Temporal Trends of Alcohol-Related Visits to the Emergency Department in the Collegiate Population

Young U.S. adults are drinking less compared to decades prior. However, according to the 2023 NSDUH survey, 29 percent of male and 28 percent of female full-time college students engaged in binge drinking during the past month. This study aimed to characterize the temporal distribution of alcohol-related emergency department (ED) visits among college students.

We reviewed collegiate student visits to a university-affiliated ED between 2018 and 2023. We compared temporal patterns of alcohol and non-alcohol related visits by day of the week and hour of the day. We characterized periods of high alcohol-related ED utilization using a temporal window–based density analysis across three resolutions: 24-hour, 48-hour, and 72-hour intervals. The total number of alcohol-related ED events falling within each window was computed using an exhaustive rolling-count algorithm. Windows were then ranked by event count to identify the top 95th percentile for each time horizon. Data were analyzed using Python, with the SciKit-Learn and NumPy libraries.

During the study period, 9809 collegiate student ED visits were documented with 9.7% associated with an alcohol diagnosis. When evaluating temporal patterns of alcohol-related ED visits by day of the week, 85.1% occurred on Friday, Saturday, or Sunday, compared to a more uniform distribution of non-alcohol visits. Alcohol-related visits were more likely to occur on weekends than weekdays (OR = 5.8, 95% CI = 5.3–6.4, p < 0.001). A similar skew was observed by hour of day, with 60.7% of alcohol events occurring during 0000-0200, representing an increased likelihood relative to non-alcohol events (OR = 6.9, 95% CI = 6.2–7.7, p < 0.001). Analysis of alcohol visits revealed patterns of incidence clustered mostly around university home football games (40%), the first and last weekend of semesters (27%), Halloween (17%) and identified Greek life-related events (10%).

Our study shows clear, predictable patterns in alcohol-related ED visits through temporal analysis. Recognizing these predictable surges can inform proactive ED staffing and resource allocation to better match anticipated demand. Additionally, these findings suggest that university-affiliated EDs should partner with university student affairs professionals to deliver targeted public education to university students.