It's been nearly a year since 19-year-old Samantha Spady was found dead of alcohol poisoning in a fraternity house at Colorado State University. Spady's blood alcohol content was 0.436 -- five times the legal limit -- and investigators say she consumed up to 40 drinks the day before she died.
Spady's death was far from the only alcohol-related campus tragedy last year, and as school starts up again this year, colleges and universities across the country are bracing for more booze-fueled chaos.
Each year, college drinking contributes to an estimated 1,400 student deaths, 500,000 injuries and 70,000 cases of sexual assault or date rape, according to the National Institute on Alcohol Abuse and Alcoholism, a part of the federal National Institutes of Health.
Government and universities are pouring millions of dollars into programs to crack down on or curb campus "binge drinking," but there's been little change in students' behavior over the past decade.
Many experts studying alcohol use on college campuses say excessive drinking is so deeply entrenched in the culture, only a radical shift in students' attitude toward drinking will help.
What Is 'Binge Drinking'?
Spady's parents, Patty and Rick, have started a group called the SAM (Student Alcohol Management) Spady Foundation, whose mission is to educate students and parents about risky alcohol use.
Patty Spady says she and her husband "regret daily" that they never talked to Sam -- a former homecoming queen and high school class president -- about the fact that heavy drinking could be deadly. But she also admits that she wasn't totally aware of the dangers herself. "I feel like kids are going out with the intention of getting drunk," she said. "About that style of drinking -- I was totally naïve."
Binge drinking is commonly defined as having five or more drinks in one sitting, and the number of college students considered binge drinkers -- around 44 percent -- has stayed about the same for the past decade.
But ask many college students, and that definition of binge drinking seems ludicrous.
Barrett Seaman, a former Time magazine editor, observed student behavior on 12 college campuses for his recently released book, "Binge: What Your College Student Won't Tell You." He found that many students are drinking far more than five drinks over the course of a night.
"Students are routinely knocking back 20 shots a night," Seaman said.
Pregaming and Other Drinking Rituals
Seaman, who admits he did his fair share of drinking at Hamilton College in upstate New York in the 1960s, says he was struck by the "intensity" of student drinking today.
One common ritual he saw while reporting for the book was "pregaming," where underage students sat in their dorm rooms or apartments and drank massive amounts of alcohol, usually hard liquor, in order to catch a buzz before going out for the evening.
Seaman says that because drinking is illegal for so many college students, they are forced to do it covertly -- and often dangerously -- because there's no telling when they will get another drink as they roam from party to party.
"It is cool to be ostentatiously drunk," he said. "It shows you're part of the elite who has access to alcohol."
Dr. Hoyt Alverson, an anthropology professor at Darmouth University, had his undergraduate students spend three years studying fellow students' social behavior at the school. Alcohol, he says, is inextricably linked with social life on campus.
In his study, he writes that first-year students especially fear being alone in their new environment, and drinking is simply the best and easiest way of "forming friendships, competing, blowing off steam, … 'hooking up,' fitting in and getting ahead amongst one's peers."
Students at Dartmouth and other schools play elaborate drinking games like beer pong, Thumper and others at parties. And drinking is often an important ingredient in "hooking up" with the opposite sex.
"Heavy drinking is so ritually scripted on campuses," Alverson said.
Harm Reduction and 'Social Norming'
Colorado State University's Alcohol Task Force kicked into high gear after Spady's death, says Carrie Haynes, a graduate assistant in the Department of Alcohol and Drug Education and Prevention.
But the campus didn't disband all fraternities or ban alcohol in general. Instead, CSU and other colleges are hoping that educating students about the harmful consequences of heavy drinking -- like sexual assault and alcohol poisoning -- will be more successful.
Many colleges' harm reduction programs include peer-education groups and tips on staying safe while drinking that go far beyond a "don't drink and drive" message. They are telling women students to stick together at parties and never leave a friend behind, and how to recognize if someone is in physical danger from drinking.
"Scare tactics are out the door," Haynes said.
CSU is also trying out a "social norms" campaign, which attempts to correct students' misperceptions about fellow students' behavior.
In a sense, social norming is peer pressure in reverse. The theory is that students overestimate how much their peers drink, and that by giving them accurate information about "campus norms," it will encourage them to change their behavior.
Though it's early in the year to tell how the tactic is affecting student behavior, Haynes is hopeful. "I see how social norming affects them [students]," she said. "They respond to positive messages."
And according to the National Social Norms Resource Center, campuses that have used social norms programs have seen rates of what they call "heavy episodic alcohol consumption" drop significantly.
Some Call for a Culture Change
In American culture, college students occupy that vague place between adolescence and adulthood, and in many ways, drinking, partying and breaking the rules are part of this transitional "growing-up" period.
So while drinking at college is nothing new, what is new is the way today's students are doing it.
Seaman and Alverson agree that raising the drinking age to 21 has been counterproductive. By making it illegal to drink, students' behavior is repressed and driven underground. Their drinking becomes furtive, intensified and, in many cases, dangerous.
Besides going to several American campuses, Seaman also visited McGill University in Montreal -- a college that more than 2,000 American students attend. The drinking age there is 18, and Seaman said the attitude toward drinking at McGill is far more "civilized," even among American students.
"In American schools, there's a very confusing message to students: Are they kids or are they adults?" Seaman said.
Both Seaman and Alverson say that changing the drinking age back to 18 would be a good start in changing campus drinking culture, but they also say that a radical behavior and attitude shift would take time.
"It's important to keep the conversation going about alcohol and drugs," Seaman said. "Students are very open about it. If you treat them as adults, they'll act like adults."