt to talk to her was a bust. Send your questions by email, she said, and I’ll decide whether I want to answer them. We had one very awkward phone interview three years ago, in which I learned very little. It took me years to arrange to meet her in person, but meet her I did, in a private corner of the cafeteria of the Ontario Science Centre in Toronto.
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