managing binge drinking in college...

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Managing Binge Drinking in College Students

Paola Pedrelli, Ph.D. Director Dual Diagnoses Studies

Depression Clinical Research Program Massachusetts General Hospital

Boston, MA

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Disclosures

Neither I nor my spouse/partner has a relevant financial relationship with a commercial interest

to disclose.

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This Lecture Reviews:

• Definition and scope of the problem

• Managing binge drinking

• Future directions

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This Lecture Reviews:

• Definition and scope of the problem

• Managing binge drinking

• Future directions

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Alcohol in Young Adults

Alcohol is prevalent among young adults • Heavy alcohol use peaks age 21-24

5

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Binge Drinking is Prevalent

6

Binge drinking Men: >5 drinks Women: >4 drinks

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Binge Drinking is Common

43%

22%

13%

05

101520253035404550

Any HED > 3 X > 5X

Past month prevalence of binge drinking

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Myths About HED

• Everyone drinks heavily in college

• Drinking heavily on weekends is OK

• Students will grow out of it

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Personal Costs of Binge Drinking

In college students

• ~600,000 injuries

• ~700,000 assault

• ~97,000 victim sexual assault

• ~1800 deaths

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Societal Costs of Binge Drinking

• Youth alcohol misuse costs $53 billion year

• $19 billion from traffic crashes

• $29 billion from violent crime

• Among <21 age: costs $27 Billion per year

• 25% from premature death

• 61% from lost productivity

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Comorbidity is the Norm

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This Lecture Reviews:

• Definition and scope of the problem

• Managing binge drinking

• Future directions

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Screening

• Throughout school

• College counseling centers

• Primary care

• Emergency care

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Screening Tools 1 NIAAA Task Force:

• Frequency of any alcohol use

• Typical number of drinks

• Frequency of heavy drinking

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Screening Tool 2 Alcohol Use Disorders Identification Test (AUDIT-C)

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Feedback: • Quantity/Frequency of Drinking • Caloric Intake • Amount Consumed, Peak BAC • Cost of alcohol spent • Norm Comparisons • Amount and % of Income Spent on Alcohol • Tolerance Level • Negative Consequences of Alcohol Use • Genetic Risk Score Explanation, advice, local referral information

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BASICS

Personalized feedback

• Normative feedback

• Estimate BAC

• Gender specific effect of alcohol

• Personalized feedback on alcohol-related problems

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Motivational Interviewing

• Therapy ~ partnership • Patient-centered • Directive method communication • Elicit own motivation to change • Explores ambivalence re change • Guide pt towards change

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Summary

• Binge drinking associated with personal and societal problems

• Screenings at different levels is critical

• Several strategies are available

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Future Directions

• Increase screenings

• Disseminate evidence-based approaches

• Develop more online treatments

• Use of app for monitoring/treatment

Psychopharmacology Friday, September 28 – Sunday, September 30, 2012

The Westin Copley Place

MGH Substance Use Disorders Conference Sunday – Tuesday, February 14–16, 2016

Disney’s Grand Floridian Resort & Spa MGHCME.ORG

Massachusetts General Hospital Department of Psychiatry

Presents

Substance Use Disorders: A Comprehensive Review and Update

SUNDAY-TUESDAY, FEBRUARY 14-16, 2016 DISNEY’S GRAND FLORIDIAN RESORT & SPA

LAKE BUENA VISTA, FL