U NIVERSITY OF W YOMING S E XPERIENCE WITH ( OUT ) M EDICAL A MNESTY Lena Edmunds, MPH, CHES AWARE Program Coordinator

M EDICAL A MNESTY J OURNEY AT UW Process that lasted nearly 1 ½ years (Nov 2006 to March 2008) Student-initiated discussions about Medical Amnesty began in November 2006 Very controversial subject and coalition divided Formed a sub-committee, reviewed other policies, collected UW-specific data, consulted with other schools, presented to student government Ultimately agreed on a resolution not to pursue a medical amnesty policy at UW

U NIVERSITY OF W YOMING Public land grant university Only 4-year institution of higher education in Wyoming Approximately 10,000 students Located in southeast corner of Wyoming, in Laramie, population 29,000. Student Health Service on campus open M-F, 8-5 Campus police department with sworn officers

A LCOHOL I SSUES AT UW Sources: National College Health Assessment, Spring 2007, 2007 Wyoming Association of Sheriffs and Chiefs of Police, May 2007

A LCOHOL I SSUES AT UW C ONT D Average of 298 students per year referred to AWARE Program for alcohol education/prevention services Hospital emergency room admissions: Nearly half of people admitted to ER for alcohol poisoning in 2005 were UW students Eighteen percent were under age 21

A LCOHOL V IOLATIONS AT UW Student receives ticket from UWPD, and/or Judicial file started, student sanctions include: paper, community service, AWARE Program Student receives ticket Referred to AWARE by local judge Sometimes judicial consequences On-CampusOff-Campus

A-T EAM C OALITION A-Team Campus-Community Coalition Membership includes students, staff, administrators, community members Mission: develop, recommend, and assess best practices in policy, prevention/intervention, and enforcement to reduce underage drinking and excessive alcohol use

S TEP O NE : R ESEARCH Findings: field lacks adequate research about medical amnesty policies Decision: survey UW students to help make data- driven decisions

UW S TUDENT S URVEY R ESULTS Questions added to NCHA, administered to a random, stratified sample in Spring 2007 N=336 (18-20 year olds) 83.3% had taken care of a drunken friend in last 12 months 14.9% thought about calling for medical help 12% actually called for medical help

R ESULTS, CONT D Didnt call: Didnt want to get that person in trouble (24.5%) Didnt want to get self in trouble (20.4%) Wasnt sure person was sick enough (60.0%) Repeatedly checked on person (80%) Turned the person on his/her side and left him/her alone (29.2%) I made sure I stayed with the person (69.4%)

C OMMENTS This kid had done it before, so we rolled him half in, half outta the shower and checked up on him from time to time. People get drunk all the time, they dont necessarily need to go to the hospital. I am trained for first aid and CPR. She wasnt that sick. He can handle his own, and the bar still served him so…

S TEP 2: R EVIEW P OLICIES School policies Cornell, University of Pennsylvania, Emory, Hanover College, Keystone College, Lafayette College, Dartmouth, University of Colorado-Boulder, College of William and Mary State legislation Colorado: House Bill (6/3/2005) North Dakota (Century Code Title 5. Alcoholic Beverages Chapter )

C OLORADO L EGISLATION An underage person and one or two other persons shall be immune from criminal prosecution…if they establish the following: One of the underage persons called 911 and reported that another underage person was in need of medical assistance due to alcohol consumption The underage person who called 911 and, if applicable, one or two other persons acting in concert with the underage person who called 911 provided their names to the 911 operator

C OLORADO L EGISLATION C ONT D The underage person was the first person to make the 911 report; and The underage person and, if applicable, one or two other persons…remained on the scene with the underage person in need of medical assistance until assistance arrived and cooperated with medical assistance and law enforcement personnel on the scene.

N ORTH D AKOTA Similar to Colorados legislation Maximum number of individuals that may be immune for any one occurrence is five, including the person in need of medical assistance

O THER SCHOOLS More private than public Twenty-four hour health service on campus No formal judicial/disciplinary actions taken, but conditions Can still receive legal consequences Does not preclude disciplinary action regarding other conduct violations (i.e. property damage, assault, etc.)

S TEP 3: P RESENTATIONS A-Tem Presentation to UW student government Invitation to attend presentation by Ft. Collins PD Very little interest expressed Presentation by City of Ft. Collins Police Officers (home to Colorado State University) to A-Team (Dec 2007) Very few instances where it has been used (less than 50 since June 2005), mostly officer-instigated Not well known among officers nor underage individuals Poor student involvement/interest

M ORE Q UESTIONS THAN A NSWERS Jurisdiction? (campus, city, county, state) Definition of Trouble? Amnesty from what? No ticket? No judicial sanctions? No education? Who? (Intoxicated student? Student who called? Others?) Legal versus judicial? Changes in state statutes? Officer discretion?

C ONCLUSIONS Process brought many constituencies together to agree on a resolution Written report of findings Increased education on signs/symptoms of alcohol poisoning Social marketing on importance of seeking help for a dangerously intoxicated person If policy were pursued, should be spearheaded by students Should be a statewide initiative, pushed through the Wyoming legislature

UW W ITHOUT M EDICAL A MNESTY Student transported to hospital Sometimes given a ticket, sometimes not If on campus, a judicial file is opened and they are sanctioned to receive educational services through AWARE Program

U NANTICIPATED P OSITIVE OUTCOMES AND F UTURE D IRECTIONS More people on board that became experts Came to agreement on a controversial subject Educational process for all Future medical amnesty possibility? Increased education on alcohol poisoning signs Will continue to collect data with NCHA survey Discussion among senior administrators, legal counsel

M EDICAL A MNESTY P OLICY A SSUMPTIONS Students can identify symptoms of alcohol poisoning Students understand the risk associated with the symptoms of alcohol poisoning Students responsible for help-seeking are sober enough to adequately judge the level of risk involved Students are currently not calling for help due to fear of getting in trouble with the university Students will be more likely to call for help if they are assured that they will not get in trouble. Source: Oster-Aaland and Eighmy (2007). Medical Amnesty Policies: Research is Needed. NASPA Journal, Vol. 44, no. 4.

C ONTACT I NFORMATION Lena Edmunds, MPH, CHES AWARE Program Coordinator University of Wyoming 1000 E. University Ave., Dept Laramie, WY Phone: (307)