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White Coat Notes

College bound? It’s time to head off drinking problems

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Globe Staff / July 19, 2010

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Parents, it’s time to talk to your college-bound children about drinking. Again.

Teens may be dialing up their drinking during the limbo between high school graduation and college enrollment. They can taste the freedom to come in a few short weeks, but talking to them ahead of time about the consequences of heavy drinking and the misperception that everyone’s doing it may affect their behavior now and later, according to research from the University of Rhode Island published in the June Journal of Consulting and Clinical Psychology.

Mark Wood, a professor of psychology at URI, led a two-year study of just over 1,000 incoming URI freshmen and their parents. Each student and one of their parents were randomly assigned to one of four interventions. In one, the student received a brief motivational session on alcohol and related problems tailored to the student’s answers on a questionnaire about drinking that all students completed. In the second, the parent was sent a handbook on student drinking in the mail. In the third, the student received the session and the parent, the handbook. In the fourth, which was used for comparison, the students answered the questionnaire but neither they nor their parents received anything else.

At the start of the study, 28 percent of the students said they didn’t drink. Those abstainers who went to motivational sessions were told about the safety and health benefits of not drinking, and reminded that they were not alone in their choice. Drinkers were warned about the risks of heavy drinking. The handbook sent to parents outlined the dangers of alcohol abuse and tools for talking about it with their children. The researchers interviewed the students again at the end of freshman and sophomore years to see who had become a heavy drinker and who had suffered the consequences, including missing classes, getting into fights, or being in regrettable sexual situations.

Among students who went to the motivational sessions, nondrinkers were less likely to begin drinking and drinkers were less likely to start drinking more heavily or experience alcohol-related problems. Students who both attended the sessions and whose parents got the handbook were less likely to have alcohol problems than students who had just one or none of the interventions.

Wood called the overall effect of the motivational sessions for students combined with parental information “modest.’’ The parental piece did not work as well as hoped, so the benefits of both didn’t add up as much as anticipated.

“It has been a very difficult problem,’’ he said in an interview. “We’re encouraged but there’s a lot of work that needs to be done on a lot of different fronts.’’

On the home front, parents should know two things, he said. First, most adolescents start drinking in their mid-teens.

“I would suggest parents talk to their kids on multiple occasions, and talk to them this summer,’’ he said. “Ideally these are conversations that have been going on since they were 12 or 13.’’

Second, the parents’ job isn’t done when their student moves out in the fall.

“A lot of bad things do happen and a lot of research we’ve done suggests parents do still make a difference by monitoring more, continuing to talk to kids about things they do, by encouraging a class schedule that keeps morning classes and no four-day weekends beginning on Thursday — and expressing clear disapproval for any drinking,’’ Wood said.

For students who don’t drink, he says the ubiquitous perception that everyone gets drunk all the time isn’t necessarily a normal part of college life.

“There are more kids out there that are like you than you think,’’ he said, although by study’s end half of the abstainers had begun drinking. “Put yourself in a position to explore more of the good things of college, intellectual and also social. There are plenty of other things that don’t revolve around alcohol.’’ -- ELIZABETH COONEY

Heavy drinking statistics
Heavy drinking by college students can have serious consequences for both drinkers and nondrinkers, on and off campus. Here are estimates from the National Health Institute on Alcohol Abuse and Alcoholism:

1,825 college students age 18 to 24 died from alcohol-related unintentional injuries, including motor vehicle accidents (2005)

599,000 students were unintentionally injured when they were under the influence of alcohol (2001)

696,000 students were assaulted by another student who had been drinking (2001)

97,000students were victims of alcohol-related sexual assault or date rape (2001)

Study rethinks aids prevalence among Haitians

Early on, before AIDS had a scientific name, the illness was sometimes called “the 4H disease’’: homosexuals, hemophiliacs, heroin users, and Haitians.

Haitians who immigrated to the United States have been thought to have higher rates of infections compared with those of other groups. But a new study led by a Haitian-American researcher finds that the prevalence of AIDS among Haitian immigrants is similar to those reported among African-Americans.

Dr. Linda Marc of the Center for Multicultural Mental Health Research at Cambridge Health Alliance led a team that analyzed national AIDS data from 1985 through 2007. According to the US Centers for Disease Control and Prevention, Haitian-born immigrants made up 1.2 percent of AIDS cases in the country, but they accounted for only 0.18 percent of the US population. That amounts to a seven-fold over-representation of AIDS among Haitian immigrants compared to the US population as a whole. But when higher population figures from Haitian consulates in US cities were used, that over-representation of AIDS cases fell to four-fold, about the same level as among African-Americans.

Haitian immigrants are likely to be undercounted by US census takers, Marc and her co-authors write, particularly if they are not in the country legally. -- E.C.

Survey: Doctors don’t always report impaired colleagues

More than one third of US physicians say doctors should not always report incompetent colleagues or those impaired by substance abuse or mental health disorders, according to a new survey by the Mongan Institute for Health Policy at Massachusetts General Hospital.

The survey, published in the July 14 issue of the Journal of the American Medical Association, also finds that substantial numbers of physicians feel unprepared to report or otherwise deal with impaired or incompetent colleagues.

“Our findings cast serious doubt on the ability of medicine to self-regulate with regard to impaired or incompetent physicians,’’ says Catherine DesRoches, who led the study.

The group surveyed 3,500 physicians. Seventeen percent said they had direct, personal knowledge of an impaired or incompetent physician during the past three years, but only 67 percent of those doctors reported the colleague to their hospital, clinic, professional society, or other authority.

The most frequently cited reason for not reporting was the expectation that someone else would report, indicated by 19 percent, followed by the belief that nothing would happen because of the report, cited by 15 percent, and a fear of retribution, 12 percent. -- LIZ KOWALCZYK

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