Fighting Addiction
Dartmouth launches an innovative new program to deal with an age-old problem: substance abuse.
DRINKING AND DARTMOUTH HAVE long been engaged in an intricate dance. Despite the statistical truth that we are no different from other colleges, the skeptics persist—a steady stream of mothers of prospective students who ask campus tour guides if Dartmouth really is one never-ending toga party. Lesser known in the court of public opinion is the fact that the College has a proud history of alumni crusading against addictions. Robert Smith, class of 1902, co-founded Alcoholics Anonymous in 1935. Thanks to "Dr. Bob," today more than 2 million people in 150 countries are in recovery with AA. Certainly no one can overlook C. Everett Koop 37, whose legacy as U.S. Surgeon General is intertwined with the fight against tobacco. Even in Dartmouth's freshman years, Eleazar Wheelocks Mohegan protegee, Samson Occom, vehemently preached against the ills of drink in his 1772 broad-side, "Mr. Occom's Address to his Indian Brethren." Quoth Occom in one of 16 rhyming verses: "On level with the beasts and far below/ Are we when with strong drink we reeling go."
Lest the tradition fail, a newly formed group is aiming to further Dartmouth's efforts against alcohol and drug addiction. The Dartmouth Center on Addiction, Recovery & Education (DCARE), established in January 2002 with a two year, $310,000 grant from the provosts office, has quickly become an administrative nerve center for dozens of faculty and students. Projects include a proposed addiction treatment program at Dartmouth-Hitchcock Medical Center (DHMC), new courses on addiction for undergraduates and medical students, and pioneering research on methods of intervention for problem drinkers. Led by psychologist Mark McGovern and psychiatry research associate Gail Nelson, DCARE is backed by a 54-member planning council chaired by Dr. Koop and DHMC oncologist Joe O'Donnell. Notably, though, the council's members go well beyond the usual suspects from psychology and psychiatry to include professors of English and Russian, an undergraduate majoring in engineering and biology, Upper Valley residents and alumni. Their mission: to serve as resources for those seeking help or information, to connect and support the work already being done on campus, to encourage new faculty and student research, and to educate the next generation of Dr. Bobs and Dr. Koops—not because Dartmouth in par- ticular has a problem with addiction, but because at least 1 in 10 Americans does.
According to a National Institutes of Health report released lastyear,31 percent of college students nationally showed signs of alcohol abuse, and 6 percent met the criteria for alcohol dependence. (These studies, of course, are only as accurate as students are honest in reporting their own behavior on questionnaires.) Dartmouth surveys have shown figures consistent with those national averages.
In addition to serving students, DCARE is also in a position to fill a great community need. New Hampshire is among the top five states in per capita alcohol consumption, but ranks 48th in funding for addiction treatment. One of the centers first key projects is an intensive outpatient addiction treatment program based at DHMC, which McGovern hopes will open by fall and be funded by patient insurance. The program would bring in patients several evenings a week for four to six weeks, ideal for working people or those taking classes, and would simultaneously serve as a training site for Dartmouth Medical School students.
Another mission for DCARE is to seek better ways to help students who may be spiraling into addiction Just how many Dartmouth students meet those criteria is hard to estimate, although McGovern suspects 5 to 10 percent either have or will develop an addiction problem. This spring DCARE began testing a new way to confront students red-flagged by the deans office. The technique puts atrisk students through two one-hour individual counseling sessions to help them assess how drinking or drugs are impacting their lives. While most colleges favor a single class involving an overhead projector and the basic "This is your brain; this is your brain on alcohol" message, McGovern says such classes, while reasonable, have never been proven to have any impact. "We think our findings will help other colleges re-think their present approaches," he says.
McGovern, 47, who joined the faculty in 2001, has the clinical psychologist's skill for quiet observation and well-crafted insight. His specialty lies in treating high achievers, such as Dartmouth students, who pride themselves on setting and attaining goals. For them, McGovern explains, addiction carries an extra burden of guilt and shame. "They are the best and brightest, who've long been told they can accomplish anything," he says. "Showing any kind of vulnerability is horrifying."
While treatment and recovery is one component of its mission, the center shares the Colleges commitment to education. (DCARE itself grew out of a course called "Alcohol, Addiction, and Health," taught for 12 years by Nelson and a rotating group of lecturers from the sciences, humanities, Medical School and community.) So far the program has stimulated at least one undergraduate course. Anthropology professor Hoyt Alverson, with help from Tuck marketing professor Punam Keller, asked students in his "Introduction to Ethnographic Fieldwork" class to observe undergraduate social life and achieve a better understanding of where, how and why students drink.
How these courses and programs will impact students' lives may depend in part on funding. Money from the provost's office will run out at the end of 2003. In the future the center will need between $200,000 and $300,000 a year—or $6 to $8 million in a permanent endowment —to operate. And while McGovern is approaching foundations and applying for grants, the nature of the service-centered program "doesn't translate easily into research grant proposals," he says.
But he is driven by the hope that Dartmouth, dogged by a centuries-old reputation for hard drinking, could take the lead in teaching the world how to better prevent and treat substance abuse. For more information go to www.dartmouth.edu/~dcare/.
Good Medicine Mark McGovern believesthe College can develop health leadersin the mold of Dr. Koop and Dr. Bob.
JULIE SLOANE is a writer for Fortune Small Business magazine.
