Even as recent headlines about fraternity hazing at Dartmouth, Boston University, Cornell, and other campuses have provoked more debate over college binge drinking, a particularly vulnerable group has slipped under the radar: the unprecedented number of students taking prescribed medications for depression, anxiety, attention deficits, and other psychiatric conditions.
While these medications have enabled many students to continue their education into college, they also make them more susceptible to the effects of alcohol abuse. Yet because the issue receives little attention — and because of the stigma often attached to psychiatric conditions — few schools are confronting it head on.
More than 90 percent of college counseling center directors report substantial increases in students arriving on campus already taking psychotropic medication. Approximately one-quarter of students receiving counseling services use such drugs. Campuswide, the total is even higher, since many students get their prescriptions from doctors outside the campus health system. Meanwhile, according to the federal government’s National Survey on Drug Use and Health, nearly two-thirds of college students ages 18 to 22 report drinking in the past month, and 42 percent of college students report binge drinking.
When I interviewed my peers for my book about growing up on psychiatric medications, I found that they drank routinely and heavily, as I did in college, while taking their prescribed drugs. But the two do not go well together. Certain psychiatric medications are used as party drugs specifically because they have mind-altering effects when mixed with alcohol. Stimulants such as Ritalin or Adderall provide bursts of energy that allow drinkers to keep drinking longer and harder. Anti-anxiety meds such as Xanax lower alcohol tolerance and get you — or your unwitting date — drunker faster.
Young adults taking medications may be highly vulnerable to abusing alcohol and recreational drugs. Medicated students often drink more than they should in order to ease their social anxiety or to feel less marginalized. To further complicate matters, alcohol can undermine the effectiveness of many drugs, reversing the action of antidepressants, for example, to make heavy drinkers more depressed.
Pharmaceutical labels contain fine-print warnings about drinking, and doctors caution patients taking psychiatric medications not to drink. Yet many students disregard the warnings. When you take medications from a young age, it’s easy to deceive yourself into thinking that you know your body and your limits. But there’s no predicting the dangers of mixing any psychotropic drug with alcohol because, as with alcohol tolerance in general, there are so many variables: how much you ate beforehand, how much you weigh, even how much you slept the previous night.
Unfortunately, there’s been little research into the effects of combining psychiatric drugs with even moderate amounts of alcohol, let alone the vast quantities consumed at college parties. Furthermore, taking multiple medications at once, as many students do, raises the stakes for miscalculation or neglect.
The stigma that surrounds medication and mental illness makes the risks of medication even more insidious. Although alcohol poisoning does sometimes make the news, obituaries and other news reports never disclose a history of prescription medication. As a result, the dangers of mixing meds and alcohol rarely enter the public discussion.
Enlightened college administrators need to devise alcohol policies that protect rather than punish students. A recent Globe column explored a Dartmouth program that seeks to curb binge drinking in several such innovative ways, including training and paying students to intervene when a peer gets dangerously intoxicated.
Similarly vigorous campaigns are necessary to educate all students about the risks of mixing meds and booze. Medicated students must be not only better informed but also protected. Simply asking students on medication not to drink is no more realistic than seeking abstinence among the student body at large.
It may be no more possible to eliminate the peer pressure that causes students on meds to drink to excess than to stop the most zealous pledge masters from inflicting forced drinking as part of hazing rituals. Yet responsible students can be taught to monitor their medicated friends during nights of heavy drinking. And if medicated students truly understood the risks they face, they could be induced to confide in friends about the drugs they take, rather than keeping their regimens secret.