Julian* remembers little of his lost Friday night in October 2003 except that he was drinking vodka shooters in a friend’s room at McGill University and having a great time. “I must have drunk most of a full 26er,” recalls the 20-year-old political-science student. At around 10 p.m., his friends say, they all walked out across the campus, searching for another party, but Julian somehow wandered off. He woke up hours later, lying in a bed in the emergency room of the Montreal General Hospital, smelling of vomit and alcohol. “To this day, I have no idea how I got there,” he says sheepishly.
Jeff* recalls drinking “way too many” beers, tequila shots and whisky and stumbling out of a friend’s party in Dundas, Ont., last year at age 17, vomiting in the bushes and then crawling into the back seat of a car. He awoke to the glaring probe of a flashlight from a police officer who called his dismayed parents to take the inebriated teen home.
Your Party—Your Liability
Beware: Binge drinking isn’t risky only to those imbibing. You could be sued and risk losing your home or all your financial assets if you are found
liable in the alcohol- related injury or death of another person, warns law professor Robert Solomon, national director of legal policy for Mothers Against Drunk Drivers (MADD) Canada.If you serve alcohol to someone who is intoxicated, you are at risk of being sued should that person go on to harm themselves or others, such as by driving drunk. “No one has been sued for serving alcohol responsibly, but if you can tell that someone is very drunk, or you know that they have had many drinks, and you continue to serve them, you are at risk,” says Solomon. The courts are even stricter if the person served is underage.Even if you serve no alcohol, you could be liable for injuries or deaths that occur on your property to someone who is drunk. A deck with a poor guard rail, the drunken, aggressive guest you don’t evict who beats up another guest, or the inebriated kid you don’t stop from jumping from your roof are all examples of liability risks should someone be harmed.Solomon has produced three pamphlets that tell parents, employers, commercial and social hosts how to protect themselves from alcohol-related liability. Visit www. madd.ca, click on Research Library, then MADD Canada Publications.
Evan,* a 17-year-old student in West Vancouver, was the designated driver at a friend’s party one night when someone shoved an incoherent, drunken Grade 9 girl into his car with the request to “take her home.” With no idea who she was or where she belonged, and worried that she may be close to alcohol poisoning, he and a friend put the semiconscious girl in a wheelchair inside the doors of the Lion’s Gate Hospital in North Vancouver and drove away. “She was so drunk we thought she might die, but we didn’t stay because we thought we’d get in trouble,” says Evan, who later learned the girl spent the night in hospital, sobering up under the watchful eyes of emergency staff.
These stories all feature good kids who were involved in binge drinking. They were lucky; none died or drove drunk or had any of the many calamities that can arise from a night of heavy drinking.
Most canadians appreciate a cold beer on a hot day or a glass of wine at dinner. That kind of responsible use of alcohol is a social lubricant that makes life a little more pleasant.
But binge drinking is different. Call it getting tanked, sloshed, blotto—binge drinking is typically defined as consuming five or more drinks for a man and four or more drinks for a woman on a single occasion. That’s enough to impair judgement, impede coordination, remove inhibitions, cause slurring of words—and potentially put someone at risk of serious health or social consequences, lasting brain damage and even death.
Binge drinking, of course, is not confined to teenagers or young adults. Nor is it new. People have been getting drunk since early humans fermented the first home brew. But what alarms public-health officials is the fact that while illicit drug use has generally been declining, the prevalence of binge drinking has been holding steady and even increasing, particularly among youth age 15 to 25. Moreover, new studies show that some kids start drinking at 13 or younger, and youth are particularly at risk from its effects.
“It is a huge issue,” says Dr. Stephen Wheeler, chief of emergency medicine for the Vancouver Island Health Authority, who notes that each Friday or Saturday night it is common to have at least four or five binge drinkers—many under 25—brought in for injuries or for monitoring in Victoria’s two hospital emergency departments.
Recent surveys of binge drinking patterns among youth are “sobering”:
• In Ontario, 83 percent of Grade 12 students drink, and 45 percent have had at least one episode of binge drinking in the previous four weeks, according to the 2003 Ontario Student Drug Use Survey. While the percentage of students binge drinking increases with each grade, the biggest single increase —from eight to 24 percent—occurs between Grades 8 and 9. “That jump tells us that a significant number of kids are starting really young,” says Edward Adlaf, coauthor of the study.
• A 2003 survey of British Columbia high-school students conducted by the McCreary Centre Society found that 46 percent of males and 43 percent of females in high school who admitted to drinking had engaged in binge drinking in the previous month, a rate that is among the highest in Canada and unchanged since 1998.
• Binge drinking is particularly worrisome on university and college campuses in Canada and the United States. Four surveys of 120 U.S. campuses over the last decade found that 44 percent of students admitted to an episode of binge drinking in the two weeks prior to the survey, a rate that has remained unchanged for a decade. The 2000 Canadian Campus Survey found similar results, with 63 percent of students reporting consuming five or more drinks in a single sitting in the previous year. The Canadian study concluded that campuses are a “risky milieu for hazardous drinking.”
Julian at McGill agrees. “It doesn’t matter where you go in Canada. On most campuses there’s a focus on ‘partying’—which means
DRINKING IN CANADA
Having a glass of wine with dinner or a beer at the end of the workday might be described as a North American and European tradition. Having a drink is also regarded by many as essential to a successful social life. A backyard party or the local bar are often the setting advertisers use to capture younger consumers by portraying drinking as cool. Beer drinking has been portrayed as a national pastime, with some advertising campaigns linking it to our pride in being Canadian.
In 2001, Canadians consumed nearly three times more nonalcoholic than alcoholic beverages. Only a decade prior Statistics Canada revealed that the ratio of nonalcoholic to alcoholic beverages was closer to two to one. Clearly, staying awake has become more important than partying. Whereas in 1991, Canadians consumed more beer (89.03 litres per person) on average than coffee (86.42), in 2004 coffee (93.69) has taken a healthy lead over the other brew (79.85). But those Canadians who do party appear to be consuming more alcohol. And the overall increase is largely attributable to the changing habits of people in their early 20s: In a decade, the figure for binge drinking among 20- to 24-year-olds has risen from less than 25 percent to just over 40. This large an increase did not occur for any other age group during that same time period. It is worth noting that there is a fairly important drop in drinking levels in the late 20s. And while toasting one’s retirement may be a common practice, drinking volume plummets as we age.
The words “alcohol abuse” and “problem drinker” typically conjure up the image of a chronic alcoholic, but in fact fewer than five percent of Canadians are alcohol dependent. Of college students, says Henry Wechsler of Harvard’s School of Public Health, only about six percent fit the definition of “alcoholic.” But binge drinking is more of a public-health problem than alcoholism as it affects a higher percentage of young drinkers.
“The probability of developing liver cirrhosis or cancer is based on the amount of tissue exposure to alcohol over many years, but every time people binge drink, they place themselves at increased risk of harming themselves or others—even if it is the very first time a person drinks,” says Jurgen Rehm, a leading expert on problem drinking.
Whatever the age, binge drinking puts a person at much higher risk of death or injuries from motor vehicle crashes, falls, drowning and other hazards of poor judgement and reduced coordination. Violence, vandalism, sexual assault, unprotected sexual encounters with the risk of unplanned pregnancy or infection from sexually transmitted diseases all increase.
New research also shows that young people, whose brains are still developing, may be at greater risk than mature adults of lasting brain damage from heavy alcohol consumption.
“We are seeing significant differences in abilities in the brains of young people who drink heavily on a regular basis,” says Susan Tapert, associate professor of psychiatry at the University of California and one of the leading researchers using magnetic resonance imaging to assess the impact of binge drinking on the brain in youth. “Drinking to intoxication seems to be particularly associated with poorer functioning on tests of learning and memory and on visual-spatial tasks such as doing a puzzle,” says Tapert, who notes that since teenagers mature at different rates, the brains of youth anywhere between age 13 and the early 20s may be at risk. “As a mother, I’m concerned about my children’s potential to drink in adolescence and have lasting brain effects.”
Another tragic danger of binge drinking—one often wrapped in stigma and silence—is the risk of death from alcohol poisoning, also called alcohol overdose. Alcohol is a central-nervous-system depressant, and it is fatally toxic at high levels. When blood alcohol levels climb rapidly, the body’s natural reflex is to vomit to purge itself of the poison.
Percentage of binge drinkers, 12 or more times a year
|Total, 12 years and over||13.9||19.5||20.7|
|75 years and over||–||2.1||2.5|
|Canadian Community Health Survey, 1994-2003 (Statistics Canada)|
Drinking too much too fast can
shut down key bodily functions such as gag reflexes, breathing, heart rate and brain function. The result can be choking on vomit, coma or cardiac arrest. (See Alcohol Poisoning, page 90.)
Rehm notes that 68 Canadians died of alcohol poisoning in 2002, “but that is likely a significant under-reporting” in part because of the lingering stigma of drinking oneself to death. With no requirement to report alcohol poisonings, doctors or coroners may instead put “asphyxiation” or “cardiac arrest” as the cause of death.
Unaccustomed to alcohol, young people often rapidly consume excessive amounts that push their blood alcohol concentrations to dangerously high levels. Since it takes at least
30 minutes for alcohol to be fully absorbed by the small intestine and enter the blood stream, binge drinkers can ingest a fatal dose of alcohol before passing out.
The p.a.r.t.y. (Prevent Alcohol and Risk-Related Trauma in Youth) program began at Toronto’s Sunnybrook and Women’s College Health Science Centre in 1986. “We wanted to show kids what can happen when you make bad choices, such as drinking too much,” says Joanne Banfield, founder of the first P.A.R.T.Y. program. Now in 68 hospitals in Canada and the United States, the program gives tours to thousands of high-school students each year through hospital emergency departments, intensive-care units, rehabilitation units and…morgues.
Alcohol poisoning is a medical emergency and swift action can save a life. Symptoms of alcohol poisoning include:
• unconsciousness or semiconsciousness; the person cannot be awakened; mental confusion• no response to pinching the skin• cold, clammy, pale or bluish skin• slow breathing (eight breaths or less per minute or lapses of more than ten seconds between breaths)• vomiting, especially when sleeping or un-conscious• seizures.Not all symptoms need be present. Call 9-1-1 or get medical help immediately. Do not leave the person alone. Do not leave the person on his or her back; he or she may choke on vomit. Gently turn the person on his or her side, perform the Bacchus manoeuvre (shown below) and stay with the person until help arrives.
Don’t worry that the person may be angry or embarrassed by your call for medical attention. Remember, it’s better to be safe than sorry.
Recently in Victoria, 75 Grade 10 students toured Victoria General Hospital and heard Dr. Wheeler and others—such as a local police officer, a paramedic, a coroner and a victim— describe in graphic detail their stories of youth-related trauma, often caused by binge drinking.“ This is what happens when your face goes through a windshield,” said Wheeler, showing a photograph of a girl with extreme facial lacerations that elicited horrified gasps from the teens. Said one 15-year-old boy: “It was the most graphic presentation I’ve ever seen. It certainly makes you stop and think.”
Parents can do their part, too. Setting minimum prices for drinks in bars and raising the drinking age to 21, argues Rehm, are two actions provincial governments could take. Lowering the driving-impaired limit to .05 blood/ alcohol concentration is being promoted by Mothers Against Drunk Drivers and other organizations as a way to further bring down the toll of drinking and driving.
Parents have a key role in reducing binge drinking, such as not serving alcohol to teenagers (see Your Party— Your Liability, page 87) and by talking openly to their teens about the risks and by modelling responsible behaviour. “If you drink to excess regularly or drink and drive, there is little you can say to your teens that will make a difference,” says Wechsler. “Show them how to drink responsibly—by drinking responsibly yourself.”