According to the Ministry of Health, nine out of ten Kiwis aged 16 — 64 have consumed an alcoholic beverage in the past year. Three in five of us consumed more than the recommended guidelines in a single drinking session at least once last year, while one in six adults has “a potentially hazardous drinking pattern”.
That sounds pretty serious, doesn’t it? “A potentially hazardous drinking pattern.” Hmm, seriously vague wording, that’s for sure. This undeniably concerning yet frustratingly hazy statistic is typical of New Zealand’s attitude towards alcohol issues. We all know that it’s a problem, but whose problem is it exactly?
Not ours, proclaim school staff and the parents of teenagers, despite reports indicating that up to 70% of secondary students consume alcohol. Not ours, cry the middle-aged cohort of casual-beers-after-work types who are the “biggest drinkers in New Zealand” according to last week’s ODT. Not ours, cry the twenty-somethings who can’t remember where they were last night, let alone how many standards they had.
One group remains silent as the grave: the 600 — 1000 Kiwis who die each year from alcohol-related causes. Of course, some are repetitive binge drinkers, some are alcoholics, and some are long-term sufferers of alcohol-related diseases. But some, says Professor Mike Ardagh, are students like you and me. They are students with no alcoholic tendencies or genetic or social predispositions to alcoholism. They’re just young adults who go out on a Thursday or Friday or Saturday night, misjudge what they’re drinking, and die.
Mike Ardagh is a Professor of Emergency Medicine, and has been working in the Emergency medicine for “twenty or so years now”. He also works for the Ministry of Health on ED standards, is an active researcher, and lectures at the University of Otago School of Medicine.
His dual role as doctor and teacher means that he is privy to the extremes of student behaviour. He deals with both responsible, motivated learners and the extremely inebriated who stumble into the waiting room late at night.
According to Ardagh, “One of the problems we see with students is that they’re ignorant when dealing with alcohol, particularly the younger ones.” He explains that this is perhaps due to their lack of experience (“not that you should attempt to train yourself”) and an inability to differentiate between moderate and excessive consumption. “That level of control is very difficult. Drunkenness isn’t a linear process, it’s not always proportional to the amount that you drink. It’s like filling a glass... you keep pouring, and it’s fine, but then, when you get to the top, it very suddenly makes a mess. It’s so hard to tell where that point is, and it changes day to day, depending on how tired you are, how much you’ve eaten, whether you’ve had a sleeping pill, and so on.”
Ardagh explains that most drunk students arriving at the ED conform to one of two stereotypes. “There are people who are plain drunk. So drunk that they can’t maintain themselves, can’t keep their own airway open. Females usually form the majority of this group, mostly due to physiological reasons. The more common group that we see are those who have injured themselves while drunk. That’s actually mostly blokes. They might have tripped over and cut themselves, fallen off their bikes, or been involved in a fight.”
After treatment, most drunkards are on their way home before they’ve even sobered up. Ardagh explains that “unless it’s extreme, most people will be discharged before morning. In some hospitals, they may be tucked up in bed and staff will keep an eye on them until morning... If the patient is kept overnight, then that provides an opportunity for a brief intervention — some discussion about their drinking, how dangerous it was, how close they came to serious harm. Very often, there’s incredible ignorance about the state they were in. Those who go home straight away don’t get that intervention. The message of danger isn’t getting through to them.” In these situations, educational responsibility tends to be picked up by the University and residential colleges. So are these colleges doing their job?
It seems that at least in part, the Scarfie drinking culture is learnt at the halls and colleges of residence that so many first years attend. Initiation ceremonies that involve drinking to the point of vomiting, and constant peer pressure to drink heavily, undoubtedly create unhealthy drinking habits in first years that they will carry through their time at university.
Vice-Chancellor Harlene Hayne has taken a hard line on this peer pressure, and is pushing for an end to “initiation” traditions. At the start of the year Knox College underwent a number of changes which were designed to reduce alcohol related harm, and specifically targeted initiation ceremonies. The challenge for halls and college is when first years head out to flats and bars, and are no longer constrained by the in house rules.
Many halls and colleges will intervene if a student comes home particularly drunk, requiring them to attend a Student Health counselling session, and often placing them on a temporary alcohol ban. And if you are ever found by Campus Watch in such a state that you might hurt yourself, you’ll find yourself reporting to the Vice-Chancellors office for a one on one chat.
There’s that word again: ignorance. Surely ignorance isn’t a generational issue. Dunedin has been renowned as a student city and therefore a party destination for far longer than any of us have been around. However, Professor Ardagh admits that intoxicated admissions at ED are becoming more serious. So what’s gone wrong?
Ardagh suggests that the shift can be attributed to changes to three main alcohol-related factors: purchase age, availability, and price. “The big difference back then was that the [drinking age] was 20, and the main drink was 4% beer. Even though the intent was similar, the consumption was similar, the opportunity for real self-harm was considerably less. It was a different kind of drinking.”
He asserts that many students arriving at the ED aren’t that far from death. “There’s very often incredible ignorance among students about the states they get themselves into. Many have limited or at least distorted memories of their drinking experiences, so there’s this perception that it’s a relatively benign thing to do. Even people who are informed have a sense of denial: ‘Oh, it will never happen to me’.”
Alcohol law reform is currently on the political agenda, with the NZ Law Commission having undertaken an extensive review of our liquor laws from 2009 — 2010. This prompted an Alcohol Reform Bill which aims to mitigate the issues of age, availability, and price. Education is also important, of course, but is hardly aided by the current social environment of peer pressure-prone s 451tudents combined with sweet-tasting and inexpensive alcohol.
Not only are inebriated students a danger to themselves, but they’re also causing strife amidst our hospital systems. In a survey presented by the New Zealand Medical Journal last year, health professionals described dealing with a range of abuse from intoxicated admissions, and also an increased workload due to patients failing to comply with treatment.
Professor Ardagh says that most students aren’t intentionally problematic, but “one thing about alcohol is that it tends to strip away social constraints. This means that people who are genuinely nice tend to be pleasant when they’re drunk. People who are dickheads tend to be even bigger dickheads when they’re drunk. There’s a high proportion of those who can control the fact that they’re idiots when they’re sober, but can’t when they’re drunk. They tend to be very disruptive in hospital.”
However, Ardagh doesn’t want to deter students from seeking help if they’re seriously in trouble, and says it’s always heartening to see “friends looking out for each other”.
Dealing with student binge drinking is difficult partly because of the complexity of defining the problem. Alcohol abuse is defined as the intentionally harmful use of alcohol, yet most cases of students’ gross intoxication are simply mishaps fuelled by ignorance. How, then, should we define the drinking habits of binging students?
Certainly some students consistently drink to excess despite recurrent social and legal problems as a result of their behaviour. In these cases, serious educational and disciplinary intervention is required.
Fewer students still might be classified as alcohol dependent – they may be unable to socialise at events which don’t involve drinking, find themselves having to drink increasing amounts due to a developed tolerance, and frequently crave alcohol. This is alcoholism, and is an illness which requires external, professional help.
We know that most students don’t drink with harmful intentions, or because they’re alcoholics. Most students simply don’t consider the real dangers of alcohol. Perhaps they just don’t have anything better to do with their spare time (in which case I’m sure Red Frogs would gladly welcome new volunteers). Although Professor Ardagh and University staff admit that the situation is gradually improving, Stewart likens students’ attitudes to drinking to those of toddlers playing with matches: “Unfortunately, some kids just don’t learn until they burn themselves.”
