It has been more than 12 years since the death of University of Iowa student Matthew Garofalo, and it's likely that few, if any, students on campus even know who he was or how he died.
On Sept. 7, 1995, Garofalo, 19, of Elgin, Ill., passed out drunk about 11 p.m. at the Lambda Chi Alpha fraternity house, where he was a pledge. It wasn't for another 12 and a half hours that Garofalo's lifeless body was found. In the hours between, Garofalo had vomited while on his back and inhaled some of his vomit. His lungs became irritated and filled with fluid until they stopped producing oxygen. About 7 a.m. his heart stopped, and he died.
Although this may be the most extreme example of the effects of binge drinking, health professionals warn that the culture of excessive drinking in Iowa City and at UI is creating problems for students right now that will continue for the rest of their lives.
They point to Garofalo's death, the death of 20-year-old Joseph Domke -- who fell from a balcony after drinking downtown underage -- drunken driving deaths, countless drunken assaults and attacks and a 2005 Harvard School of Public Health study that states UI has a binge drinking rate of nearly 70 percent -- the highest in the Big Ten -- as reasons for their concern.
Binge drinking is defined as five or more consecutive drinks in a sitting in a two-week period for men and four or more for women.
Harvard's statistics also show that although the percentages of occasional binge drinkers have declined since the study began in 1993; the percentage of frequent binge drinkers has increased.
UI students rate much higher than college students on average, where only two of five students nation wide report binge drinking.
It's for all of those reasons and the adverse health and societal effects of binge drinking that medical professionals and many others are in support of the proposed 21-only ordinance, which would ban 19- and 20-year-olds from bars. Proponents of the legal age measure argue that by restricting access to alcohol, the binge-drinking rate would significantly drop.
Will binge drinking decrease?
However, opponents argue such a measure would not decrease binging and simply would push underage people out into the communities and into unsupervised and potentially dangerous house parties.
Atul Nakhasi, a UI junior who founded the anti-21 group, the Student Health Initiative Task Force, said the proposed ordinance "directly impacts student health and safety," by potentially driving underage students to house parties.
"We're going to end up seeing more underage drinking," said Nakhasi, a pre-medicine student. "Now instead of using ID checks, you could have middle schoolers at the party. Instead of serving checkers (who can control the number of drinks served), you're going to have students with greater underage drinking. And what we're going to see is a likely increase in DUIs (and) sexual assaults."
Richard Dobyns, a clinic professor of family medicine at the UI, said it's difficult to speculate whether or not there would be more house parties.
"Could there be? Sure. You can speculate in either direction," Dobyns said. "There's always been house parties, there's always been pre- and post-drinking. Basically, what this initiative will instigate, not by itself, is a reduced alcohol consumption culture."
Dobyns said he believes the drinking rate among students has reached epidemic proportions. That belief has caused Dobyns to take action and act as a spearhead for the 21-only proposal.
"I mean, if you saw that the state of Iowa had twice the influenza numbers of any other state, you would hope your community would do something about it," he said. "You need to respond. It's not ethical to walk away from something like that."
Dobyns said he has a broad definition of the health effects of binge drinking and although students' binge drinking doesn't do much immediately, there are consequences later on. People who develop alcohol-related issues are more likely to have difficulty forming meaningful relationships and experience trouble holding down a job, as well as an increased likelihood of developing mood disorders, unwanted pregnancies, unwanted sexually-transmitted diseases, premature coronary disease, liver disease, vascular disease and neurological disease.
"If you define health a little more broadly, you would include those things as well," Dobyns said.
Dobyns added that public policy should not be based on random events, such as Garofalo's death.
"It's extremely sad for everyone," he said. "However, you have to look past those sad issues and look at the everyday sad issues."
Effects: now and later
Dr. Peter Nathan, a professor emeritus in community and behavioral health, was acting UI president at the time of Garofalo's death. He said it was hard to predict whether Garofalo's death would have been prevented by a 21-only measure.
"Would this have happened to Matthew if the referendum happened at the time?" Nathan said. "Matthew didn't drink in the bars."
Like Dobyns, Nathan -- an alcoholism researcher for 40 years --said binge drinking at a young age doesn't immediately do much to students, health-wise. However, he said frequent binge drinking can lead to cutting classes, less studying, an increased risk for injury, forgetting things or doing regrettable things.
The long-term effects are more severe, Nathan said. Frequent binge drinkers -- which represent about 46 percent of the student body -- are at a much greater risk to develop alcoholism after college.
"Alcoholism, in turn, is associated with a lot of sociological, psychological and physical problems," he said. "Alcoholics, on average, die several years early."
That's not to say Iowa City is inundated with alcoholic graduates from the university. Nathan said well-educated communities like Iowa City tend to have fewer alcoholics than other places.
Nathan said out of each graduating class, there could be up to 5 to 10 percent of the students who meet the criteria for alcohol dependence. Many of them don't stick around Iowa City, though.
"Students who graduated from here do a whole lot of things," Nathan said. "Some stay here, many don't."
Nathan said if parents are worried about sending their kids to the UI and having them come home with alcohol abuse problems, their concerns are valid, although coming to the university does not doom students to a life of alcoholism.
"The damage is still there"
However, centers that treat people for substance abuse problems, such as MECCA, are seeing people in their late teens and early 20s. Steve Steine, the clinical coordinator for MECCA's Iowa City location, said students are coming to the facility for outpatient programs.
"Most of the college students that we are seeing are those that have had a first or second OWI offense," Steine said. "Or, they may have what we would call recurrent alcohol-related issues; two or more public intoxications, two or more PAULAs, that really would have them meeting the criteria."
Steine said the facility doesn't track whether or not their patients are students, but of the 24 people enrolled in the current outpatient program -- an entry level program aimed at younger people and those experiencing first time substance abuse problems -- there are 10 people 21 or younger. He did not know whether or not they were university students.
"It's difficult to track," Steine said.
Steine didn't wish to weigh in on his view of the ordinance but said the problems with alcohol consumption might not be solved by laws and fines.
"If students get charged with a PAULA in a bar, they usually just get a ticket, pay a fine, that's it," he said. "They don't get any attention until there's something recurrent. I've known some students who have had multiple possession tickets and aren't mandated to doing some substance abuse program."
Ed Haycraft, an abuse counselor for UI Student Health, said the health center already is treating students for secondary effects of alcohol abuse. In 2006, 600 to 700 students came to Student Health for alcohol-related issues. Haycraft said they either attended the Seminar on Substances, an educational program, or the Brief Alcohol Screening and Intervention for College Students (BASICS) program.
"There's quite a few young people that come in and say, 'Well, I'm depressed,' and we ask them, 'How much are you drinking?' " Haycraft said.
Haycraft said drinking releases dopamine -- a chemical that triggers a pleasurable feeling -- into the brain. When the drinking stops and the production of dopamine halts, drinkers come down from that high and feel depressed.
However, in terms of physical effects, outside of getting sick or falling and hurting themselves when they're drunk, Haycraft said binging won't do much to younger drinkers.
"When you are 18 to 20 years old, you snap back real quick," Haycraft said. "But the damage is still there. It's one of those things that people don't realize when they're 18 to 20."
But some damage is being done right now. According to an annual report compiled by Student Health, of the 875 surveys completed, 73 percent reported they had experienced hangovers from drinking, 52 percent said they had vomited, 32 percent said they had injured themselves while drinking and 29 percent said they had unintended or regretted sex.
Students like Nakhasi, UI Student Government President Barrett Anderson and many others said they don't refute the negative health effects of binge drinking, just the approach taken by the 21-only measure.
"This is not going to fix these issues of underage drinking," Nakhasi said. "We recognize there's a problem...Our goal is not to only address and oppose this measure, but propose a possible solution."
Still, Ralph Wilmoth, the outgoing director of Johnson County Public Health, a 21-only supporter, said something must be done.
"The whole idea that we have an environment that supports that behavior is a contradiction to the very principles that public health is based on," Wilmoth said.
source: Press Citizen