A “How To” Guide

Essie Auker, LPC, CACAssistant Director,

Health and Wellness CenterPenn State Altoona

What is social detox?

It is NOT being alone on a deserted island!!!

What is social

detox?It is NOT taking refuge in your car while attending your family reunion!!!

What is Social Detox?

It is NOT soaking in a bubble bath after accompanying your son’s kindergarten class to

the zoo!!!

What is social detox?

It is NOT turning off your phone, cell phone, computer, locking your office door and plugging in

your ipod!!!

This IS social detox!!!!

What is social detox???Many people may not need medical based

detox . A residential Social Detox typically requires no medication. Patients are monitored by a 24-hour staff with medical personnel available should any complications arise.

The monitoring of clients who need detoxification services but have no health risks associated with the withdrawal process

A safe place to sober up

The ProblemThe dilemma is what to do with those students who

are drunk but not to the level that requires ER treatment.

Due to the lack of options these students are usually “handed over” by Residence Life staff, University Police officers, or local police officers to a roommate or a friend who agrees to “babysit” the intoxicated student.

This creates a significant potential for tragedy as these students are not equipped, nor should they be expected to bear the responsibility for determining if the intoxicated student needs further assistance.

The ProblemArizona State University Survey What considerations would lead students to decide

whether to call for help for someone who is passed out or incoherent due to consuming too much alcohol

“Not knowing what to do” was cited by 47.6 percent of the survey respondents compared with only 35.5 percent who said they would hesitate for “fear of getting a friend into trouble.”

Maust R. (2007 Fall, Vol. 9 No 2). Medical Amnesty---Effective or Not? Catalyst, 6-7

Scope of the problemCollege students and alcohol useProblems related to excessive alcohol use by

college students

College Students and Alcohol Use The majority of college students are NOT heavy drinkers -- 22.8 percent abstain altogether from alcohol useWechsler, H.; Eun Lee, J.; Kuo, M.; Seibring M.; Nelson, T. B.; and Lee, H. “Trends in College Binge Drinking During a Period of

Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Surveys: 1993–2001.” Journal of American College Health 50: 203–217, 2002.

According to the NIAAA -- about four out of five students drink -- approximately half of the drinkers engage in heavy episodic consumption Wake Forest Researchers found -- 63 percent of students under 21 drink -- 20 percent of the drinkers usually have seven or more drinks -- More than half (54 percent) of the drinkers get drunk at least weekly Wake Forest University Baptist Medical Center (2005, May 24). Students Who Get Drunk Weekly Have Higher Risk Of Injuries.

Problems Related to Excessive Alcohol Use by College StudentsDeath: 1,700 college students between the

ages of 18 and 24 die each year from alcohol-related unintentional injuries (Hingson et al., 2005)

Injury: 599,000 students between the ages of 18 and 24 are unintentionally injured under the influence of alcohol (Hingson et al., 2005)

Assault: More than 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking (Hingson et al., 2005)

Drunk Driving: 2.1 million students between the ages of 18 and 24 drove under the influence of alcohol last year (Hingson et al., 2002)

Vandalism: About 11 percent of college student drinkers report that they have damaged property while under the influence of alcohol (Wechsler et al., 2002)

Property Damage: More than 25 percent of administrators from schools with relatively low drinking levels and over 50 percent from schools with high drinking levels say their campuses have a "moderate" or "major" problem with alcohol-related property damage (Hingson et al., 1995)

College students who get drunk at least once a week are significantly more likely to be hurt or injured than other students drinkers

-- three times more likely to be hurt or injured due

to their own drinkingWake Forest University Baptist Medical Center (2005, May 24). Students Who Get Drunk Weekly Have Higher Risk Of Injuries.

On a campus with 10,000 male college drinkers -- there will be 500 or more occasions on which more than 24 drinks may be consumed -- at these levels most people will pass out or become comatoseGruenewald PJ, Johnson FW, Light R, Saltz RF. Understanding college drinking: Assessing dose response from survey self-reports. Journal of Studies

on Alcohol 64(4): 500-14, 2003

Secondhand effects -- more than three-quarters of students living in res. halls, fraternities or sororities report that they have

experienced at least one secondary effect due to another student’s

drinking -- 60 percent had interrupted study or sleep -- 48 percent took care of a fellow drunk student -- 29 percent were insulted or humiliated -- 20 percent (females) experienced an unwanted sexual

advance -- 19 percent had a serious argument or quarrel -- 15 percent had property damaged -- 9 percent had been pushed, hit, or assaulted -- 1 percent (females) were the sexually assaulted or

acquaintance rape Wechsler, H.; Eun Lee, J.; Kuo, M.; Seibring M.; Nelson, T. B.; and Lee, H. “Trends in College Binge Drinking During a Period of

Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Surveys: 1993–2001.” Journal of American College Health 50: 203–217, 2002.

We asked: How do other colleges handle intoxicated students?

In 2003, email survey sent out to 11 colleges “Who determines if a an individual is acutely

intoxicated? -- Residence Life professional staff (2/5) -- Residence Assistants (2/5) -- Campus Police (4/5) -- Campus Health Services staff (1/5) --Other (3/5) all of the above or a combination of the above

or paramedics

“If a student does not require medical treatment is he/she released to another responsible, sober individual over the age of 18?”

-- Yes (4/5) -- No (0/5) -- Comments: “Res. Life will not accept responsibility for an intoxicated student.” “We do not put another student in

charge of a student under the influence because

of liability issues.”

In 2006 -- internet search failed to locate a campus-based detox center -- 10 colleges with demographics similar to Penn State Altoona contacted—no detox center -- Big Ten Universities contacted—no detox centercomments: -- if BAL over .24% they hospitalize, otherwise a friend is found to watch the student -- Res or Housing Director takes the student home and sits with them -- Release to underage roommates -- Have three holding cells monitored by trained

student volunteers (PBT over .10%)

We asked: How does Penn State handle intoxicated students?

2007 Penn State University CSAP poll—19 campuses and University Park

“Please describe a typical scenario where a staff member has encountered a student who was drinking too much and may be at risk for alcohol poisoning”

--Police and Res Life professional staff determine if the student should be taken to the hospital. If it is determined the student does not need medical attention, RAs check on the student for a few hours. -- The Coordinator notifies Police Services and a PBT is administered. If above o.25%, hospitalization would be considered. If the PBT is not high and we believe the student is not a danger then they are released to a sober student.

Two Model Programs 1. New England College 2. Lock Haven University

New England College In Henniker, MassApproximately 1,060 undergraduates• 450 graduate students• 52% Men & 48% Women• Campus Residents: 70%

Protective Custody Program“A temporary custody of a student by a Campus

Safety Officer or a protective custody monitor for the sole purpose of the students protection due to the students intoxicated, impaired, or incapacitated state in which they pose a threat to themselves or to another”

Program in existence for 10 yearsIs under the direction of the Dept. of Campus SafetyStudents are referred to program by Campus Safety

Officers or Henniker Police Dept.If a student refuses to go to program, Henniker

Police transport student to jail

Includes on and off-campus students If PBT is below .10% and the student passes police impairment

tests, the student is released on his/her own recognizance back to the community

-- if he/she fails the impairment tests, is remanded to a protective custody monitor If PBT is over .10%, but under .25%, and the Campus Safety

Officer determines the student to be a threat to themselves or others, the student is placed in the protective custody room with a monitor

-- Must remain in custody for a minimum of four hours -- If after 4 hours, the student is under 21 and PBT is higher than .10%, the student must remain in protective custody until the PBT falls below .10% -- If after 4 hours, the student is over 21 and still posing a

threat to themselves or others, the student must remain in protective custody until they can be released back to the community

Protective Custody MonitorsRecruited from the campus—can be students ,

faculty or staffCannot have a history of alcohol complaintsMust have a minimum of current CPR/Standard First Aid certificationMust complete Blood Bourne Pathogens trainingMust stay with student at all timesCan only monitor two students at a timeAre compensated $25 per hourAre on call

While in Protective CustodyNo visitorsSubmit to a breathalyzer testing upon

admittance and departureHave vital signs assessed upon admittance

and departureIf condition worsens, 911 is calledIf student becomes uncooperative, the duty

officer is called and the student is transported to Merrimack County Jail to which he/she shall remain for 24 hours

Cost of the programStudents are sent an invoice -- includes description of the charges (routine cleaning, linen, monitor fee, administrative fee, biohazard kit) -- the lowest amount is $155 -- must be paid in full to the Business Office within 30 days, or, -- the total amount due will be added to student bill and submitted to home address for payment The college does give a budget to manage the

program -- enough money to cover expenses

Lock Haven UniversitySituated in Central Pa4,665 at the Main Campus in Lock HavenSeven residence halls

Lock Haven University EMT Program

For students who are not able to take care of themselves

In effect for 9 yearsFalls under the Housing DeptDr. Carol Latronica manages it—she hires the EMTs

and manages scheduleIs housed in the infirmary where Police Services is

also locatedHas several beds and is equipped with an EMT bagOpen 7:00pm Friday through 7:00am Sat; also 12

hours Sat through Sun morningTypically sees 10 students per semester

Emergency Medical TechniciansRecruited by Dr.Latronica—she has never

had difficulty finding enough EMTsUsually hires 4-5 EMTs that rotate weekendsHave to have proof of EMT and CPR

certification Paid minimum wage—24 hours per weekend,

whether called in or notDon’t use breathalyzer machineAlways refer to ER if vomiting

Referrals to EMT program On or off-campus residents; not for non-

studentsAge 18 and overHall Directors or on-duty Dean usually

determines referral to EMT programLock Haven Police or apartment owners can

refer students 

ProceduresNo agreement or acceptance form requiredParents are NOT contacted; however, they are

called if the student wants to leaveStudents are required to stay until 7:00 AM the

next morningFee is $50—no matter how many hours they are

thereStudents are usually cited for underage drinkingJA--first violation—1 yr probation and online assessment --third violation—expelled

Now it’s our turn!!!

The Penn State The Penn State Altoona Altoona Sober Up Sober Up

Safely ProgramSafely Program

How to develop a social detox:Steps we’ve taken so far

Began as issue raised through our ADAPT committee

Researched how other colleges handle intoxicated students

Received approval from U.P. Risk Management to proceed

Developed a proposal -- identified the need for the program using

stats from our campus -- identified the liability issues if we do not

have the program -- garnished support of key players -- outlined solutions -- proposed evaluative measures -- developed a timeline -- submitted proposal to the Chancellor

Needs Identification

PBT/BAC 2004/2005

2005/2006

2006/2007

2007/2008

Fall 2008

.15 to .20 13 20 28 30 21

.21 to .26 3 11 9 8 5

In the Penn State Altoona spring 2008 Alcohol, Tobacco, and Other Drug Survey:

-- thirty nine percent thirty nine percent of students replied they had to

babysit a drunken student. “What would you do if a friend has passed out and

cannot be awakened?” -- fifty seven percent fifty seven percent of our students responded

that they would not call 911 or enlist the help of an

R.A.

Liability Issues

Our Number 1 concern is the safety of our students

By releasing students who are intoxicated to a roommate or a friend, we may be endangering the intoxicated student and/or the roommate/friend and possibly other students

Would we rather be sued for helping a student or be sued because we did nothing and a student was injured, or even worse, died?

We got the “thumbs up” from University Park to proceed!!!!!

Garnished Support of Key Players

Most are on the ADAPT committee so this was easy

-- Director of Student Affairs -- Director of Police Services -- Director of Judicial Affairs -- Director of Health and Wellness Center -- Police from the Altoona Police DeptMost importantly we have the support of our

Chancellor, Lori Betchel-Wherry

Outlined SolutionsDetermined which dept. will oversee the programNeed to find a place where the program will be housedMedical protocols and procedures will be developed

by Health Services staff -- Vital signs and PBT levels will be gathered at predetermined intervals -- Establish guidelines with criteria to determine when transfer to E.R. is indicated or student is

safe to be discharged

Write policies explaining the program -- identify who is eligible for services -- who can refer to the program -- guidelines to determine when a student

should be referred -- procedures to refer the student -- explanation of what happens when students

are receiving services -- what to do if a student refuses to go to the program

-- process for billing student for services rendered

-- determine if student will be cited for underage

drinking -- Judicial Affairs policy regarding

violations

Evaluative MeasuresCollect data from the program -- number of students referred -- number of students who refused services -- review PBT levels -- number of students requiring transfer to E.R. -- number of referrals from each referral source -- number of students cited for underage

drinking -- number of students referred more than once -- how many students referred per evening

Collect data on underage drinking citations from Police Services , Judicial Affairs and local Police Depts

Analyze all data -- determine utilization of the program -- assess if program needs to be expanded -- assess if program has impacted citations

Established timelineFebruary 09—submitted PLCB grant applicationAugust 09—secure room for the program,

establish polices, procedures, and protocolsOctober 09—develop brochures and letters to

inform students and parents of programNovember 09—recruit EMTs, disseminate

program info campus-wideDecember 09—send out letters and brochures to

all parents, train EMTs, purchase equipment needed for program, hold meetings with local police depts

January 2010—implement programMay 2101—analyze data to determine

utilization and program effectiveness, write year-end report

August 2010—revise program if indicated by year-end report, include program info at FTCAP and freshmen orientation

Submitted Proposal to Chancellor

Submitted to her in FebruaryApproved by the Chancellor

Submitted PLCE Grant Application

Requesting money to purchase PBT machine for the program

Requesting funds to cover the compensation of 4-6 EMTs

-- rotate being on-call Thurs- Sat from 9:00PM to 7:00 AM -- 500 hours that need to be covered in spring 10 -- will be paid minimum wageRequesting money to cover costs of three hour

training

The The Beginning!!!Beginning!!!

Thank YouPlease contact me if you would like a copy of the

powerpoint and/or if you have any questions.

Contact info: Essie Auker Assistant Director, Health and Wellness Center Penn State Altoona

Phone: 814-949-5540Email: esa11@psu.edu