More than Molly- Real Talk about Drug Facilitated Sexual Assault

If you’ve been anywhere on the internet lately, you’ve probably heard about Rick Ross’ newly released single U.O.E.N.O., during which he raps “Put molly in her champagne / She ain’t even know it / I took her home and I enjoyed that / She ain’t even know it,” The song has sparked controversy and online petitions calling for companies like Reebok to drop Rick Ross as a spokesperson and radio stations to remove the song from their playlists. I gotta tell you- I’m pretty pumped about this. I’m pumped that the public is outraged with Ross’ lyrics and glorification of drugging a woman with ecstasy (a.k.a. “molly”) in order to have sex with her and that I haven’t found one article citing that the ambiguous woman Ross is referring to should have watched her drink.

Despite my elation about the public conversations being prompted by Ross’ lyrics, our conversations about drug facilitated sexual assault need to go beyond illicit drugs and drink spiking. If we’re going to talk about drug facilitated sexual assault (DFSA), we need to be willing to engage in a conversation about alcohol. Alcohol is by far the most commonly used substance in drug facilitated sexual assaults, whether alcohol is forced upon the victim* or a perpetrator takes advantage of someone who has willingly consumed alcohol.

Up to 52% of a sample of men who reported committing a sexual assault since the age of 14 had been under the influence of alcohol at the time of the assault(s) (Gidycz, 2007). High risk drinking has been linked to sexual perpetration among first year college students, with heavy drinkers being more likely to report that they have perpetuated a sexual assault (Neal & Fromme, 2007).

What theories are there to explain the frequent concurrence of alcohol and sexual violence perpetration? Researchers speculate that either:
(a) alcohol causes a causal role in sexual violence perpetration
(b) the desire to commit sexually violent acts prompts perpetrators to use alcohol heavily so that their actions are seen as more socially acceptable/excusable since they are intoxicated
(c) various other factors contribute and cause both high risk drinking and sexual violence perpetration (Abbey, 2008; George, Stoner, Norris, Lopez, & Lehman, 2000).

The National Resource Center on Domestic Violence and Pennsylvania Coalition against Domestic Violence explain the relationship between American culture, alcohol use, and sexual violence as one that includes multiple factors.

“American culture glamorizes alcohol consumption and links it to sexual desire, sexual performance, aggression, and other types of disinhibited behavior. This affects people in two ways. First, as noted above, people may decide to drink when they want to be sexual, aggressive, and/ or disinhibited. Alcohol provides them with the “liquid courage” to act in the way they wanted to act. Second, intoxicated individuals are likely to interpret other people’s behavior in a manner that conforms to their expectations. Thus, a smile is more likely to be viewed as a sign of sexual attraction and a mildly negative comment is more likely to be interpreted as grounds for an aggressive response” (Abbey, 2008).

Even with societal pressure and the cognitive effects of alcohol, no matter how drunk a person is it does not excuse committing a sexual assault.

If you’re worried about a friend’s high risk drinking and concerned that their own alcohol use may be influencing their sexual decision making, you can encourage them to make an appointment with an Alcohol and Other Drug Intervention Specialist at Student Wellness. Alcohol and Other Drug Intervention Specialists assist students in exploring the social, academic, and sexual consequences of their drinking and encourage positive changes in drinking behaviors through Tarheel BASICS. Remember, how drunk a person is does not excuse committing a sexual assault.

Look out for Raise the Bar, a Student Wellness initiative launching in April as a part of Sexual Assault Awareness Month. Raise the Bar is an outreach and training program for local bar establishments offering education on DFSA and training on bystander intervention, providing bar staff the information and  tools to intervene and prevent drug facilitated sexual assault.

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*The term victim is used because this post focuses on circumstances surrounding the victimizing experience of DFSA, not the recovery process

• Abbey, A. (2008, December). Alcohol and Sexual Violence Perpetration. Harrisburg, PA: VAWnet, a project of the National Resource Center on Domestic Violence/Pennsylvania Coalition Against Domestic Violence. Retrieved month/day/year, from: http://www.vawnet.org
• George, W.H., Stoner, S.A., Norris, J., Lopez, P.A., & Lehman, G.L. (2000). Alcohol expectancies and sexuality: A self-fulfilling prophecy analysis of dyadic perceptions and behavior. Journal of Studies on Alcohol, 61, 168-176.
• Gidycz, C.A., Warkentin, J.B., Orchowski, L.M. (2007). Predictors of perpetration of verbal, physical, and sexual violence: A prospective analysis of college men. Psychology of Men and Masculinity, 8, 79-94.
• Neal, D.J., & Fromme, K. (2007). Event-level covariation of alcohol intoxication and behavioral risks during the first year of college. Journal of Consulting and Clinical Psychology, 75 , 294-306.

Di-Hydrogen Monoxide: Chemical Alert Warning

As you travel on spring break, make sure you are aware of your body’s levels of Di-Hydrogen Monoxide. Too little Di-Hydrogen Monoxide can result in the following symptoms:

• Increased thirst
• Dry mouth and swollen tongue
• Weakness
• Dizziness
• Palpitations (feeling that the heart is jumping or pounding)
• Confusion
• Sluggishness
• Fainting
• Inability to sweat
• Decreased urine output
• Yellow or amber urine output
• Fever over 101 degrees
• Vomiting

As you may have figured out, Di-Hydrogen Monoxide = H₂O. For you the chemistry-averse among you, that’s what’s commonly referred to as “Water”.

In all seriousness, how much water you drink is important for your health, safety, and ability to enjoy spring break. As you can see from the list above, dehydration can have some very serious health effects.

If someone does exhibit signs of dehydration, get them to a cool place and have them sip water, chew ice chips, suck on a Popsicle, or sip a sports-drink. Loosen their clothing, and seek shade or air-conditioning immediately. If symptoms worsen or persist, take the person to an emergency room or call an ambulance.

Prevention

College students, if they choose to drink alcohol over spring break, can be especially susceptible to dehydration. Alcohol, like caffeine, is a diuretic. Diuretics act on the kidneys to make you pee more than usual, which results in your body losing too much of its water and becoming dehydrated.

The symptoms of a hangover are mainly due to your body being dehydrated, and can best be cured by drinking water, not a caffeinated beverage.

Hydration is especially important on spring break, when people travel to warm weather where they may be sweating more, enjoying the sunshine more, and expending more energy traveling than they normally do in Chapel Hill.

So to stay hydrated and prevent the above symptoms, follow these 5 easy steps:

1. Have a full water bottle with you at all times.
2. Sip water before and during exercise or exposure to heat.
3. Break up the time you spend in hot temperatures. Find air-conditioned or shady areas and allow yourself to cool down between exposures to the heat.
4. Wear light colored and loose-fitting clothing, and carry a fan or mister to cool yourself. Doing so will lessen the amount of water you lose by sweating.
5. If you choose to drink alcohol, alternate between alcoholic and non-alcoholic beverages. This will help you pace your drinking and stay more hydrated.

So now that you know the signs of dehydration and how to avoid it, have a great, safe (and well-hydrated) spring break!

Medication Label Literacy

Reading the label on your medications – both prescription medications and those available without a prescription (over-the-counter or OTC medication) – is critical for your health.

What’s On the Label

How to Read Over the Counter Medicine Labels

All non-prescription, over-the-counter (OTC) medicine labels have detailed information about the proper use of the medication as well as pertinent precautions to help you choose which treatment is best for you.  It is important to remember that just because a medication is available “OTC” or is “all natural” does not necessarily mean it is safe and effective for every person who may use it, or that it does not have any potential interactions with other medications, foods, or health conditions.

Below is an example of what an OTC medicine label looks like as well as how to read it.

Image courtesy of womenshealth.gov

How to Read Prescription Medication Labels

All prescription medication labels include information about use and precautions. They are also dispensed with a sheet of printed material with more detailed information about the drug. We encourage you to ask your health care provider questions before getting a prescription, and then request an educational consult with your pharmacist when filling the prescription. By both hearing and viewing important information about your medication, you are more likely to avoid misusing it and get the most benefit from it.

Below is an example of what a prescription medicine label looks like as well as how to read it. All pharmacy labels will look slightly different and may have the information organized slightly differently, although the included information should be the same.  Please note that most prescriptions expire 1 year after the date that the prescriber writes it, but the expiration date of the medication itself is often different and always listed on the prescription label.

Image courtesy of consumerreports.org/health

The Campus Health Services Pharmacy offers consultations with pharmacists who are well-versed in the needs and issues of college students. Please utilize this service! Common questions you may consider asking include:

1. How should I take this medication?
2. How much should I take?
3. Is this ok to take after drinking/smoking/using other drugs?
4. I sometimes take (insert herbal medication, OTC medication, other prescriptions). Are there any interactions?
5. Will this impact my life in any way (driving, sleeping, mood, etc.)?
6. Are there other options if I don’t want the effects you’ve described?
7. Do you have any tips on how I can remember to take this at the right time?
8. What do I do if I forget to take a dose?
9. How long should I take this medication?

Many of these questions can also be answered with critical reading of the medication bottle and the patient information that comes with it, but some may be more specific to you and your needs. Ask your pharmacist or health care provider your questions. If you forget to ask an important question or have one arise after you’ve left, please contact your pharmacy. The Campus Health Pharmacy phone number is 919-966-6554.

Sources:
FDA, U.S. Food and Drug Administration 1-888-INFO-FDA (1-888-463-6332) http://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm133411.htm

Consumer Reports Health, http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/money-saving-guides/english/ReadingLabels.pdf

Women’s Health.gov http://womenshealth.gov/publications/our-publications/how-to-read-drug-labels.pdf

Speed Drinking: How Alcohol Glass Shape Makes Us Drink Faster

If you choose to drink alcohol, you may have noticed that people use many methods to help them pace their drinking to avoid the nastier side of having too much, too quickly: The hangovers, the poor decisions, the embarrassing behavior, being more drunk than intended, or even vomiting. Yuck.

But sometimes how quickly we drink is influenced by things that we may not even consider. Recently researchers tried to determine if the shape of the glass has any influence on the speed at which people drink beer. The findings? Yes, the shape of the glass plays a role.

Researchers are not entirely sure why this is the case, but one hypothesis is that a more curved glass impairs your ability accurately judge where “half-full” is, and thus are less able to accurately judge the pace at which you are drinking. This may lead to someone having drinks more quickly than they realize.

So what does this mean for you? It means that keeping track of how much you drank and how quickly you drank it is harder from a curved glass, and thus it’s harder to make sure you are making good decisions about your drinking. When drinking from a curved glass, keep in mind that you may drink faster than normal, so leave more time between drinks to let your body process the alcohol.

Below is a list of tips that can be helpful to people who want to avoid the negative consequences of having too much, too fast. It’s important to find a method that works well for you, and helps you stay in control of how much alcohol you consume in a night!

• Set a maximum number of drinks in a night
• Avoid shots
• Avoid drinking games
• Alternate between alcoholic and non-alcoholic drinks
• Hold a drink in your hand (non-alcoholic or alcoholic), to avoid being offered more drinks
• Put extra ice in your drink
• Know how many standard drinks you are consuming (Hint: 12-ounce beer=1oz shot=4oz serving of wine)
• Don’t drink something if you don’t know how much alcohol it contains
• Set a maximum number of drinks per hour
• Stop drinking at a predetermined time
• Be aware of how you feel BEFORE making the decision about another drink
• Set a maximum number of drinks for the night, and have a friend help you stick to that goal

Again, it’s important to figure out what works best for you, to make sure that you stay safe and healthy!

If you are concerned about your or a friend’s drinking or drug use, check out the services available at UNC Student Wellness, like Tar Heel BASICS. Also, Counseling and Psychological Services is always a great (free!) resource for UNC students.

As always, take care of yourselves!

Redefining Drug Overdose

Everyone knows that only hardcore drug addicts overdose, right? 

Actually, this statement may be one of the most dangerous misconceptions driving the overdose epidemic in our country. In the United States, accidental overdose, which includes overdose due to alcohol, illegal drugs, and prescription drugs, has now overtaken motor vehicle crashes as the number one cause of injury death (i.e. non-disease-related death, like falling or homicide). Opioid pain relievers, like Oxycodone and Hydrocodone currently account for more overdose deaths than cocaine and heroin combined. Prescribed for acute or chronic pain, these drugs provide relief for thousands of people. But, as with any drug, they carry the potential for abuse and overdose. In order to fight the growing overdose epidemic, we must challenge misconceptions about overdose victims.

As a Health Educator at UNC Campus Health, I have worked with college students who have experienced accidental overdose due to a combination of alcohol and prescription drugs. Many are smart, studious high achievers. Often they are taking prescription medicines as prescribed, unaware of the toxic effects of mixing their drugs with alcohol. They wake up in the hospital shocked and confused: “How could I have been so near death from just one pill?” one student asked me after taking a prescribed opioid and drinking a few beers.

But accidental overdose is not limited to young people. In fact, the mean age of overdose victims is 39, suggesting that older adults are overdosing just as much as younger populations.  I experienced this firsthand when I worked on a research project investigating falls in older adults. I encountered seniors who had accidentally taken too much of their medicines and ended up in the hospital from an overdose. Many were reluctant to talk about their experience out of shame or embarrassment, not realizing that many drug overdoses happen in this way.

Another group at higher risk for overdose is veterans. Soldiers suffer disproportionately from chronic pain, PTSD, and mental illness, and the medicines prescribed for these illnesses place them at higher risk for an overdose. Opioid pain reliever prescriptions among soldiers have increased from 30,000 to 50,000 since the Iraq war began, so it is no wonder our troops suffer four times more overdose deaths than their civilian counterparts.

So what can be done? Opioid pain relievers contribute disproportionately to the problem. A drug called naloxone can reverse the effects of an opioid overdose, but because of naloxone’s prescription drug status, it must be administered by a doctor or self-administered. One option currently under discussion is expanding the law to allow overdose bystanders (i.e. friends and family) to administer the drug. Another way to reduce overdose deaths is through a 911 Good Samaritan Law, which would grant amnesty from any drug or alcohol related charges to a person calling 911 on behalf of an overdose victim. For the UNC students I work with, this could be a lifesaver, since so many of them avoid calling 911 for fear of getting in trouble.

These two efforts are part of an overdose prevention bill currently underway in the North Carolina General Assembly (NCGA). On February 5^th, a policy summit will be held at the NCGA in Raleigh where these issues will be discussed more in depth. Drug overdose is not simply about addicts using illegal drugs (although this is an important population to consider). The prevalence of prescription drug use means that we must redefine what an overdose victim looks like: from the studious UNC student to the soldiers who risk their lives for our country.

It’s easy to feel powerless about these issues, especially from a policy standpoint. But, if you want to learn more about overdose or NC state politics, come to the FREE Policy Summit on February 5^th in Raleigh. This is your chance to see politics in action and meet legislators and other folks who are working hard to prevent overdose in NC. The event is free, but you still need to register at http://www.nchrc.org/news-and-events/events/north-carolina-overdose-prevention-summit/.

CAFFEINE!

With exam season on the way and the end-of-semester paper crunch coming, students will be turning to caffeine to help them make it through the long days (and nights) of work. It’s important to know that caffeine cannot replace sleep, and that your brain works best when you have time to sleep before taking an exam. So plan ahead, prioritize, and get some sleep! Your GPA will thank you. Also, learn more about caffeine by checking out the cool info-graphic below. Click to enlarge. Happy Studying!

Is Pre-Gaming a Good Idea?

College students, if they choose to drink, pre-game at higher rates than other populations. But is pre-gaming a good idea, or does it lead to more negative consequences than good?

College students tell us they pre-game for a variety of reasons: to avoid underage drinking tickets at a bar or dance club, to spend less money on alcohol, or because they attend a party ahead of time where drinking occurs.

While avoiding legal trouble and spending less on alcohol are admirable goals, does pre-gaming help? According to the research, pre-gaming actually results in a higher likelihood of heavy drinking, spending more money, hangovers, blackouts, and risky behaviors like vandalism.

This is because pre-gaming lowers your inhibitions and impairs your ability to make good decisions later in the night, like alternating alcoholic drinks with water, or knowing to stop drinking when you’ve reached your limit. The research, by author Florian Labhart of the Addiction Switzerland Institute in Lausanne, indicates that on nights that don’t involve pre-gaming people drink less on average, and are less likely to experience the negative effects associated with having too much alcohol.

Here at Campus Health we have harm-reduction approach, which means that we are not making any judgments with regards to alcohol or drugs. We focus on helping students identify ways they can reduce their risks for alcohol and other drug related harm, and we help students put in place strategies that they find useful to avoid the negative consequences that they identify.

So if you choose to drink, make sure that you are aware of the risks involved, and make sure you know that pre-gaming is not always as good of an idea as it sounds.

As always, stay safe, and stay healthy!

Inspired by this post in Men’s Health

4 Things You Need to Know on Halloween

Ahh, Halloween. As a kid, it was a time to prepare a costume, carve a pumpkin, gather with friends and family, and have a wholesome night of fun dedicated to obtaining and consuming too much candy. For adults, Halloween is still about consuming too much. But for some, it’s alcohol causing the tummy aches.

There are many ways to celebrate Halloween without alcohol present: Have a costume competition with some friends, bake up some tasty Halloween-themed treats, have a scary movie marathon, or plot an elaborate way to scare the crap out of your roommate. But if you choose to have an adult beverage to celebrate Halloween this evening, make sure you do these 4 easy things to stay safe and avoid tummy aches.

1. Eat a meal before you start drinking, and make sure you have plenty of water before and during drinking. Eating a meal beforehand helps slow down the effects of alcohol and will allow you to make safer decisions all night. And alcohol is a diuretic, which means it dehydrates you, so it is important to drink water all night. Also, switching between non-alcoholic and alcoholic beverages is a good way to make sure things don’t get out of hand.
2. Know how much you are drinking. Don’t drink from communal punch bowls, trashcans, etc. as you have no way of knowing how much alcohol is in there and how it will affect you. Also, the taste of the alcohol is easily masked, so don’t rely on how strong the punch tastes. Taking back control over how much alcohol you are consuming by making your own drinks.
3. Use the buddy system. Don’t be afraid to speak up or take action if there is something going on that you or your friends are uncomfortable with. Everyone is entitled to having a good time on Halloween, and that starts with feeling safe. Keeping an eye on each other can help get you there.
4. Have an exit strategy. Some of the most dangerous situations arise late in the night, when people have had too much alcohol to make good decisions. Set a limit for yourself ahead of time, because it’s hard to know when to stop once you have started. So decide ahead of time when you are heading home, and have plans in place to get home safe. Obviously, don’t get into a car when the driver has been drinking. Have a way to get a cab, take a bus, or call a sober friend as a backup.

With these things in mind, have a happy, healthy, safe Halloween!

Your Guide to Alcohol and the Law

Getting an alcohol citation can be expensive, embarrassing, and very frustrating.   Many students can minimize their risk of getting a drinking ticket by becoming informed.   So, before you make any decisions about purchasing or drinking alcohol, make sure you know the law; know the consequences; and know your rights.

Know the Law:  

It is ILLEGAL to….

• Purchase or attempt to purchase alcohol if you are under 21.  This includes attempting to order a drink at a bar or purchasing beer at a grocery store
• Possess alcohol if you are under 21.  This includes alcohol found in your vehicle or in your hands as you walk down the street, even if it is unopened.   An underage person suspected to be under the influence of alcohol (smells like alcohol, holding an empty Solocup that smells like alcohol, visibly intoxicated, etc) can be charged with underage possession.
• Use a Fake ID to purchase or attempt to purchase alcohol or to enter an over 21 drinking establishment.  Using a Fake ID to get into a bar can still result in a citation even if no alcoholic drinks are purchased or consumed.
• Purchase alcohol for an underage friend.
• Drink and Drive.  If you are 21 and over, this means having a blood alcohol content (BAC) of at least 0.08. It is also illegal to consume alcohol while driving or to have any alcohol in your system when there is an unsealed alcohol container in the passenger seat.   If you are under 21, you can get a DUI for having any alcohol in your system.
• Possess an open container of alcohol in any publicly owned area, such as streets, sidewalks, municipal parking lots, public parks, playgrounds, recreational fields, tennis courts, athletic fields, and in any buildings owned by the town.  This law applies to people 21 and over.  If you are under 21, you will be charged with underage possession.  

Know the consequences

Typical consequences for the above offenses include a misdemeanor charge, fines, and court costs.  Additionally, many students are required to complete an 6-week alcohol education class as well as a 1-on-1 alcohol assessment.  A DUI results in a 1-year revocation of your Driver’s License for the first offense.  Depending on the situation, a student may also face imprisonment.   UNC Dean of Students has their own set of consequences for students that may include academic and/or housing probation.

Know your rights

If you are stopped by the police, here’s some helpful advice from UNC Legal Services…..

1. You are not required to answer questions. You can choose to remain silent. Think “UNC”: “Uh, No Comment.”
2. If police request to search your person or belongings, and you do not wish to be searched, you may say, “I do not consent to a search.”
3. If the officer proceeds to search you or your belongings, such as your wallet, backpack, or car, do not resist.  If you do not consent to the search, simply say, “I do not consent to a search.” (If the search is unlawful, it can be suppressed in court.)
4. If an officer asks for your identification, do not present a fake ID.  If you present proper identification and an officer asks to see your wallet to check if you have a fake ID, you can refuse.  After refusing, you may then ask, “Officer, am I free to go?”
5. You are not required to submit to a breathalyzer unless you are driving a car.  If you are a passenger in a vehicle, you may refuse a breathalyzer without legal consequences unless you are underage and visibly intoxicated.  If you are approached on the street (e.g. walking home or outside a party), you may refuse a breathalyzer without legal consequences.  After refusing, you may then ask, “Officer, am I free to go?”
6. NEVER physically resist a police officer.  Simply remain silent and remain calm.
7. If you are arrested, state clearly for the officer, “I am going to remain silent.” Then remain silent.

Some additional things to keep in mind if you are stopped while driving….

1. YOU MUST display your driver’s license upon an officer’s request.
2. YOU MUST write your name (for the purpose of identification) upon an officer’s request and provide your name and address (and the name and address of the auto’s owner).
3. If the officer pulls you over while driving, you must submit to a breathalyzer test or your license will be revoked. You do have the right to contact an attorney for advice.
4. You may be asked to perform dexterity tests, but you are not required to do so.  There are no formal legal penalties for refusing to do so.

For more information:

UNC Legal Services http://www.unc.edu/student/orgs/sls/legal:alcohol

Alcohol Law Enforcement (ALE) https://www.nccrimecontrol.org/Index2.cfm?a=000003,000005,000272,000274

Smart Ways to Keep Tabs on Drinking

Happy Monday Morning! How did you spend your weekend? Did you participate in any of our Healthy Heels recommendations? If you were out drinking, do you remember how many drinks you had? Do you know what your blood alcohol concentration (BAC) was?

Keeping an eye on how many drinks you have can help you manage your budget and help you make sure you are keeping your BAC at manageable levels. Keeping your BAC below certain levels can help you avoid the nastier side of drinking – the hangovers, the missed classes, and days spent recovering when you should be studying – while still allowing you to go out, have fun, and enjoy drinks with friends.

With this approach in mind, here are some online tools and phone apps we’ve found that could be useful to someone who wants to take the first steps towards monitoring their drinking on-the-go. If you know of another good way you keep track of how many drinks you’ve had in a night, feel free to share in the comment section!

For starters, there is a very cool iPhone app called DrinkTracker available in the App Store for $1.99. It uses an algorithm to calculate your real-time BAC as you are drinking, taking into account how quickly your body processes the alcohol based on your weight, height, gender, and how long you have been drinking. It’s also has some cool integration with Google maps to help you find the next bar or get home safely by contacting a local taxi service, or even emailing a friend your location. Click here to check it out.

For Android users, we recommend the free AlcoDroid app.  Like DrinkTracker, AlcoDroid uses sex, weight, and type of drink to give you a current BAC estimate. In addition, AlcoDroid plots your BAC over time, giving you an idea of when you’ll be below the legal driving limit or back to zero.  It can also track the cost of your drinks and graphically chart your daily, weekly, and monthly alcohol consumption statistics. Click here to learn more about Alcodroid and its many features.

While these apps are great tools for monitoring your drinking, we want to remind everyone that any information provided should be taken with a grain of salt.  They can’t take into account other things that affect BAC levels, such as whether you have eaten a balanced meal beforehand, or things that are specific to you, such as genetic factors.  It’s very important to stay within your comfort zone.  If you normally wouldn’t drive after having 4 beers in 2 hours, don’t change things up just because DrinkTracker says you’re good to go.  These apps are meant to keep you informed, not to push your limits.

For more information on drink tracking and other cool apps, check-out this page.