'21 for 21': A Deadly Binge Drinking Ritual on College Campuses

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By Amanda Gardner
HealthDay Reporter

FRIDAY, June 6 (HealthDay News) -- It's called "21 for 21," a college drinking ritual with deadly consequences.

Students down 21 alcoholic drinks on their 21st birthday, and, according to the largest study of its kind, researchers at the University of Missouri determined that many students jeopardize their health -- and their lives.

"We have to really sit up and take notice regarding this phenomenon. This is a significant public health concern, and we need to attend to the ways in which we can get a better message out there," said Suzy Gulliver, professor of psychiatry and behavioral science at Texas A&M Health Science Center College of Medicine, who was not involved with the study.

Interestingly, women engage in the practice almost as often as men, according to the study, published in the June issue of the Journal of Consulting and Clinical Psychology.

And although the study didn't look at the health effects of such behavior, deaths have been reported, said study lead author Patricia Rutledge, an associate professor of psychology at Allegheny College in Meadville, Pa., who conducted the research while a research professor at the University of Missouri.

"We have reports of people dying from this going back several years," said Rutledge. "One young man, Brad, who died on his 21st birthday, consumed 21 shots in under 24 hours."

Three previous studies had looked at the ritual, but all were much smaller than the new study, Rutledge said.

For the new study, the researchers sampled 2,518 students, all of whom had already turned 21, at the University of Missouri in Columbia.

Eighty-three percent of the students said they'd consumed alcohol to celebrate this milestone birthday, and many said they had consumed excessive amounts of alcohol. Twelve percent of men and women reported consuming exactly 21 drinks, while an additional 22 percent of males and 12 percent of females said they'd exceeded that number.

Based on the information supplied by the students, the researchers estimated that 49 percent of the men and 35 percent of the women had estimated blood alcohol contents of 0.26 or higher, a level that could cause serious health problems such as disorientation, coma and death. That means an average size woman would have to drink between seven and nine drinks an hour to attain a blood alcohol content of 0.26, and an average man would have to drink between 10 and 12 drinks, the researchers said.

"What generally happens is that we are normally protected by alcohol when you pass out before you get too drunk and get to the stage of death," said Dr. Evaristo Akerele, vice president and director of medical and psychiatric affairs at Phoenix House in New York City. "What happens here is somebody keeps the mouth open and keeps putting more and more alcohol so you override [the tendency to pass out first]. It's potentially fatal."

Some interventions for the problem already exist, Rutledge said. For instance, many universities have instituted the "birthday card," which is sent out before a student's 21st birthday and includes information on blood alcohol content. But reports on the effectiveness of the birthday card have been mixed, she said.

Said Akerele: "The focus needs to be more on this age group. And more peers need to be included in the process so they are aware of the dangers."

More information

Visit B.R.A.D.21 (Be Responsible About Drinking) for more information on this topic. The Web site was created in memory of Bradley McCue, a Michigan State University student who died of alcohol poisoning after celebrating his 21st birthday.