Alcohol on the brain: a look at the long term

For years, Ben had assumed all alcoholics were homeless men huddling below bridges inside cardboard boxes and nursing bottles out of paper bags like he saw in movies. But that was before Ben began college and came to know an alcoholic much more personally — himself.

In less than one semester, Ben, who did not want to reveal his last name, developed a dependence on alcohol that altered that belief, and his life, forever.

The college party life

While attending a Kansas City, Kan., high school, Ben liked to drink and attended parties on weekends. Within his circle of friends, getting drunk was typical. But Ben also always had a limit. As an athlete, he had coaches constantly demanding his time and fitness. His parents expected an equal dedication to academics. The discipline was enough for Ben to graduate high school with a 3.5 grade point average.

But the following fall, when Ben enrolled at Missouri State University, those parameters disappeared. Without coach or parental oversight, Ben could binge drink as freely as he wanted. He said he found students who seemed not only to accept, but to encourage his excess.

By the end of his first semester, Ben began to realize his habits weren’t normal. The parties, which he attended at first to socialize, had transformed solely into a means of getting drunk. His former easy-going personality turned to bitterness, and he started to withdraw even from friends and family.

“It went from like a bonfire to a forest fire,” he said. “I was just high constantly, drunk constantly, whatever it was constantly. I was rarely going to class.”

As Ben skipped classes, his grades deteriorated rapidly. His GPA plummeted from a 3.0 in the fall to a 1.8 in the spring. Trust with friends broke down and relationships were shattered.

“I had no control of my actions anymore,” Ben said. “It wasn’t like I went out and tried to quit the next day, but that was my first glimpse. I definitely felt it physically, emotionally, spiritually — every single way I could.”

Newly researched dangers

Alcohol has a profound and dangerous effect on the personal lives and the academic lives of college students, said Sandra Brown, psychology professor and alcohol research specialist at the University of California San Diego.

She said in addition to harming relationships, students who binge drink are also inflicting severe damage to their brains.

Binge drinking, she said, reduces the ability of adolescents and young adults to reason and lowers their ability to remember information by 10 percent. She said it also notably decreases the size of the frontal cortex and the hippocampus – two of the most crucial parts of the brain.

Most alarming, she said, was both damaging effects could result from as few as 100 episodes of legal intoxication, or drinking to a blood alcohol level of .08 percent.

Students who binge drink twice per week could suffer the harm in less than one year, she said.

“Teens who drink heavily, even if they’ve abstained for weeks, remember about 10 percent less of the information they learned just 20 to 30 minutes ago,” Brown said. “If you are remembering about 10 percent less than your peers in the short run, that’s going to have a cumulative effect over time, making school and learning new information more challenging.”

A common occurrence

Emily Williams, Overland Park graduate student, said this alcohol related decline in academic performance has occurred in the lives of a number of her friends. Witnessing their grades and other parts of their lives decline from drinking has influenced her decision not to drink excessively.

While in college, she said, she has had to clean up the vomit of her friends and keep vigil alongside them for hours they wouldn’t ever remember.

Williams said she mostly chooses to limit herself because she wants to save her friends and family the pain binge drinking has caused her. Since childhood, Williams said, alcoholism and binge drinking have polluted the closest circles in her life, starting in her family. She carries memories of family members whose personalities would sour with each drink they downed.

“I’ve been affected in ways I don’t wish upon anyone else,” Williams said. “I have two beers or a beer and have a glass of water.”

But Williams said her decision not to drink excessively in college has felt isolating at times. On nights when some of her friends would fade into stupors, other sober students seemed scarce and scattered.

More than half of all undergraduates at the University of Kansas have self-reported drinking to the point of doing something they regretted, according to a May 2008 KU Alcohol Priority Group report.

As a University student who has struggled in the past with alcohol in the college culture, Ben worries that other students who binge drink regularly, like he used to, could become alcoholics.

He said he remembers being in denial of his dependence on drinking before he sought support. By the time he tried to find help by the spring of his freshman year, he realized he had entrenched himself in his habit so deeply that that solutions wouldn’t come easily.

“I tried doctors,” Ben said. “I tried antidepressants, relationships, learning about it. Nothing really ever worked.”

Ben said the college culture of excess made his efforts to quit drinking especially difficult his freshman year in Springfield, Mo. As he tried to break his addiction, he often felt like the only student his age at Missouri State trying to quit drinking.

“It was really tough,” Ben said. “In that town, there wasn’t anybody my age trying to get clean.”

The significance to students

Kathryn Tuttle, associate vice provost for student success, said she is worried about how binge drinking has become especially popular among younger students.

She said a 2009 survey at freshman orientation raised new concern by showing students are coming to college with binge drinking habits.

Of the incoming freshmen, 47 percent self-reported that every time they drank, they would “binge,” or consume five or more drinks in one sitting, Tuttle said.

She said the University has made new efforts this fall to combat binge drinking among all age groups, including a new mandatory alcohol course and a parent notification program. She said the University would expand those efforts to include an alcohol awareness presentation at the freshman orientation next summer.

But the University also has to reach out to the community and high schoolers to influence students before they bring more binge drinking to campus, said Marlesa Roney, vice provost for student success. Roney has collaborated with community members and student senators on the issue of alcohol abuse, and she addressed the University last spring after two students died in alcohol-related incidents.

Roney said in order to reverse threatening binge drinking practices, steps to prevent alcohol abuse would need to be joint efforts by both faculty and students.

“It’s an accepted part of our culture,” Roney said. “Unless it results in death, it is often viewed as a positive.”

A changing culture

College wasn’t always a culture of excessive drinking, Roney said. Although she went to a different university, Roney said she attended college in the late ’70s and early ’80s, a time when the attitude toward alcohol appeared almost the opposite. Binge drinking, she said, did not seem to exist, and the concept of drinking to the point of “blacking out,” or not remembering parts of the night, was unthinkable.

“It was a very different kind of situation where most people, if they got drunk, it was not intentional,” Roney said.

Roney said she began to see the influences of a budding binge drinking culture while she served as a chapter advisor to a sorority at Purdue University. She said exactly one decade after she graduated she realized a more serious problem was arising.

“What I began to hear more in the early ’90s in my role as a chapter advisor in a sorority in Purdue was, ‘I want to go out and get drunk tonight,’” Roney said. “By the ’90s there was an intent to get drunk.”

Roney said she watched that problem slowly deteriorate in the subsequent decade into the more life-threatening culture for students who binge drink today.

“Now, from what I hear from students, there is actually an intent to get blackout drunk,” Roney said.

John Drees, a registered nurse at Lawrence Memorial Hospital, said he noticed the growing popularity of excessive drinking through the 10 years he spent working in the hospital’s emergency room.

Every year at the hospital, Drees said, the number of alcohol poisoning cases increases, and from 2000 to 2008, it shot up by 59 percent. By 2008, he said more than 1,500 patients came in for an alcohol-related health problem, 600 of which were University students. Drees said the most common age of alcohol poisoning patients was 18, the same as a typical college freshman.

“Most of the times they didn’t set out that night to end up in the emergency department,” Drees said. “Their idea was to have fun, but unfortunately they’re not having fun.”

He said the biggest problem arose when the culturally prescribed idea of fun became overindulgence.

“If someone has one drink it’s usually not a problem,” Drees said. “It’s when someone has 18 drinks or 21 drinks on their 21st birthday. They’re overdosing is what they’re doing.”

Patty Quinlan, supervisor of nursing at the Watkins Memorial Health Center, said she has noticed the widespread culture of alcohol abuse on campus from the students who come in needing an IV or other treatment after heavy episodes of drinking.

She said she was even more concerned that almost none of these students seemed to consider the future health implications of their binge drinking.

“Usually college-aged students don’t think about when they’re in their 50s or 60s or beyond,” Quinlan said.

Michael Monroe, Lawrence Police Department sergeant, said Lawrence residents, including students, have not only been ignoring personal risks when it comes to alcohol, but also endangering others by climbing behind the wheel after they binge drink He said that this fall, officers have handed out more OUI, or Operating Under the Influence, charges in Lawrence than in years passed.

“We didn’t pull anyone out of there to make up for our other shortages of manpower,” Monroe said, of the officers who patrol for drunk drivers. “We really try to focus on that.”

The unnoticed effects

Tuttle said that in addition to having concern about the short-term dangers associated with excessive drinking, she also worries about the effect gradual brain damage from binge drinking could have on academics.

She said the latest University alcohol report showed approximately two-thirds of students admitted to consuming five or more consecutive drinks at least once in the past month, a statistic nearly double the 37 percent national average for college students.

“Binge drinking over a regular period of time can affect your cognition. It can affect your memory. It can affect your attention. It can cause impaired decision making,” Tuttle said.

“When you think about your life as a college student, that’s kind of right where it is, whether it’s simply managing those skills in an exam or in a paper,” she said.

Brown said the degree of possible damage — 10 percent in mental functioning — should cause extra alarm among college students. In college, she said, 10 percent could mean the difference between an A student and a B student or a B student and a C student.

She also said harm of that degree, despite popular belief, has shown to be even more significant than damage from marijuana use.

“It’s clear that alcohol produces problems that we can measure more easily than we’ve been able to manage with marijuana use,” Brown said. “It may be that it affects the brain in ways other than we’re measuring, but certainly we’re able to measure the problems more definitively than the thinking problems associated with marijuana.”

And evidence for the damage seems clear. Already approximately 25 percent of college students nationwide have self-reported a poorer personal performance in school to excessive drinking, according to the National Institute on National Abuse and Alcoholism.

Brown also said the actual figure of academically affected students was likely much higher than estimated because the decline in cognition often goes unnoticed by heavy drinkers.

“That’s the danger of this,” Brown said. “It’s very subtle and its gradual. It’s really that you probably may not end up performing to your full capability rather than you look like you have severe brain damage.”

An uphill battle

Fighting the effects of binge drinking on campus, especially through grass roots student efforts, is a challenge, Tuttle said. She said the only organized student group she knows of that is formally trying to combat binge drinking on campus is the Peer Health Educators.

Jenny McKee, director of the group, said although the group addresses a series of topics, alcohol abuse is one of its central focuses.

“It’s a national epidemic,” McKee said. “It truly is.”

One of the 25 Peer Health Educators this fall, Bridget Heine, said she typically spends 12 hours per week trying to educate her peers on alcohol abuse and other health-related subjects. Heine, St. Louis senior, said she recognizes, however, that the group still has a lot of ground to cover when raising awareness about alcohol and disproving common misunderstandings.

“There are physical effects, but not a lot of people really think about those too much,” Heine said. “Especially in college, everyone thinks I’m young and I’m only doing this in college so it isn’t going to happen to me. The internal effects are things you don’t really see, but they’re happening.”

Looking to the future

Brown said as she and other researchers at the University of California San Diego continued to uncover results about these effects, she hoped they could soon provide guidelines for how much a person could drink before causing damage. She said that, even more importantly, she hoped they would discover what the recovery process is for those who have already suffered brain damage from binge drinking and what, if anything, could expedite healing.

“I would say probably within the next year, we will have enough cases studied longitudinally where we’ll be able to submit something to one of the scientific journals,” Brown said. “Certainly we want to get this information out as quickly as we can.”

Karen Hansen, doctor of psychology for the Veterans Affairs San Diego Health Care System and co-researcher with Brown on alcohol abuse, said a good test students could try now to determine whether they are damaging their brain is to check for hangover symptoms after they drink. She said common hangover symptoms — which include headache, thirst, fatigue, depression, difficulty sleeping, irritability, nausea and vomiting — are usually indicators of underlying brain damage.

“If you’re a heavy drinker that has regular hangovers or withdrawal symptoms, there’s a 95 percent chance that your brain is affected,” Hansen said. “The more hangovers, the heavier the symptoms, the more times you have black outs, the more the damage is occurring.”

Hansen said any brain damage from drinking is particularly dangerous for young adults because the human brain continues to develop through age 30. She said the misconception that only older adults need to worry about brain damage couldn’t be more false.

“It’s really the opposite, that the adolescent brain is more vulnerable to the effects of heavy drinking than the adult brain,” Brown said. “That’s a little scary because typically when adolescents drink, even thought they don’t drink as often as adults, they drink on average about twice as much.”

Teresa King, Lawrence gastrointestinal physician, said other negative effects, such as liver disease, normally arise in older patients. She said she has seen patients younger than 30, however, who drank heavily before, during and after college who are already showing symptoms of organ damage.

“I have seen it in young people,” King said. “You can have things happen long before it’s diagnosed because it doesn’t cause any outward signs.”

Hansen said she eventually hoped her findings could help deter the mental and physical self-destruction among high school and college students.

Brown said she thought in the college setting in particular, where students work to develop their minds, understanding how binge drinking could be a step backward in the learning process could have a profound effect.

“People change their behavior when they know what they do causes problems for them,” Brown said. “There is such a thing as designated drivers now because people know drinking affects their driving. If people knew drinking affects their thinking abilities maybe that would help them make better decisions when they drink.”

A story of recovery

Ben said it eventually took legal trouble and a 12-step fellowship to bring about his first dry day in more than a year when he was a freshman. By then, he said, it didn’t matter any longer that the others in the fellowship were all older than he was. Their common struggle fostered the support he needed to start stripping alcohol use from his life, despite his resistance at first.

“I didn’t walk into the program necessarily wanting to stop using and drinking,” Ben said. “I walked in wanting to stop hurting. And then, after a while, I finally found out I couldn’t do both. I couldn’t live a better way of life and use.”

In the three sober years since Ben quit drinking, he has taken a roundabout route to arriving at his junior year of college. He earned a 3.8 GPA, a two grade point improvement, in his first sober semester at Missouri State University, but then moved to Lawrence to find a new college setting.

In Lawrence, he attended the University for three straight semesters, starting in the Fall 2007, but took a year off to work before enrolling to return this spring.

Ben recognizes that he is not a typical junior. He is older, and so are most of his friends from the 12-step fellowship he has joined in Lawrence since he arrived. His new hobbies of playing harmonica, reading and exercising are atypical weekend night activities for undergraduates, who might prefer to slam shots or frequent the college bar scene instead.

But he knows he lives differently now, in part, because he has a darker past, a past that will always be a part of him. He calls alcoholism a disease without a cure, and said he has accepted that he will have to continue to fight that disease for the rest of his life. But he said one of his greatest hopes was that his story would help others who binge drink before they too suffer like he has.

“There’s no cure you can give me to make me never want to use again,” Ben said. “There’s no magic formula. There are no magic words.”

source: Daily Kansan