Risk Management

Most colleges and universities in the U.S. have prevention programs that address the issues of alcohol, tobacco, and other drug use and abuse. Some, like UT Austin, invest substantial time and effort into these programs.

The terms risk management and harm reduction describe the foundation of most modern college prevention programs, including those of UT Austin, University Health Services (UHS), Alcohol & Drug Education Programs (ADEP).

Risk Management & Harm Reduction Basics

Alcohol/drug risk management is based on a few simple, basic assumptions that may appear obvious at first glance but serve as the foundation for most college risk management programs:

• Heavy drinking & other drug use results in negative consequences.
• Moderate drinking & other drug use results in fewer negative consequences.
• Light drinking & other drug use results in few negative consequences.
• Abstinence from alcohol & other drugs results in no negative consequences.
• By raising the level of responsible decision-making, the risk associated with all drinking & other drug use will decline.

Consider the following Consumption-Problems continuum:

Alcohol/Drug-Related Problems

The goal of risk management prevention programs is not to convince students not to drink, but rather to manage their alcohol consumption to reduce the likelihood of harm by moving from right to left along the continuum.

Strategies You Can Use

As an individual, there are many simple strategies that you can put into place to reduce the risk and potential harm associated with drinking. Reasearch shows that the more strategies a person uses, the less likely he/she will experience negitive consequences (like hangovers, regret, memory loss, etc.). For example, you can:

• Choose safe and familiar settings in which to drink
• Drink with people you know and trust
• Set a limit and stick to it
• Count your drinks
• Learn how to say, "No thanks" and "No more"
• Avoid all drinking games, always
• Eat something before and while you drink
• Alternate alcoholic with non-alcoholic drinks
• Avoid drinking on top of medications
• Mix your own drinks or know exactly what's in them
• Have a plan to get home safely (E-Bus & DDP)
• Pace drinks to one per hour

UHS-ADEP: A Risk Management/Harm Reduction Approach to Substance Abuse Prevention

Statistics vary from survey to survey and from year to year, but typical reports indicate that about 70% or more of senior high school students and 80% or more of college students have consumed alcohol within the past year, and that around 40%-50% of college students engage in binge drinking.

Prevention experts estimate that over 30% of college drinkers can be labeled alcohol abusers using diagnostic criteria utilized by medical doctors and licensed counselors. Survey data tells us that about 41,500 (83%) UT students drink. If estimates of alcohol abuse among college students are accurate, that means that during any give long semester, we have about 12,500 students abusing alcohol.

Add to those figures the alarming number of alcohol poisoning cases that occur on college campuses, and you wind up with a lot of parents, school administrators, social science researchers, and students themselves feeling worried and demanding that colleges somehow "prevent" the abuse of alcohol and other drugs on their campuses.

To prevent literally means to keep something from happening. Prevention programs deliver education and interventions that encourage individuals and groups of individuals to avoid and/or change behavior that may precipitate the onset of negative outcomes and problems.

College-based alcohol & drug prevention programs, at least the really good ones, apply multiple strategies - activities, programs, and services - that attempt to accomplish the following:

• Educate students about alcohol and drugs in an effort to encourage responsible decisions around their use
• Intervene on students who have experienced negative consequences around alcohol and drugs so as to reduce the harm and manage the risks associated with their use
• Support students who are in recovery from substance abuse and addiction
• Promote constructive lifestyles and norms that discourage alcohol & drug abuse
• Develop social and physical environments that facilitate alcohol and drug abuse-free lifestyles

Alcohol/Drug Prevention Strategies

Alcohol/drug prevention strategies are generally divided into three categories, depending on the target audience.

• Primary, Universal, or Population-Based Prevention
  Activities that target the general public or an entire population cohort that has not been identified on the basis of individual risk
• Secondary, or Selective Prevention
  Activities that target individuals or subgroups of the population whose risk has been identified as higher than average
• Tertiary, or Indicated Prevention
  Activities that target individuals who have been identified as high risk through behavior that suggests signs or symptoms of alcohol or drug abuse or addiction

UHS-ADEP Strategies for Alcohol/Drug Prevention

Note that the activities that comprise these strategies are not discreet; they overlap between categories.

Primary, Universal, or Population-Based Prevention

• ADEP provides primary prevention through activities and events that target all students by trying to increase their knowledge about alcohol and drugs. These activities typically focus on responsible decision-making regarding the use of alcohol and drugs, as well as on possible negative consequences associated with their misuse and abuse. Activities include, for example:
• Information distribution through tabling: HealthSmarts, Party on the Plaza, Wellfest, Stressfest, Spring Break Survival Skills, National Alcohol Screening Day, Great American SmokeOut, National Collegiate Alcohol Awareness Week
• SSB corner displays, UHS exam room and residence hall poster projects
• Peer educator workshops delivered to general UT population

Secondary, or Selective Prevention

• ADEP provides secondary prevention through programs and services that target individual students or groups of students who appear to be at greater risk than the population as a whole. These programs focus on risk management and harm reduction and include, for example:
• Individual Consultations
• Choices: Risk Management Classes
• Peer educator workshops delivered to high risk groups
• 21st Birthday Cards
• Designated Driver Pledge (DDP) Program

Tertiary, or Indicated Prevention

• ADEP provides tertiary prevention through programs and services that target individual students who have demonstrated high-risk behavior, including symptoms of substance abuse or dependence. These services focus on substance abuse education, intervention, and counseling and include, for example:
• Individual Consultations and Counseling
• Choices: Risk Management Classes
• MIP (Minor in Possession) Classes
• Smoking Cessation Program
• Center for Students in Recovery

Other Approaches to Alcohol/drug Prevention

Social Norms/Social Norms Marketing

This primary prevention strategy is based on the theory that individuals use alcohol and other drugs in ways that are consistent with their perceptions of environmental norms.

The fundamental assumption of this strategy is that students modify their behavior to "fit in" with the normative expectations of their peers. Research consistently has shown that despite the fact that most students drink responsibly or not at all, they believe that other students drink considerably more than they actually do. And if students are aware that most students really do drink responsibly, it may remove perceived peer pressure to do the same.

UT has conducted one major social norming marketing campaign called "7 Out of 10" following survey research indicating that almost seven out of ten UT Austin students drink four or fewer drinks when they do drink.

Environmental Strategies

Environmental strategies are based on the theory that students do not make decisions about their use of alcohol entirely on their own and that they are influenced by a variety of sources.

These sources include, for example, messages given or implied by the campus community about the role of alcohol and drugs on campus, by policies and procedures set by the university, and by the surrounding community's policies affecting the availability of alcohol and enforcement of alcohol/drug laws.

Environmental strategies that have been shown to work:

• Limit alcohol availability
• Reduce alcohol-use options
• Increase enforcement of laws and policies
• Train beverage servers and monitor compliance

Environmental strategies that conventional wisdom suggests should work:

• Offer alcohol-free social and recreational options
• Create health-promoting normative environment
• Restrict marketing and promotion of alcohol