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The nightmare scenario

What if someone died? It’s the nightmare scenario, one that, as President Tilghman writes on today’s Opinion page, keeps her up at night: a Princeton undergraduate who dies from alcohol poisoning.

While the University has not recently experienced any alcohol-related deaths, they are by no means foreign to Princeton. In March 2007, a freshman at Rider University, roughly seven miles from Princeton's campus, died after a night of binge drinking at a fraternity house.

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Vice President for Campus Life Janet Dickerson explained that, while Princeton had not experienced any comparable tragedies recently, “We’ve had our share of real challenges.”

“I don’t want … to say that we’re not potentially vulnerable,” Dickerson said. “We’ve had students in the recent past who have been intubated … We cross our fingers and pray and hope every day that we don’t have such an incident.”

Dickerson and other University administrators explained that the University is constantly reviewing its alcohol policies and looking for ways to prevent high-risk drinking on campus. Several groups are involved in evaluating the University’s policies, they added, and though the University is in a strong position to combat high-risk drinking, it has a long way to go.

In a survey conducted by The Daily Princetonian last week, 78.5 percent of the nearly 1,000 undergraduate respondents said they drank alcohol, and a plurality of students (29 percent) reported consuming alcohol at least several times per week. In 2008, 72.5 percent of college students in the country had been drunk at some point in their lives, and 85.3 percent had consumed alcohol, according to a joint report by the National Institute on Drug Abuse, the National Institutes of Health and the U.S. Department of Health and Human Services.

According to data from the 'Prince' survey, nearly 53 percent of respondents said they had been drunk enough to throw up, but only 7.6 percent reported having gone to McCosh Health Center because of intoxication. Less than 4 percent said they had been to the University Medical Center of Princeton for inebriation.

On a campus with these levels of consumption, University policies surrounding alcohol have been an important issue for administrators.

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Dickerson, whose office oversees the University’s alcohol policy, called it “an evergreen issue,” explaining that the Alcohol Coalition Committee, which was formed in December 2007 to combat high-risk drinking, is constantly reviewing the guidelines for undergraduate students.

The last time the campus saw a significant change in alcohol policy was in fall 2007, when Public Safety officers first began patrolling hallways in search of parties and RCAs were encouraged to report alcohol consumption by underage advisees and shut down parties in their halls.

Since then, there have been some minor initiatives taken, including the USG’s distribution this fall of “alcohol business cards” designed to inform students about the dangers of alcohol consumption and the University’s rules. The USG also recently clarified policies for the registration of events where alcohol is served.

Outgoing USG president Connor Diemand-Yauman ’10 came to office last February facing charges of his own, for serving alcohol to a minor after he called for help for an intoxicated friend. Though Diemand-Yauman said the charges were false, the experience helped inform some of his goals as USG president, including his aim “to clarify and reconcile the conflicting alcohol policies between [Princeton] Borough and the University.”

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Hilary Herbold GS ’97, senior associate dean of undergraduate students and co-chair of the Alcohol Policy Working Group (an Alcohol Coalition Committee subcomittee), said the working group’s goal is to provide the Office of the Dean of Undergraduate Students with a set of recommendations about the future of alcohol policy by April.

The group has not finalized the specifics of its recommendations, Herbold explained, but it is focusing on the best ways to implement disciplinary policies to “deter or reduce high-risk drinking.”

“One consensus that we’ve reached is that, as much as possible, alcohol policy should do as much as it can to distinguish [between] violations [that] don’t represent a high level of risks versus behaviors that are not only violations, but also extremely risky,” Herbold said. “The consequences should be different. Exactly how they should be different is something we are still talking about.”

The group has also discussed how to address behaviors such as “pre-gaming with hard alcohol,” she added.

“We have conducted major reviews of the policies, and I think that the strategic work [has] been done by the ACC [Alcohol Coalition Committee] … to make sure that we’re doing as well as we can,” Dickerson explained. “I don’t feel that we’re in a situation where we would have to reassess anything if there were the great misfortune of a tragic event. But I would hope that we would respond as we have in other serious crises. We would all work together.”

In the aftermath of the death at Rider, the student’s family sued the school. As the suit was settled in 2009, that university reshaped its alcohol and Greek life policies.

“The lessons that we took from it [are] that we need to focus on safety first, [that] we need to be consistent in enforcement of our policies, and that we have to constantly be active in education,” said Anthony Campbell, the associate vice president for student affairs at Rider.

Following recommendations made by a newly appointed task force, the campus’ culture changed significantly, Campbell noted. Rider’s social scene was once dominated by Greek life, but now that full-time staff members are stationed in the Greek houses, the University’s licensed campus pub has taken over as the primary party destination, he said.

The administration at Rider had also implemented a “Good Samaritan” policy, an on-demand shuttle program and heightened education campaigns about the risks of alcohol, Campbell said.

The University aims to approach high-risk drinking on campus as though there had already been an alcohol-related crisis, administrators said. “What we really want to do is act as if [a tragedy] has happened, to kind of work with the focus and urgency we would have if something like that had happened,” Herbold said.

Dickerson said that if such an incident were to occur, her office would likely “redouble” its education efforts on high-risk drinking.

She also noted that, though Princeton is in “a little bit better situation than many other” colleges because students rarely drive, she thinks the campus needs to be constantly vigilant, and the administration is prepared.

Asked to envision an ideal alcohol policy, Dickerson said, “I think we’re near there.”

“One of the things that I’m very happy to have seen emerge in the recent past is a greater student ownership of policy development and policy review,” she said. “We’re getting to a place with a really successful equilibrium.”

University policy, as stated in "Rights, Rules, Responsibilities," is that students have the “immediate obligation” to contact University or town medical or safety officials if they are in the presence of “a severely intoxicated person.” "Rights, Rules, Responsibilities" stresses that admission to McCosh will not lead to disciplinary action, nor will escorting a student in need unless “other circumstances indicating a violation of University policy are observed.” Failure to call for assistance in such a situation is considered an “especially serious violation of policy.”

While almost 80 percent of ‘Prince’ survey respondents said they had never feared disciplinary repercussions in calling for help for an intoxicated friend, 10.4 percent said they had decided not to call for fear of disciplinary action, and 11.5 percent said they feared repercussions but decided to call anyway.

The survey also revealed that 48.7 percent of respondents had knowingly served alcohol to a minor, which is a violation of University policy.

Now entering her last semester at Princeton, Dickerson reflected on the alcohol policy changes positively, citing the beginning of substance-free housing, University Health Service’s alcohol response team and an alcohol recovery support group as some of the important steps made during her tenure.

Evidence of high-risk drinking on campus is part of what drives policy considerations.

Though Dickerson explained that there have been some extreme cases, it is “rare” for University Health Services (UHS) to deal with students who have reached a fatal blood-alcohol level, Executive Director John Kolligian and Director of Medical Services Pete Johnsen said in an e-mail. Kolligian and Johnsen stressed that other factors, such as level of responsiveness and vital signs, also play a part in determining a student’s level of danger.

When a student is at risk of dying, they said, he or she is transported to the emergency room at the University Medical Center of Princeton. On any given night, they explained, McCosh is “staffed with nurses and nurse’s aides,” though clinicians are on call, and “in anticipation of occasions in which student volume might be high,” they “augment Inpatient Service staffing, whenever possible.”

Kolligian and Johnsen explained that they do not see every reported case of dangerously intoxicated students, noting that often Public Safety is directly called. They said between 35 and 45 percent of cases reported to Public Safety or UHS warrant a trip to the University Medical Center of Princeton.

A student who is brought there for alcohol-related concerns, upon returning to McCosh, must complete a questionnaire and online alcohol education program that helps UHS evaluate the situation. Depending on the results, UHS may recommend a meeting with a Counseling and Psychological Services alcohol expert.

Roughly 1,700 college students between 18 and 24 years old die each year from alcohol-related causes, according to the National Advisory Council on Alcohol Abuse and Alcoholism’s College Drinking task force.

The National Institute on Alcohol Abuse and Alcoholism reported this summer that 45 percent of students acknowledged recent binge drinking, defined as consuming five or more drinks on one occasion. The report also revealed that the number of alcohol-related student deaths per year had increased by nearly 400 between 1998 and 2005.

The ‘Prince’ survey results suggested that, on campus, drinking behavior may be correlated with affiliations with certain student groups.

Among the most notable differences on campus illuminated by the data was that, while more than two-thirds (67.2 percent) of varsity athletes reported that they at one point had drunk enough to throw up, only half (50.6 percent) of non-athletes had.

Furthermore, while 94.3 percent of fraternity or sorority members said they drank, that number was 75.4 percent for non-members. Of students in Greek organizations, 62.6 percent said they drank several times per week, but only 23 percent of other students said the same. Nearly 70 percent of fraternity or sorority members said they had blacked out, while only 30 percent of non-members reported having blacked out.

Just more than half of respondents who were bicker club members reported drinking several times per week. While this figure was 34.4 percent for sign-in clubs, it was only 21.3 percent for people who were not club members, including underclassmen, independent juniors and independent seniors. More than 20 percent of bicker club members have taken or have called for someone to be taken to the University Medical Center of Princeton for intoxication, while only 7.8 percent and 4.5 percent of sign-in and non-members had, respectively.

Herbold stressed that student input had been, and would continue to be, vital in developing the best policies possible, adding the interaction between the USG and the Alcohol Coalition Committee had been particularly helpful on this front. “The most effective changes come from below,” she explained. “They come from the students themselves.”

“We still won’t satisfy everyone,” Dickerson said. “We’re going to have challenges, but I think we are doing a very good job of holding the policies that we have up to review on an annual basis so that we’re not taking anything for granted, and we’re open to trying to make changes.”

Combating high-risk drinking cannot be fully accomplished by schools alone, Diemand-Yauman said, adding that he believes it will require the involvement of the state legislature. He noted that, in his ideal world, the drinking age would be lowered to 18.

“That would solve nearly all of our problems,” he said in an e-mail. “Until that day, we will continue to see problems when it comes to reconciling local and state legislation with university policies across the state.”