Alcohol Use Disorders Among US College Students and Their Non–College-Attending Peers

BACKGROUND: Heavy/binge drinking among college students has become a major public health problem. There is consistent evidence suggesting that young adults in college are drinking more than their non-college-attending peers, but it is still not clear whether they are more likely to suffer from clinically significant alcohol use disorders. OBJECTIVE: To compare the prevalence of alcohol use disorders and alcohol use disorder symptoms in college-attending young adults with their non-college-attending peers within the same study in a large and representative US national sample. DESIGN: Cross-sectional survey. SETTING: Civilian, noninstitutionalized US population. PARTICIPANTS: Young adults (n = 6352) from the 2001 National Household Survey on Drug Abuse (19-21 years of age, 51% female, 66% white, 14% African American, 14% Hispanic). MAIN OUTCOME MEASURES: Lifetime, past-year, and past-month drinking, past-year and past-month weekly drinking, past-month weekly binge drinking, past-month daily drinking, typical quantity consumed in the past month, and past-year DSM-IV alcohol dependence and abuse diagnoses. RESULTS: Eighteen percent of US college students (24% of men, 13% of women) suffered from clinically significant alcohol-related problems in the past year, compared with 15% of their non-college-attending peers (22% of men, 9% of women; overall odds ratio = 1.32). The association between past-year alcohol use disorder and college attendance was stronger among women (odds ratio = 1.70) than men (odds ratio = 1.14). College students were more likely to receive a diagnosis of DSM-IV alcohol abuse than their peers not attending college; despite the fact that those in college were drinking more, they were not more likely to receive a diagnosis of DSM-IV alcohol dependence. CONCLUSIONS: College students suffer from some clinically significant consequences of their heavy/binge drinking, but they do not appear to be at greater risk than their non-college-attending peers for the more pervasive syndrome of problems that is characteristic of alcohol dependence.