Birthday Booze: Students Report Drinking Heavily

What better way to celebrate turning 21 than by ingesting a life-threatening dose of poison?

That's the birthday treat of choice for many 21-year-olds, who proudly down 21 drinks in honor of the big day. Thirty-four percent of college men and 24 percent of women say they drank 21 drinks or more to celebrate their birthdays, according to a new study. That reflects the popularity of drinking games like "21 for 21," "drink your age," or the "power hour," in which the celebrant tries to drink 21 drinks between midnight and 1 am on his or her birthday eve. The maximum number of 21st-birthday drinks reported by a woman was 30, while the maximum for men was a mind-blowing 50.

Festive? Sure, if your idea of fun includes puking in a bucket while your friends watch. It's almost as much fun as dying of alcohol poisoning, or frying enough brain cells to cancel out the benefit of all that studying. In this survey of 2,518 University of Missouri students, 35 percent of the women and almost half of the men reported drinking enough to have had a blood-alcohol level of 0.26 or more. That's perilously close to 0.30, at which point the brain stops telling the body to breathe. Most birthday drinkers manage to avoid death—alcohol accounts for about 1,400 student deaths a year overall. But not everyone's fortunate. Brad McCue, a junior at Michigan State University, died on his 21st birthday in November 1998 after pounding down 24 shots in about 90 minutes. His friends put him to bed when he passed out, unaware that a person's blood-alcohol level can keep rising during sleep. The coroner figures that he died about 4:30 a.m.

"If I told you that there was going to be some day in our country where tens of thousands of people were going to be poisoned, we would go crazy," says Patricia Rutledge, the lead author of the Missouri study. "But that's essentially what's happening." The students in Rutledge's study, which was published in the June Journal of Consulting and Clinical Psychology, reported their own drinking, which isn't completely reliable, but other studies of birthday drinking report similarly staggering drink counts. In a survey last year at the University of Washington, students averaged 10 drinks on their birthdays. Students who had problems associated with the birthday binge, such as throwing up or blacking out, were more likely to have problems with excessive drinking in general. Other research has found that teenagers who drink a lot are more likely to have problems holding jobs and maintaining relationships as adults.

What's the solution? "I'm tempted to say, 'Just don't do it,' but that's not going to happen," says Rutledge, who is now an associate professor of psychology at Allegheny College in Meadville, Pa. She envisions students coming up with alternative 21st birthday celebrations, along the lines of what people have done with alternate spring breaks. "Something more elegant, more adult." (When her own daughter celebrated her 21st, Rutledge bought her her first legal drink at a bar in New York.) Her practical advice to youthful drinkers:

• If you're going to binge drink, be sure you've got friends who will watch you and take you to the hospital or call 9-1-1 if you pass out or can't walk on your own. The University of Wisconsin does a good job of explaining how to tell if someone who has been drinking is in serious trouble. Symptoms include taking less than eight breaths a minute, and having clammy, pale, or bluish skin.

• Use a blood-alcohol chart to find out how many drinks it takes a person of your weight to get in trouble and how many it takes to kill you.

• Many schools have experimented with sending students birthday cards just before they turn 21, explaining the risks of binge drinking. The program was launched by Cynthia and John McCue, who started the BRAD Foundation after their son died. Some studies have found that the cards made no difference in the amount that students drank, but a report in last November's Journal of American College Health found that students who read and remembered the card's contents did drink slightly less on their birthdays. That study also found that asking parents to discuss drinking with their almost-21 children actually made students less cautious, a result that the researchers didn't expect.

Rutledge isn't alone in advocating for pragmatic approaches to reducing the risk of 21-year-olds binging on their birthdays. One of the more provocative ideas comes from John McCardell, the former president of Middlebury College. He argues that the 21st birthday binge would disappear, and college binge drinking would decrease considerably, if the legal drinking age was lowered to 18.

Would making drinking legal in college make drinking safer? Tell me what you think.