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Counseling Center

Division of Student Life and Enrollment

Problem Drinking

How do you know there is a problem?  Drinking becomes a problem when a person starts to regularly experience negative consequences due to their alcohol consumption.  Red flags typical of someone who is drinking too much include:

  • spending too much money on alcohol
  • frequent hangovers
  • skipping school or work
  • fights
  • accidental injuries
  • legal problems
  • high-risk sexual practices
  • unwanted sexual contact

These negative consequences can happen at a variety of drinking levels.  A person who binge drinks several times per month may have more problems than someone who drinks moderately every day.

In general, people who stay within both the recommended single day and per week guidelines are very unlikely to develop a drinking problem.  Only 9% (less than 1 in 10) of the US adult population exceeds both the daily and weekly guidelines. 

Low Risk Drinking Guidelines

Although it is true that college students drink more than non-college students, it is a MYTH that all college students drink.  According to a 2012 survey: 

  • 1/3 of the ETSU student population does not drink regularly or at all
  • Only about 20% of ETSU students engage in binge drinkingregularly (during the last month)
  • Most ETSU students drink in low risk ways

For some students, it feels like heavy drinking is more common than this. Social norm research has shown that overestimating the amount others drink is a frequent mistake.  This is especially true within certain campus subpopulations or specific friend groups. 

One of the best ways to avoid a drinking problem is to avoid high-risk drinking peer groups

Binge Drinking


A blackout is a period of amnesia caused by severe alcohol intoxication during which a person actively engages in behaviors like walking and talking but does not create memories for these events as they transpire. This results in missing periods of time in the person’s autobiographical record. Depending on how impaired the brain is, missing events could range from mundane behaviors like brushing your teeth and getting into bed, to dangerous and traumatic events like driving a car, getting into a fight or committing—or being the victim  of—a sexual assault or other crime.Why Do We Get Blackout Drunk


The risk for blackouts increases at a Blood Alcohol Concentration (BAC) of .15 or greater. Behavior during a blackout is very unpredictable. People who have experienced a blackout before are at higher risk for blackouts in the future. To avoid this risk, keep your BAC at the perfect buzz (less than .08).

Alcohol Overdose

Sobering Up

Don’t believe the urban myths, nothing sobers you up but time.

It takes about one (1) full hour for the human body to completely process one standard drink (SD) of alcohol—that is to return BAC to 0.00.  This means that if you go to bed dizzy and disoriented at 2AM after a night of heavy drinking, and your BAC is .20, you will still be intoxicated (.110) in the morning when you drive to school for you 8 o’clock class.  Not only could you get a DUI, but you won’t be totally sober until 4 o’clock in the afternoon!!!

As for caffeine, it has no effect on BAC; it just makes you a more alert and energized drunk, at higher risk for doing something stupid and hurting yourself.


Learn more.

Relationship Violence

Almost all family and relationship violence is connected to alcohol or drug misuse.  Alcohol lowers a person’s inhibitions, making them more prone to anger.  Interpersonal violence is always unacceptable and is a red flag that a person has a drinking problem. Learn how to get help!

Drunk Sex

It is impossible to give legal consent for sexwhen a person is incapacitated due to the effect of drugs or alcohol.  So if you or your partner are legally drunk (BAC > .07), don’t have sex. Drunk sex is sexual assault, not to mention all the other possible problems: 

  • having sex with someone you later regret
  • failing to use protection
  • having sexual performance problems.Why Drunk Sex Can Hurt Your Relationship

Avoiding drunk sex is just another good reason to learn to moderate your alcohol use!  


Sexual Assault

75% of all sexual assaults on college campuses involve alcohol! In addition 9 out of 10 involve someone the survivor knows and trusts.  This puts a different spin on getting drunk with your friends Learn more!

Drinking and Driving


This is a slang term that refers to a real problem in which a person restricts food calories to make room for alcoholic drink calories. Some people may even purge both their food and alcohol to avoid the calories.  These behaviors most often stem from the fear of weight gain and are more prevalent in college-aged women, although men also experience them. In extreme cases, drunkorexia may be related to bulimia or anorexia, in which the alcohol is used to make vomiting easier or to help manage eating anxieties. However, individuals without eating disorders that restrict their caloric intake before going out are also at high risk for negative consequences

Curtailing food calories in favor of drink calories carries several risks:


  • Drinking on an empty stomach gets you drunk faster, which typically leads to a higher Blood Alcohol Concentration (BAC), which in turn increases the likelihood of negative consequences especially making bad decisions.
  • Food and drink restriction often causes dehydration which further increases the risk of intoxication by decreasing blood volume.
  • Caloric reduction may also lead to binge eating due to extreme hunger, which is some people triggers a purging episode.
  • Substituting alcohol for food calories puts a person at long-term risk of not getting the nutrients needed to function properly.


Want to read more about this?

                National Eating Disorders Association

                Everyday Health

                Psychology Today

                Atlantic Monthly

Alcohol & Sleep Problems

A little-known but critical negative consequence of drinking too much is sleep disruption.  This is especially true for college students, as a lack of sleep interferes with the acquisition of learned material. It also increases day-time drowsiness and has been connected to mood problems, such as depression.


According to research findings. although alcohol does allow healthy people to fall asleep quicker and sleep more deeply for a while, it reduces rapid eye movement (REM) sleep, which is necessary for real rest.  And the more you drink before bed, the more pronounced these effects.

Learn more about sleep deprivation in college students.


Mixing Alcohol & Energy Drinks /Caffeine

When alcoholic beverages are mixed with energy drinks the caffeine in these drinks can mask the depressant effects of increased alcohol—a decrease in energy, feeling drowsy, or sometimes getting sad. Some people use these predictable effects to moderate their drinking.  With caffeine on board, the likelihood of binge drinking increases.  The likelihood of doing stupid things also rises, also known as The Jackass Effect. Alcohol and Energy Drinks

It is also important to note, that caffeine has no effect on the metabolism of alcohol by the liver and thus does not reduce blood alcohol concentrations (BAC).  The bottom line is that caffeine does NOT sober up a person, it just makes them a more energetic drunk, with increased risk of negative consequences such as a DUI.


Mixing Alcohol and Other Drugs

There a many very dangerous alcohol and drug combinations.  Even marijuana poses a risk when combined with very large amounts of alcohol, as it reduces the body’s natural tendency to throw up:  vomiting is a positive response to alcohol poisoning in that it empties stomach contents and potentially prevents Blood Alcohol Concentration (BAC) from rising further. 

Other common, but extremely risky combos are:  mixing alcohol with prescription drugs such as relaxants and pain killers (this can cause breathing to stop); mixing alcohol with cocaine which results in the creation of a highly toxic metabolic byproduct, cocaethylene, which damages the users heart.

See the chart below or learn more here.

Drug Class

Trade Name(s)

Effects with Alcohol



Severe reactions to even small amounts: headache, nausea, convulsions, coma, death.


Penicillin, Cyantin®

Reduces the drugs' therapeutic effectiveness.


Elavil®, Prozac®, Tofranil®,


Increased central nervous system (CNS) depression and blood pressure changes. Combination use of alcohol with MAO inhibitors can trigger massive increase in blood pressure, resulting in brain hemorrhage and death.


Allerest®, Dristan®

Drowsiness and CNS depression. Impairs driving ability.


Anacin®, Excedrin®

Can intensify alcohol's effects. Irritates stomach lining. May cause gastrointestinal pain, bleeding.


Valium®, Ativan®, Xanax®

Dangerous CNS depression, loss of coordination, coma. High risk of overdose and death.


heroin, codeine, Darvon®

Serious CNS depression. Possible respiratory arrest and death.


amphetamine, cocaine

Masks the depressant action of alcohol. May increase both blood pressure and physiological tension. Increases risk of overdose.



Other Stupid Things

The #1 reason why the use of alcohol by college students is the greatest public health risk faced by this population is the increased risk of accidental injury when a person is drunk.

Being intoxicated causes both a decrease in muscle coordination (including vision) and an increase in impulsivity and risk taking.  This is a dangerous combination and sends thousands of students to the Emergency Room every year for everything from simple cuts, to bone breaks, to serious head injuries caused by falls.

Bystander intervention is critical.  If you see a friend doing something stupid, intervene.

Screening Tools

Social Norms

DSM5 Criteria for Alcohol Use Disorder

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