A New Booze Worry

First, there was vodka eyeballing. Then, there was Four Loko. Now, maybe, there is “butt-chugging.”

A University of Tennessee at Knoxville student was recently hospitalized with a blood alcohol level of 0.4, dangerously close to what is considered a lethal dose. The student, a member of the Pi Kappa Alpha fraternity, which has since been suspended from Tennessee until at least 2015, also had injuries that made doctors suspect possible assault, until a fraternity brother said the student have been given an “alcohol enema.” (Despite evidence recovered from the fraternity house, the student denies ingesting alcohol this way.)

Popularized by a scene in one of the “Jackass” movies, alcohol enemas can be extremely dangerous because they bypass the body’s usual mechanisms for slowing alcohol consumption. In 2005, a man with a blood alcohol content level similar to the Tennessee student’s died from an alcohol enema.

But although the alleged incident at Tennessee has generated nationwide discussion – and disgust – experts say it’s not too surprising, nor is it any more alarming than other binge-drinking behaviors. And some experts on campus alcohol abuse are worried that the massive publicity over the incident at Tennessee may encourage students to try a very dangerous method of getting drunk -- which until now they haven't seen on their campuses.

“Alcohol consumption among college students at a high level is not surprising,” said Laura Forbes, associate professor of health education at the University of Alabama at Birmingham and chair of the American College Health Association’s Alcohol, Tobacco, and Other Drug Coalition. “They’re always trying to dodge appropriate alcohol metabolism… College students that have the invincibility factor may be willing to try and experiment with different modes and amounts of administration.”

Though perhaps not surprising, alcohol enemas are rare, experts said, and not an immediate issue most universities should need to address.

Anecdotally, Jennifer Bauerle, director of the National Social Norms Institute at the University of Virginia, said she was in a meeting last week, when the “butt-chugging” news broke, with directors of student health, including three physicians, and no one in that meeting had heard of alcohol enemas before.

Similarly, Ken Schneck, dean of students at Marlboro College and co-chair of the Alcohol and Other Drug community of NASPA: Student Affairs Administrators in Higher Education, said he asked students on his campus about “butt-chugging,” and most of them “scoffed and rolled their eyes.”

“They said, ‘You have to be an idiot to even contemplate that,’ ” Schneck said.

Aaron White, program director for College and Underage Drinking Prevention Research at the National Institute on Alcohol Abuse and Alcoholism said it’s hard to know exactly how common – or uncommon – this practice is because it’s rarely tracked.

“If a young person ended up at the hospital for an alcohol overdose, it’s unlikely they’re going to be asked, ‘How did you get the alcohol into your body?’” he said. “We fell pretty certain these are isolated incidents, but we don’t have a way to be sure.”

One way or another, experts agree that the Tennessee incident raises concerns about binge drinking generally and creates an opportunity for education.

Part of that education could be social norming, said David Arnold, director of Alcohol Abuse and Impaired Driving Prevention Initiatives for the BACCHUS Network, in which students are given real statistics on drinking in their community to demonstrate that most of their peers don’t engage in risky drinking behavior. Bauerle oversees the social norming program at the University of Virginia, and said the university has seen positive results.

“What might be going on at the University of Tennessee right now is this idea that, ‘Wow, all fraternity students are doing this,’ and really that’s just not true,” Arnold said.

Education on the dangers of extreme drinking practices could help, too. Arnold said when the “Jackass” movie came out, sparking initial interest in alcohol enemas, he was working at a university, and received a number of questions about “butt-chugging,” though no reports of the behavior actually occurring.

“I could see this being something students are curious about and looking for more information on,” he said. “Colleges and universities need to be prepared to answer questions.”

That said, most experts do not think alcohol enemas warrant a specific educational initiative. Instead, they suggest a broad evaluation of alcohol education programs.

“I’m very fearful for some of my colleagues thinking, ‘We’ve got to put together the alcohol enema workshop,’ ” Schneck said. “We are not going to be able to stop students from trying new things that are amazingly dangerous… so, what is it we can do to empower them to intervene when the next thing comes up?”