BU Today

Health & Wellness

Anatomy of an Alcohol Transport

What actually happens when BU students drink too much

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Most students heading out on a weekend night to the GAP—Allston’s infamous house party district along Gardner, Ashford, and Pratt Streets—never imagine that their night will end in an emergency room. That, however, can be their final destination if they drink too much and pass out at a house party, stagger home along Commonwealth Avenue, or swipe a credit card instead of their student ID when entering their dorm—three actions that can suggest to friends, passersby, resident assistants, and security staff that they are in need of help from the Boston University Police Department.

Since January 2012, the BUPD has overseen the medical transports of more than 460 students who drank too much, most of them freshmen and sophomores living in on-campus housing. Nearly an equal number of male and female students were transported across all age groups, except among sophomores, where roughly two-thirds of cases were women. A medical transport can be a frightening and embarrassing experience (parents are informed), so frightening and embarrassing that, police say, very few students require more than one. But unless a student has personally experienced it, what actually happens during a medical alcohol transport remains a mystery. To unravel that mystery, BU Today spoke with several people involved with transports. We also contacted students who had been transported, but none were willing to talk about the experience.

First, a little perspective.

“The reality,” says Leah Barison, a Wellness & Prevention Services counselor at Student Health Services (SHS), who works with students who’ve been transported, “is that one in three BU students chooses not to drink. And among those who do drink, two out of three do so responsibly. For the most part, people are not massively overdoing it, but they tend to think that others are doing it more.”

That skewed perspective can fuel rash decisions. “For a lot of students, their first year of college is the first time they’ve tried alcohol, and they aren’t aware of their limits,” says Katharine Mooney, director of Wellness & Prevention Services. “They just want to meet people and make friends, and alcohol is used as a social lubricant to do that.”

A call for help

Medical transports usually begin with a call to BU Police. Often, someone realizes that a friend or acquaintance is dangerously drunk. More often, an RA recognizes the signs of alcohol poisoning and calls for help.

“I’m certain that over the years, RA intervention in incidents involving intoxicated students has saved lives,” says David Zamojski, assistant dean of students and director of residence life.

When police arrive, they consider two options: they can bring the student in for protective custody to sober up, or they can call an ambulance to get the student medical attention. Most prefer the second choice. “We don’t know how much they drank or if they took drugs,” explains Thomas Robbins, BUPD police chief. “We want them to be safe.”

Since the beginning of fall semester, at least 40 students have been transported to the Boston Medical Center (BMC) emergency room. During the peak period, the weekend of September 25 through 28, 13 were brought to the hospital. That number alarmed University officials, who are now seeing the number of transports decrease as the semester progresses. September and October are historically the worst months for transports, and—for unknown reasons—February and April come in close behind. Overall, transports have been decreasing since 2011, when the number for the year rose above 250.

Students have criticized the BUPD, claiming that they send drinkers to the ER when they’re just tipsy, but Mooney says that’s not true, noting that last year’s average blood alcohol content (BAC) among transported students was 0.19, more than twice the legal limit in Massachusetts for driving.

Boston University BU, alcohol transport anatomy, what happens alcohol poisoning, college drinking dangers

Number of medical alcohol transports of BU students, by month, since January 2010. Graphic courtesy of BUPD

Time as treatment

Andy Ulrich, executive vice chairman of the BMC emergency department, says impaired students arrive at his ER unable to have a coherent conversation, are generally uncoordinated, and often fall asleep. Sometimes he and his staff give students a Breathalyzer to get an accurate read on their BAC or start an IV to prevent dehydration. In most cases, “time is the treatment,” he says. “It’s a pretty standard equation, how long it’s going to take for their BAC to come down.

“Rarely do we have to do anything more extensive or more aggressive,” adds Ulrich, who’s also a School of Medicine associate professor of emergency medicine. “Certain drugs can be treated with an antidote or by pumping the stomach, but the effects of alcohol are so quick after you take it, there’s nothing left in the stomach to pump to lower the alcohol level.”

Ulrich says he worries less about alcohol poisoning than sexual assault and secondary injuries from falls or car accidents. He and his staff also monitor students for signs of drug use, and they try to determine whether the alcohol binge was spurred by out-of-hand social drinking or if it might mask a chronic problem, suicide attempt, or mental illness.

Students are free to leave the ER once they sober up, Ulrich says, and they are released into the custody of a family member or friend. The physical trauma is mostly behind them; now they face the mental, emotional, and social challenges awaiting them back on campus.

Alcohol 101

The University requires all medically transported students to attend counseling through Wellness & Prevention and to use an online educational program called Alcohol eCHECK UP TO GO, which provides accurate and personalized feedback. Barison and her colleague Dawn Belkin Martinez, an SHS social worker, receive a list of all medically transported students from the BUPD each week, and they reach out to them to schedule counseling sessions.

Barison says most come in willingly and express a mix of emotions. They feel disappointed in themselves, and they worry about what their families will think. They also worry about their scholarships and athletic status.

While her office encourages abstinence, Barison teaches harm reduction by attempting to provide students with the skills they need to drink safely. Counselors and students discuss drink sizes and alcohol content (a Solo cup filled to the brim is 18 ounces, or a beer and a half). They cover the meaning of BAC, and how weight and birth sex determine how much a drink will affect them over time. And they talk about alcohol’s biphasic effect, where one drink can act like a stimulant and feel good, but additional drinks push students to the “point of diminishing returns,” leading to a loss in coordination, speech, and judgment.

Boston University BU, alcohol transport anatomy, what happens alcohol poisoning, college drinking dangers

Number of medical alcohol transports of BU students, by year, since 2010. Graphic courtesy of BUPD

There’s a tendency to think that “some is good, more is better,” Barison says. “With alcohol, that’s not the case.” She helps students brainstorm strategies for how to drink more responsibly, such as eating beforehand, spacing out drinks, and sticking to a nightly limit.

Barison then sends students away with homework. They keep track of their drinking on a notecard and complete e-CHECK UP. She and the students review this information in a follow-up session, and they discuss a plan for moving forward.

Should the situation call for it, Barison may refer students to Behavioral Medicine at SHS for short-term mental health counseling or to an outside provider for long-term care. If she perceives a chronic drinking problem, she gives them a list of support groups, such as Alcoholics Anonymous, which holds a meeting at Marsh Chapel every weekday from 1 to 2 p.m.

(No) crime and punishment

Students transported from residence halls meet with a Residence Life official to discuss the incident, while those transported from public property or off-campus housing meet with a Judicial Affairs officer. They are reminded that first offenses could mean University probation and a $100 fine. Second offenses up the ante. Students with a second on-campus offense could lose housing privileges, while those found off-campus or on public property could face deferred suspension. Third offenses are rare, but they could trigger suspension from BU.

“Things do change after a second transport,” says Alan Brust, Judicial Affairs assistant director. “If it happens again, you may have a serious problem, at which point we may have to talk about you going home to sort it out.”

Underage students often fear they or their intoxicated friends will get in legal trouble if they call the BUPD for help. Robbins says that unless they’ve committed a crime such as vandalism or assault, there will be no repercussions from his department. “It’s more important that you get help for your friend,” he says.

Zamojski says students who call the BUPD to have themselves or a friend transported do not face University sanctions. “The University will not give you a record if you get medical attention for a friend who needs it,” says Kenneth Elmore, dean of students. Bottom line, say all concerned, if you see someone in trouble from drinking too much, make the call. It could save a life.

Students have to remember “that they’re not bystanders,” Elmore (SED’87) says. “It’s up to all of us to look after each other” by acting confidently, managing a night out responsibly, and keeping an eye on those who don’t. “I want you to have all the fun you can stand,” he says, “but I want you to have a plan to do that.”

26 Comments
Leslie Friday, BU Today, Boston University
Leslie Friday

Follow Leslie Friday on Twitter at @lesliefriday.

26 Comments on Anatomy of an Alcohol Transport

  • Jeffrey Bouchard on 10.10.2014 at 8:03 am

    The Security Assistants manning each dorm lobby are the first to respond to any students that arrive and are in need of medical attention. It is their training and experience that determine if the student is having difficulties physically and/or mentally and they are the ones that call BUPD for evaluation and/or medical transport. They deal with alcohol related incidents as well as medical, aggressive behavior ect. on a daily basis. Some of the Security Assistants on this campus have years of experience and have training twice a year to keep them up to date on new procedures and policies that have been implemented. The S/A’s are the “first responders” in these matters.

    • Brian on 10.10.2014 at 10:22 am

      In my experience, it’s often the RAs who call for transports most often, followed close behind by the Res Safety staff (security assistants).

      • Jeffrey Bouchard on 10.10.2014 at 10:35 am

        I beg to difer….The S/A’s on campus made the calls on 5 separate occasions last night alone. The Residential Safety staff is the first to see the students walking into the residences.

        • Brian on 10.10.2014 at 11:00 am

          Then things have changed since I graduated; Res Safety definitely let a lot of people in they shouldn’t have and the RAs would find them vomiting in the bathroom; the only Res Safety staff that were pretty consistent were Warren Towers

  • Student on 10.10.2014 at 8:42 am

    This article fails to include the medical bills that students, who already have hundreds of thousands dollars of student loans, recieve after BU sends them to the hospital. For just an ambulance ride and a water drip you’re looking at somewhere around $6,000. That’s after insurance. If you’re trying to inform students of “what really happens”, including the financial detriment that a night like that will create seems necessary.

    • Brian on 10.10.2014 at 10:11 am

      ^ This is not true. The average cost of a transport prior to insurance is about $1200. Insurance covers most of that and the hospital stay. Who ever sold you $6000 as the number lied to you or didn’t have medical insurance.

      • Brian on 10.10.2014 at 10:20 am

        As a follow-up, many students who experienced high costs for ambulance rides did so as a result of insurance that was “out of network” (these were the ones who often ended up paying close to the full $1200-$1500). Under ACA it no longer matters whether it’s in or out of network, ambulance rides for emergency situations are covered. Just thought that was an important clarification.

        The $6000 is still completely fabricated or was a pre-insurance figure.

        • Catherine Caldwell-Harris on 10.11.2014 at 1:03 pm

          Just because insurance pays for it doesn’t make it free or a non-cost. We all pay insurance premiums. I appreciate the comment of the parent saying that the cost was worth it — but is there a way to not incur such a high medical cost AND send a message to the student AND make sure student are not in medical danger? BU has many students who are EMTs, and of course access to all the BU medical school students who could be hired to be on hand on the Charles River campus to offer emergency medical care for heavily intoxicated students. This should still be followed by the classes etc. discussed in the article.

  • Parent on 10.10.2014 at 9:59 am

    Good point about the cost of the hospital transport – it should be part of freshman/parent orientation. However as a parent of a 2011 transport, I am fulling in support of BU’s practice. It was a wake up call for my son, and a lesson he had NO desire to relearn. Worth every penny and made a huge impact. We know someone who died of alcohol poisoning on a campus and appreciate that those odds are reduced at BU. Believe it promotes responsible drinking and awareness of personal limits. I can also say it impacted all his roommates in a positive way and likely prevented one of them ending up with a transport.

  • Unknown on 10.10.2014 at 10:37 am

    Honestly, the ambulance should be out there saving people’s lives who have gotten in an accident or had a heart attack, not saving some kid who is tipsy or stupid enough to get themselves dangerously drunk.

    • Brian on 10.10.2014 at 10:49 am

      So you’d rather let the kids die or get seriously hurt? Come on. Yes, it’s an issue, but you’re not looking at it from the right perspective. It’s all private ambulance companies anyway; it’s not Boston EMS.

    • Gary on 10.10.2014 at 1:39 pm

      And people don’t make other bad decisions before being in an accident? Texting while driving? Crossing a dark street while wearing dark clothes? Riding a bike without a helmet? Thankfully, the first responders don’t evaluate what happened leading up to someone needing their help. They just help.

  • exchange student on 10.10.2014 at 11:31 am

    In what unity is the 0.18 limit expressed please? Are we talking air , blood and which imperial units?

    In France , driving limits are 0.25g/L of air or 0.5g/L of blood.

    • Andrew on 10.10.2014 at 11:47 am

      BAL or BAC is blood alcohol level/blood alcohol concentration. A blood alcohol concentration of .08 (eight one hundreths of one percent) means that there’s .08 g/dL of blood. So a .18 would mean that there were .18g/dL of alcohol in your blood.

    • Shannon on 10.10.2014 at 11:56 am

      In North America, BAC (blood alcohol concentration) is measured in grams of alcohol per 1 dL of blood. The legal driving limit in most states is 0.08 g/dL.

    • Wellness & Prevention Services on 10.10.2014 at 12:12 pm

      For Massachusetts, the legal driving limit is .08 grams of ethanol per deciliter of blood (g/dL) – using the same units, the limit in France is .05 g/dl.

      Last year, we saw an average BAC of .19 g/dL among students who were transported.

      I hope this helps!

      • Student on 10.10.2014 at 12:25 pm

        What was the highest BAC last year? Thinking of following up on an article I wrote for a class.

      • CAS student on 10.13.2014 at 3:10 am

        Also interested in writing about this issue…in the article it says Dr. Ulrich at BMC said they “sometimes” perform a breathalyzer test to gauge BAC, is the average BAC given in this article only for those students given the breathalyzer test? And if so, what percentage of transports does this cover?

  • David Zamojski on 10.10.2014 at 2:02 pm

    As director of Residence Life, I can confirm that BU Housing’s security assistants are often the first members of the University staff to identify students who are displaying signs of alcohol intoxication while entering our high-rise residences. We appreciate the important role the security assistants play in our halls 24 hours a day, seven days a week.

  • Anonymous on 10.10.2014 at 11:30 pm

    Although I am no longer at BU (graduated in 2012), I was a student who was transported in 2009 (female, was a sophomore, suppose I fall into the statistic). I went to the ER at BMC with a 3.0 BAC, truly horrible, and I was lucky to live – do not remember the incident until I woke up in the morning. Though I have fond memories of college, I am also very shameful of my excessive drinking habits from those past years (and there are many others like me). Though my transport was somewhat of a wake up call – I continued to binge drink throughout the rest of my college career.

    My advice for parents, students, etc is to figure out if you are one of those people that does not know their limit, or ignores it (like me). I WISH my parents had told me that I have some pretty severe genes in my family history that I didn’t know about. If you have a child in college, or going into college, please talk to them if you have a history of alcohol issues yourself, or if it runs in the family. Not trying to be too personal, but that’s a lot of times the root of the issue.

    I hope the number of college students transported goes down – and I agree with the policy of not punishing someone who helps out a friend. A girl who I didn’t even know found me unresponsive in my dorm (I had somehow gone to the wrong floor) – and thank God she did the right thing and called the RAs – I clearly got in trouble, but I desperately needed medical attention (like woke up with heart monitors on). I cringe when I think about it.

    PLEASE BE CAREFUL students, and if you have a binge drinking problem, admit it to yourself, and stop drinking period. Thank you BU for trying to address the binge drinking issue and transport situation on campus. I can say that when it happened to me there was a very good process set in place, but I do think that it should be very, very strongly encouraged that students that have had a transport stop drinking period. Drinking coffee instead when going out can be just as fun (just not too much coffee).

    • Curious George on 10.14.2014 at 1:42 pm

      Thank you for sharing your experience with us.. A 3.0 BAC must have been frightening.. God bless you on your future endeavours and I hope you continue reaching out to kids who may be going through now what you had to go through then.

  • Catherine Caldwell-Harris on 10.11.2014 at 10:17 am

    When I clicked on the link for “anatomy of an alcohol transport” I wondered if it was a scientific discussion of how alcohol is transported in the bloodstream. Fascinating and informative. As a professor here at BU, I appreciated this in-depth and rigorous discussion.

  • Student on 10.13.2014 at 1:34 pm

    “for unknown reasons—February and April come in close behind”

    BU: One of the best universities in the nation;
    still doesn’t understand the basic student body and their habits.

    This spike is common knowledge.

  • Gene Dalton on 10.13.2014 at 5:28 pm

    I have worked at BU for many years and have personally observed the disrespect and abuse towards security staff. Intoxicated students feel they are entitled to say and behave they want to regardless. When I was a student here in a dorm as well as an RA, Escort Founder and supervisor, security at the GSU and supervisor for Residential Safety. I have seen more than any should. People don’t realize not only the cost, humiliation, damage to dorms and the community celebrating way into the nights disturbing our neighbors, tearing down traffic signs, stop signs and orange construction signs not to mention the abuse to security staff who are here to keep them safe. I have seen it all. I have been a director of numerous pre-release programs, worked with thousands of ex-offenders and homeless men and women, almost all have shared with me the damage they regretfully have caused their families, their status in society, employment. They have thrown their own lives away and never saw it coming. Yes I have seen it all. As a member of a very large family I was the first and only one to have been the only one to have fortunate to attend college and because of some wonderful people I was able graduate from BU twice, happily married and have six children. I feel sorry for those who feel they are being punished for drinking to the point where your whole life and future is out of whack and the many friends and family who try try and try again to help. They are hurting too. I one time ask a group of inmate at Walpole prison “How many of you planned to be in prison?” Not a hand went up. I repeated the question and again not a hand went up”. Almost all said alcohol and drugs are why they are there. I challenged that statement and stated they put them selves there. Why, because THEY DID NOT PLAN, THEY DID NOT TAKE ADVANTAGE OR SEEK EDUCATION TO HELP THEMSELVES AND THE WORLD A BETTER PLACE. THEY DID NOT THINK ABOUT CONSEQUENCES. THEY DID NOT THINK.

  • Cara Fram on 12.08.2014 at 4:30 pm

    how about a story called Anatomy of a Drug Overdose?
    Ask a nurse(I did) at Boston Medical about the number of drug overdoses by college students and the numbers are worse. Heroine is cheaper than alcohol. It’s a bigger problem right now. Maybe some of the new police body cameras can record what it looks like to be overdosing on heroine. A video of a young person having a heart attack from heroine might be a good deterrent from them trying this very addictive drug.

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