Developing and Maintaining a Social Detox Center on Campus

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Developing and Maintaining a Social Detox Center
on Campus

• A How To Guide
• Essie Auker, LPC, CAC
• Assistant Director,
• Health and Wellness Center
• Penn State Altoona

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What is social detox?

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

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What is social detox?

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

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What is Social Detox?

• It is NOT soaking in a bubble bath after
  accompanying your sons kindergarten class to the
  zoo!!!

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What is social detox?

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

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• This IS social detox!!!!

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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

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The Problem

• The 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.

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The Problem

• Arizona 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

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Scope of the problem

• College students and alcohol use
• Problems related to excessive alcohol use by
  college students

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College Students and Alcohol Use

• The majority of college students are NOT heavy
  drinkers
• -- 22.8 percent abstain altogether from
  alcohol use
• 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
  19932001. Journal of American College Health
  50 203217, 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.

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Problems Related to Excessive Alcohol Use by
College Students

• Death 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)

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• 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)

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• 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 drinking
• Wake 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 comatose
• Gruenewald 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

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• 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 students 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
  19932001. Journal of American College Health
  50 203217, 2002.

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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

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• 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.

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• In 2006
• -- internet search failed to locate a
  campus-based
• detox center
• -- 10 colleges with demographics similar
  to Penn
• State Altoona contactedno detox
  center
• -- Big Ten Universities contactedno detox
  center
• comments
• -- 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)

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We asked How does Penn State handle intoxicated
students?

• 2007 Penn State University CSAP poll19 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.

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Two Model Programs

• 1. New England College
• 2. Lock Haven University

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New England College

• In Henniker, Mass
• Approximately 1,060 undergraduates
• 450 graduate students
• 52 Men 48 Women
• Campus Residents 70

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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 years
• Is under the direction of the Dept. of Campus
  Safety
• Students 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

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• 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

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Protective Custody Monitors

• Recruited from the campuscan be students ,
  faculty
• or staff
• Cannot have a history of alcohol complaints
• Must have a minimum of current CPR/Standard First
  
• Aid certification
• Must complete Blood Bourne Pathogens training
• Must stay with student at all times
• Can only monitor two students at a time
• Are compensated 25 per hour
• Are on call

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While in Protective Custody

• No visitors
• Submit to a breathalyzer testing upon admittance
  and departure
• Have vital signs assessed upon admittance and
  departure
• If condition worsens, 911 is called
• If 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

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Cost of the program

• Students 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

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Lock Haven University

• Situated in Central Pa
• 4,665 at the Main Campus in Lock Haven
• Seven residence halls

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Lock Haven University EMT Program

• For students who are not able to take care of
  themselves
• In effect for 9 years
• Falls under the Housing Dept
• Dr. Carol Latronica manages itshe hires the EMTs
  and manages schedule
• Is housed in the infirmary where Police Services
  is also located
• Has several beds and is equipped with an EMT bag
• Open 700pm Friday through 700am Sat also 12
  hours Sat through Sun morning
• Typically sees 10 students per semester

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Emergency Medical Technicians

• Recruited by Dr.Latronicashe has never had
  difficulty finding enough EMTs
• Usually hires 4-5 EMTs that rotate weekends
• Have to have proof of EMT and CPR certification
• Paid minimum wage24 hours per weekend, whether
  called in or not
• Dont use breathalyzer machine
• Always refer to ER if vomiting

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Referrals to EMT program

• On or off-campus residents not for non-students
• Age 18 and over
• Hall Directors or on-duty Dean usually determines
  referral to EMT program
• Lock Haven Police or apartment owners can refer
  students
•  

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Procedures

• No agreement or acceptance form required
• Parents are NOT contacted however, they are
  called if the student wants to leave
• Students are required to stay until 700 AM the
  next morning
• Fee is 50no matter how many hours they are
  there
• Students are usually cited for underage drinking
• JA--first violation1 yr probation and online
• assessment
• --third violationexpelled

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Now its our turn!!!

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• The Penn State Altoona Sober Up Safely Program

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How to develop a social detoxSteps weve 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

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• 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

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Needs Identification
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• In the Penn State Altoona spring 2008 Alcohol,
  Tobacco, and Other Drug Survey
• -- 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 of our students
  responded that
• they would not call 911 or enlist the
  help of an R.A.

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Liability Issues
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• 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?

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• We got the thumbs up from University Park to
  proceed!!!!!

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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 Dept
• Most importantly we have the support of our
  Chancellor, Lori Betchel-Wherry

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Outlined Solutions

• Determined which dept. will oversee the program
• Need to find a place where the program will be
• housed
• Medical 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

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• 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

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• -- process for billing student for
  services rendered
• -- determine if student will be cited for
  underage
• drinking
• -- Judicial Affairs policy regarding
  violations

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Evaluative Measures

• Collect 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
  

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• 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

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Established timeline

• February 09submitted PLCB grant application
• August 09secure room for the program, establish
  polices, procedures, and protocols
• October 09develop brochures and letters to
  inform students and parents of program
• November 09recruit EMTs, disseminate program
  info campus-wide
• December 09send out letters and brochures to all
  parents, train EMTs, purchase equipment needed
  for program, hold meetings with local police
  depts

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• January 2010implement program
• May 2101analyze data to determine utilization
  and program effectiveness, write year-end report
• August 2010revise program if indicated by
  year-end report, include program info at FTCAP
  and freshmen orientation

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Submitted Proposal to Chancellor

• Submitted to her in February
• Approved by the Chancellor

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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
  900PM to
• 700 AM
• -- 500 hours that need to be covered in
  spring 10
• -- will be paid minimum wage
• Requesting money to cover costs of three hour
  training

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• The Beginning!!!

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• Thank You
• Please 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 [phone]
• Email esa11_at_psu.edu