Kinara Patel started to drink. The fall semester at Villanova University had just begun, and Patel, an 18-year-old business major, had returned to the Philadelphia-area school for her sophomore year.

She met up with friends at an off-campus party and then at a nearby pub, where she flashed a fake ID, a police investigation would find. Her last stop was a male friend's room in a neighboring dorm, where she crashed on a futon at 2 a.m. When a friend went to wake her for class, her skin was cold, her lips bluish. She had died of alcohol poisoning.

Patel's memorial, held in the Gothic cathedral at the center of Villanova's campus, drew so many students, faculty, and staff that a line spilled out of the church. "We come together to mourn Kinara, but also to celebrate who she was with us," eulogized Rev. Peter M. Donohue, Villanova's president. "This is not supposed to happen to someone so young."

Yet it keeps happening. The same month Patel died, 19-year-old Rachael Fiege, before she had even attended a class at Indiana University, died of a brain injury after falling down a steep flight of stairs at an off-campus party. She hadn't been binge drinking, but her friends mistakenly assumed she had passed out and waited hours before calling for help. Last August, Jiaya Dai, 19, died of alcohol poisoning only days after arriving at Michigan State University, reportedly after playing a drinking game. A month later, 19-year-old Caitlyn Kovacs died at Rutgers University. News reports say she was at a Delta Kappa Epsilon party when friends realized she was in trouble and rushed her to a hospital.

Binge drinking — often defined for women as four or more drinks in a row — has remained stubbornly high for at least two decades on campus. (One group of college presidents has argued it developed after the drinking age was raised to 21, driving alcohol underground.) Thirty-five percent of students reported binge drinking in 2014, according to a University of Michigan survey.

Thousands of them are landing in the ER. Alcohol-related hospitalizations among college students soared by 70 percent in recent years, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA). A 2015 study found that an average of 113 15- to 24-year-olds die each year directly of alcohol poisoning. "That's a lot of women we are losing in their prime age," says study author Dafna Kanny, Ph.D., senior scientist of the alcohol program at the Centers for Disease Control and Prevention.

Whereas college students 20 years ago mostly drank beer, they now favor harder stuff. In particular, the trend in flavored alcoholic beverages — hard lemonade and other malt drinks, ready-to-drink cocktails, and supersize alcopops — is fueling excess drinking, according to a 2015 study in the American Journal of Public Health. That's mirroring what law enforcement is seeing on campus, says Jack Whelan, the district attorney of Delaware County in Pennsylvania who reviewed Kinara Patel's case. "It's going down like candy," he says. "I don't think kids realize this kind of drinking can lead to death."

The habit also raises the risk for unwanted pregnancy, injuries from falling off balconies or being struck by a car, sexually transmitted diseases, and most strikingly, sexual assault. Yet steps to curtail heavy drinking are being tied to sexual violence in ways that many young women find troubling.

In January, Dartmouth College announced a campus-wide ban on hard liquor after reports of hazing and sexual assaults. Like efforts at other campuses, the ban seemed to imply that if only women didn't drink, they wouldn't be raped. Equally unsettling, the policy seemed to give a pass to men. "It blames alcohol for assaults and not the people responsible," says Julia Dressel, a Dartmouth junior and former student assembly vice president. Activists also believe such bans could discourage rape victims who'd been drinking from making a report.

All of which makes binge drinking a difficult topic to talk about, much less change. Colleges are trying various strategies to confront the issue, from education and amnesty to cracking down on rule-breakers. But is any of it really changing drinking habits? What would?

Students drink the most during their first six weeks of freshman year, according to the NIAAA. "As a freshman, you have expectations that college is absolutely crazy and you have to drink as much as you can, whenever you can," says Ariana Terman, 22, a recent graduate of Indiana University. "As college goes on, you come to realize it's not the end of the world not to be crazy drunk at every party."

"Freshman year, we had no worries, no responsibilities, and the ultimate freedom from home. We also had no friends, which means more reason to do whatever it takes to establish a friend group," agrees Lina LeGare, 21, a senior at the University of South Carolina. New students also have less experience with drinking, says Jessie Webster, 20, a junior at the University of Illinois at Urbana-Champaign. "If freshmen drank in high school, it was like this big secret. They get to college where everyone is encouraging them to drink openly, and they just go nuts."

Drinking can be liquid courage, a bonding experience, or stress relief in an intense time. "I would consider myself a hard worker, so honestly I find it enjoyable to let loose," says Kayla Breeden, a 22-year-old senior at Ohio University. "As bad as it is to admit, I also feel there is a sense of comfort in being drunk. You don't have to feel stupid — or as stupid — for saying or doing something you would regret because alcohol is to blame, not you."

Students say they don't always set out to binge. But when so much of university social life — frat parties, concerts, formals — revolves around drinking, it becomes normalized. "During football season, if you don't have a red Solo cup in your hand during the whole game, you feel out of place," says Stephanie Lacayo, 23, a University of Georgia grad who also attended Florida State University.

Often, the person handing you the cup is male. If a woman stops by a guy's room, she's offered alcohol, students say; the reverse is less likely. And even now, in the 21st century, national sorority rules forbid women from having alcohol at social events in their houses. "That means sorority sisters go to fraternities, so they're in a male-dominated space and they are always a guest," says Eliana Piper, the 2014 president of the Panhellenic Council at Dartmouth. "That contributes to a lot of unfair power hierarchy." A task force at the University of Oregon last year found that sorority sisters at the school are far more likely than non-Greek women to have been raped.

Some sorority members praise the systems in place to ensure members don't drink too much — for example, agreeing on code words or pairing up girls at events. Many houses have a "sober monitor" program that requires some percentage of members to abstain at events, notes Julie Johnson, Panhellenics chairman of the National Panhellenic Conference, the umbrella group for 26 sororities.

Johnson argues that women do have the power to choose how and where they socialize. "Events held at men's fraternities are generally cosponsored with a sorority, and the women have a substantial influence in setting the tone," she says. If the balance of power is unequal, she suggests, the solution might be to throw parties at a third-party venue.

In winter 2014, Piper and four other leaders of the Dartmouth Panhellenic Council sent an extraordinary email to the campus listserv. They announced they'd be boycotting rush and condemned the culture of drinking and sexual assault. "We didn't want to bring more women into the system before we think it's a safer place to be," she says.

When Piper pressed send on the email at 3 a.m., she and her sisters feared a huge backlash. The previous spring, Dartmouth women had protested sexual assault, and received rape and death threats from fellow students. But instead of threats, Piper got hundreds of emails from women in sororities, thanking them for validating their experiences.

Last fall, the Student and Presidential Committee on Sexual Assault at Dartmouth recommended that sororities go "local," shedding ties with national groups so they can set their own rules, including on serving alcohol. Dressel, whose chapter of Sigma Delta is local, is helping lead the campaign. "I can invite people into that space and also ask people to leave," she says. "It's a place that is controlled by women. And that is pretty rare on this campus."

School administrators searching for a way to control drinking face an uphill battle, as students admit. "Binge drinking has become part of the American college experience for a lot of people," says Webster, the University of Illinois junior. "We see it in movies and TV shows and hear about it in songs, and it's something a lot of people feel they need to do at least once or they didn't do college right."

Students tend to view drinking "like a weekend in Vegas," says Toben Nelson, an associate professor of epidemiology and community health at the University of Minnesota who studies college drinking. "They think the general standards of society don't apply in their protected bubble." That might be why campaigns to highlight the dangers of overdoing it — posters on campus, online courses, bystander intervention training — aren't especially effective.

After Caitlyn Kovacs died, Rutgers withdrew recognition of Delta Kappa Epsilon and launched reviews of five other houses for incidents involving alcohol. In March, most North Carolina State University fraternities temporarily suspended events with alcohol. In addition to banning liquor, Dartmouth's president warned that student groups who misbehave "will not be a part of our community."

But it's not clear that hard-alcohol bans work either. At least nine colleges have tried them, and the results seem to be mixed. Bates College instituted a ban in 2001; in 2010, 34 students at the small Maine school went to the hospital for alcohol poisoning.

Students say strict policies can backfire in unintended ways. In the fall of 2011 at Occidental College, in Los Angeles, eight people were rushed to the hospital after getting drunk before a school dance at which no alcohol was served. "Because there were strict rules, kids would take shots in the dorms really fast, afraid of being caught," says a student who was at the college then. "Then they'd walk to the dance, and there'd be a story about someone who fell. Ambulances came on campus pretty much every dance I went to. If you provide a safe campus where students can drink and feel they're not going to be judged or penalized, that would have been a better dynamic." Occidental does regularly hold events with alcohol for students 21 and over, notes Jim Tranquada, Occidental's director of communications. After the 2011 episode, which was unique in its size, the campus put a moratorium on dances for the 2013–2014 school year, and six dances were held during the past year without incident.

Students say fear of discipline might make them think twice about calling for help if a friend was dangerously drunk. "I would call authorities now, but honestly, before I was 21, I probably would have been a little more hesitant," says Brittany Tate, 23, a 2014 graduate of NCSU. Some schools have experimented with amnesty — if you get caught drinking or sent to the hospital, you don't get in trouble. In response to Rachael Fiege's death at Indiana University, her mother Angela — an ER doctor — founded Rachael's First Week, which raises awareness of freshman-year risks and urges students to get help. "Our school has educated us that neither the victim nor the witness will get in trouble for calling an ambulance," says IU senior Lucy Valencia, 21.

Still, asking coeds with no training to assess the situation is asking a lot. Sarah Corsa, a resident adviser at Occidental, found this out last spring. After a concert, students walked a sophomore who had been vomiting to the dorm. "I didn't know if she was OK," Corsa says. "It's really hard to tell." Corsa called her supervisor, who called a campus safety officer, who urged her to call the paramedics.

The most effective ways to keep drinking in check, it turns out, are not campus policies but state laws. In 2005, Nelson authored a study that looked at 10,000 college students in 40 states. The results were striking: Binge drinking, on and off campus, was lower in states with stricter laws and more money and manpower to enforce them. The study cited restrictions on drunk driving, keg sales, happy hours, open containers, pitchers, and advertising. Penalizing bars that overserve also helps, Nelson says, because business incentives for selling alcohol are high.

Schools want to do something for their campus, Nelson says, but what really matters is the availability of alcohol in the broader society. Pointing fingers at students — and no one else — won't solve the problem. "Our society thinks of alcohol as fun, it's a driver of economic development, it's a social lubricant that helps you meet more people — and all those things are true," Nelson says. "But it's also a dangerous substance with a wide range of negative consequences. The more we say it's no big deal, the more the negative consequences will happen."

This article was originally published as "What the Hell Happened Last Night? " in the October 2015 issue of Cosmopolitan. Click here to subscribe to the digital edition!

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