The Deadly Drinking Mistakes Smart Girls Make

How could a girl who hardly ever partied end up dead after one night of overindulging? What Happened? and how does this affect you? Cosmo investigates...

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Laura Treanor didn't really want to go out that January night. She had been plagued by a headache for the past week, but it was hard not to be swept up by the good times: Her friends, classmates, and sorority sisters were all still feeling celebratory about the inauguration of Barack Obama two days earlier. And being a sophomore at George Washington University, in Washington, D.C., meant all the excitement was practically in her backyard.

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So Laura, 19, decided to have a glass or two of champagne with a roommate and then tag along to the popular hangout spot Adams Mill Bar and Grill. Before departing, Laura-an aspiring journalist and contributing editor to the school's paper, GW Hatchet-called her folks in Yorktown Heights, New York, a northern suburb of Manhattan, around 9 p.m.

Her mother, Ann-Marie, was working out on the treadmill when Laura called, so she only spoke to her father. "I'm having a hard time getting on that thing now," says Ann-Marie, "because I'm reminded of how I didn't say good-bye…good night to Laura."

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Of course, she had no way of knowing the tragic turn her daughter's life would take that night. After reportedly having two drinks at the bar, Laura and a friend returned to their campus resi dence hall just after 2 a.m. A security camera video shows Laura entering the building after searching her purse for her keys. Her mother has seen the tapes and says Laura looks fine- not unsteady or unco-ordinated.

According to what a close friend told Ann-Marie, Laura stopped off at another room on a different floor in the tower. But no one is quite sure whether she had anything more to drink there or exactly when she left to return to her room. This is what is known: The next morning, a roommate called 911 after she couldn't wake Laura. She had died in her bed during the night.

It took the medical examiner three months to figure out what had killed Laura. There were no obvious signs, and her family wondered if perhaps it was tied to the headaches and fatigue she'd mentioned. Finally, in late April, the findings were released: The cause of death was acute alcohol intoxication. Laura's blood alcohol content (BAC) was 0.29-more than three-and-a-half times the legal limit for driving and equal to roughly seven to nine drinks for a 120-pound woman.

"I don't understand how this all happened," her mother says. "Laura was not a drinker. She might've had a drink at New Year's Eve or something, but she didn't seek it out." Of course, parents don't always know the whole story, but there were no signs that Laura had been a frequent heavy drinker.

If she didn't have the occasional beer or cocktail, she was an exception among college-age women. Almost two-thirds of young adults ages 18 to 20 and more than three-quarters of those 21 to 24 are current drinkers, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Because drinking is so rampant (and legal at 21), it can be easy to forget that alcohol is a drug-a potentially lethal one. And it's been claiming even more young victims over the past decade. According to a recent NIAAA report, drinking-related deaths in the 18-to-24 age-group have increased steadily since 1998, along with binge drinking.

That last bit's a no-brainer, right? If you regularly pound drinks, of course alcohol poisoning will be a danger. But here's the ironic thing: Being a light or inexperienced drinker can actually put you more at risk. "You don't need to have a long-standing history of alcoholism to experience this horrible consequence," explains Jason Powers, M.D., chief medical officer at a group of rehab centers throughout Texas. "It can happen with the first use." Here's what you need to know about how and why alcohol can kill... And how you can keep yourself safe.

PARTYING UNTIL THEY DROP

One night in October two years ago, Minnesota State student Amanda Jax celebrated her 21st birthday by partying with friends. They started out with a couple of rounds of beers at an apartment, then headed to a bar. What followed was a staggering mix of drinks consumed in under two hours: more beer, a shot of whiskey, a shot of rum, three additional shots of hard liquor, a shared pitcher of Long Island iced tea, and a cocktail called a cherry bomb - cherry vodka mixed with an energy drink.

Amanda passed out in a friend's apartment and was dead by morning. The cause of death was acute alcohol poisoning; her BAC was 0.46, almost six times the legal driving limit. That level is beyond what researchers call Lethal Dose 50, or LD50, which is around 0.4 BAC and the point at which about 50 percent of drinkers would die, says Scott T. Walters, Ph.D., associate professor of health promotion and behavioral sciences at the University of Texas School of Public Health.

How you react to alcohol is very individual, so there's not one universal formula. First, your genes play a role. "Some people come to the table with a faster engine," Walters says, meaning they metabolise alcohol more quickly than others. Because it speeds out of their system, they can drink more without getting toxic. Gender and weight are also involved. Women are not only usually smaller than men, but they also have a higher fattowater ratio, explains Walters. In other words, the alcohol has less space to hang out in women's bodies. Instead, it remains concentrated.

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That's why for women, binge drinking is defined as having four or more drinks in about two hours, but for men, it's five drinks. Reaching LD50 requires a major binge: "A 120pound woman would have to consume 10 drinks in an hour," Walters says. "That's a 12pack of beer or three to four Long Island iced teas."

You'd think it would be easy to steer clear of the LD50 zone by pacing yourself and slowing down when you start feeling out of it. But this is where drinking hi s tor y becomes very important, says Walters. The risks of alcohol poisoning are higher for novice drinkers in part because they don't know their limit... Or the telltale signs that it's time to quit.

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Amanda's case shows how easy it is for all these factors to spiral out of control. According to a lawsuit filed by Amanda's parents against her bar buddies, she didn't purchase one drink. It says her friends supplied a steady, lethal flow of alcohol to the 100pound prenursing student. Even after she was obviously intoxicated, the suit says, her friends continued to ply her with alcohol. Reports say that Amanda passed out at the bar and had to be carried out to a car by a friend.

YOUR BODY ON A BINGE

Drinking, whether a little or a lot, is a wholebody experience. It starts in the liver, says Dr Powers, where you process about one drink per hour. If you keep it to that, you will probably get a little buzzed but not intoxicated. Start slamming back drinks faster, though, and your body doesn't have time to process all the alcohol, so there is a higher amount circulating through your body, including around your brain and vital organs.

The first signs of that are those classic wasted symptoms: loss of inhibitions and euphoria, followed by lack of coordination, disorientation, and slurred speech. Keep imbibing and alcohol starts affecting nerves and critical systems that regulate the big stuff: your heartbeat and breathing.

Eventually, too much alcohol in the blood can prompt a complete shutdown of the respiratory center in your lower brainstem. End result: You are in a coma and stop breathing. You have about six minutes before the lack of oxygen to your brain leads to the breakdown of body systems and permanent neurological damage. Pretty soon, your heart stops, and you die.

That's one way it can happen. Another involves the digestive system, because alcohol is a stomach irritant that can cause vomiting, says Mary Claire O'Brien, M.D., associate professor of emergency medicine at the Wake Forest University School of Medicine. And throwing up while you are drunk can be deadly.

This past spring in Allendale, Michigan, Grand Valley State student Linzy Duvall, 21, went out for dinner and drinks with friends on a Friday night. Like Laura, she wasn't known as much of a drinker. After hitting a few bars and having some drinks , Linzy and her boyfriend headed back to her place. The next morning, Linzy woke up feeling lethargic. She vomited and went back to bed, her boyfriend told police.

He then left her off-campus apartment to get food. When he came back, Linzy was dead. The medical examin er reported that she died of aspiration pneu monia due to alcohol intoxication-she had vomited in her sleep and inhaled it into her lungs. If your blood alcohol gets high enough, explains Dr O'Brien, it suppresses your gag reflex. ("What con stitutes high enough var ies from person to person," she adds.) If you pass out and throw up, you could choke on your own vomit.

KILLER COCKTAIL

A new trend is raising the risks of drinking even more: combining alcohol and energy drinks. Dr O'Brien's research shows that 1 in 4 college drinkers is doing it and those who do get drunk twice as often per week as those who just drink alcohol. "Energy drinks ameliorate the sensation of drunkenness," she says. "You are drinking, and you feel okay, so you keep drinking."

A 2006 study compared male volunteers who drank either straight alcohol or energy-drink-infused cocktails over a short period of time. The energy-drink group reported feeling much less intoxicated than the plain-alcohol group did... But the groups performed equally poorly on physical tests and had the same breath-alcohol content. "In other words, you have an awake drunk," Dr O'Brien says.

That not-drunk feeling is especially dangerous because there's a time lag with alcohol: After you stop for the night, your BAC keeps rising as you process the liquor in your stomach. An example is Jell-O shots, Dr. O'Brien says. The alcohol in the Jell-O is still being absorbed from the stomach and circulating… Even if you've passed out.

Whether Laura had any energy-drink cocktails-or even how much she drank besides the champagne-remains unclear. But for her family and friends, the details hardly matter anymore. All they know is that the smart, radiant, much-loved girl is gone-lost to one night of fun. Messages posted to her Facebook page attest to how she will be forever missed.

"Hi, Laura," begins a recent wall note from her mother. "Thinking of you as always. Daddy and I planted tomatoes and peppers. Two of your favourite foods. [Your sister] Margaret went to the pool yesterday, and [your brother] Kevin went to a BBQ. Other than that, the house was empty without you."

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