Deadly Rite of Passage

Having a few too many drinks can mean more than just a blackout or a bad hangover. People who engage in binge drinking--some without even realizing it--are courting danger, experts warn.

Binge drinking is most common at colleges and universities, where many young adults treat drinking to excess as a rite of passage.

“Binge drinking is a problem on every campus,” said Joe Kertes, vice president and dean of students at Chapman University in Orange.

A 1997 study from the Harvard School of Public Health reports that 42.7% of all college students engage in binge drinking, defined as consuming an excessive amount of alcohol within a short period of time. The numbers are lower in California but still troubling: Nearly 30% of the state’s students admit to the dangerous behavior.

The well-publicized deaths of several college students from binge drinking in 1997 highlights the risks:

An 18-year-old freshman at the Massachusetts Institute of Technology drank himself into a coma and died. A 20-year-old fraternity pledge at Louisiana State University died from alcohol poisoning.

“Alcohol is always toxic. It’s really a poison,” said Steven Schandler, professor of psychology at Chapman University and chief of addiction research at the Long Beach Veterans Affairs Health Care System, who added that binge drinking can lead to alcohol poisoning. “Because it’s a poison, like any other poison, if you take in a little bit, you might tolerate it, but if you take in a lot, you might die.”

Administrators and doctors say that college freshmen are especially at risk for alcohol poisoning, in part because they often lack the maturity to refrain or stop. And for some who may be new to drinking, their bodies have a relatively low tolerance for alcohol.

But problems with alcohol aren’t limited to teenagers and young adults.

A 39-year-old Buena Park man recently recalled that two days of steady imbibing on a trip to Las Vegas several years ago left him in bad shape.

“My whole body was saying, ‘Help, we’re in trouble,’ ” said Curt, who did not want his last name used. “My stomach hurt. My head hurt. I had a hard time breathing.”

Curt didn’t go to a hospital, but in retrospect, he said he should have. Instead, for three days, he didn’t work, hardly ate and drank only water. The experience changed his drinking habits. He still drinks beer socially, but when he thinks he’s approached his limit, “I stop, because I don’t want to go there again.”

Doctors say blood alcohol levels of about .4%--five times the legal intoxication limit of .08%--can induce potentially lethal side effects in most people.

Alcoholics have higher limits. Although not well understood, enzymes that break down and expel alcohol in the liver and kidneys do so more effectively in seasoned drinkers, allowing them to tolerate more, Schandler said.

Regardless of a person’s tolerance, alcohol exerts its influence when the amount of alcohol taken in exceeds the amount that the body can digest.

At that point, alcohol passes from the bloodstream into the brain and begins its attack.

Alcohol first affects the brain’s cortex, which controls more sophisticated thought processes. That’s why people generally become less inhibited under the influence of alcohol, and some are more willing to try things that could be dangerous to themselves or others.

Coordination, mainly controlled by the cerebellum, is the next to go, leading to slurred speech and difficulty walking in a straight line. As excessive drinking continues, alcohol moves deeper into the brain until “it gets to the very basic structure of the brain stem that affects things like respiration and heart beat,” said Dr. Bret Ginther, an assistant clinical professor of emergency medicine at UC Irvine.

At that point, people may pass out or fall into a coma. Their vital signs may weaken.

“The most common cause of death from alcohol poisoning is respiratory arrest,” said Ginther. Eventually, the heart simply stops.

Getting to that point is fairly unusual. But Ginther said that at least once or twice a month, patients--often college students--are brought into the emergency room at UCI Medical Center in Orange suffering from alcohol poisoning.

Signs of alcohol poisoning include vomiting, pallor, unresponsiveness and, in extreme cases, loss of consciousness.

“When a person shows signs of poisoning, it’s important to get them to a hospital as quickly as possible,” said Schandler.

College officials say they are always on the lookout for alcohol abuse but say there is no fail-safe method to keep students from drinking.

Many colleges try to educate students, especially those caught drinking illegally or causing disruptions. The Higher Education Center for Alcohol and Other Drug Prevention in Newton, Mass., advocates a community-based approach that includes administrators, faculty, police and businesses in the fight to curb binge drinking, in part by being on alert for people abusing alcohol. The center also stresses the importance of parental guidance and urges parents to have frank discussions with their children about excessive drinking.

“This is cultural. If we’re going to change the method, it will take time and a collective effort,” said Joel Epstein, associate director for the center.

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Drinking Dangers

Excessive drinking, especially by people with a relatively low tolerance for alcohol, can be lethal. In addition to presenting the obvious risk of accidents, massive amounts of alcohol poison the brain and can lead to coma, respiratory arrest and death. Her’s how alcohol affects the body.

How Much Alcohol

These drinks contain about equal amounts of pure alcohol:

Beer: 12 ounces

Wine: 3 ounces (12 percent)

Whiskey: 1 ounce (80-proof alcohol)

Effects of Alcohol

Here is how alcohol affects an occasional drinker with low tolerance:

120-pound female

Minimal Behavior Change: 1 to 2 drinks

Intoxication*, Four times increase in probability of an accident: 3 to 4 drinks

Gross Intoxication, 25 times increase in probability of an accident: 5 to 7 drinks

Stupor, Dazed, unaware: 11 to 15 drinks

Coma, Unconscious and unresponsive: 15 to 25 drinks

Death: 25 to 40 drinks

180-pound male

Minimal Behavior Change: 1 to 2 drinks

Intoxication*, Four times increase in probability of an accident: 3 to 7 drinks

Gross Intoxication, 25 times increase in probability of an accident: 7 to 10 drinks

Stupor, Dazed, unaware: 11 to 15 drinks

Coma, Unconscious and unresponsive: 15 to 25 drinks

Death: 25 to 40 drinks

* Legal intoxication varies by state. In California it is 0.08% blood alcohol, at the low end of this range.

Order in Which Brain Regions are Affected...

Cortex: Alcohol hinders judgment and decision-making abilities.

Corpus callosum: Bridge between the right and left sides of the brain. Alcohol interferes with coordination.

Thalamus: Alcohol inhibits short-term memory.

Hypothalamus: Helps control basic drives and tells pituitary gland what hormones to release. Alcohol disrupts, and pituitary gets wrong signals.

Brain Stem: Switchboard that conveys information between the brain and body. Alcohol inhibits information flow, which can impair or stop heartbeat and breathing.

Cerebellum: Alcohol inhibits motor control and attention.

....And How the Body Reels

Depressed central nervous system

Weakened vital signs; possible respiratory arrest

Liver and kidneys are overwhelmed.

Irritated digestive system

Increased urine output

Large amounts of alcohol may cause impotence

Sources: Dr. Steven Schandler, Chapman University; American Medical Assn. Encyclopedia of Medicine