Managing Mayhem: How Doctors Handle Seasonal Chaos

Dr. Frederick Epstein, chair of emergency medicine at Bay Medical Center in Panama City, Fla., a popular spring break city, is ready for the onslaught. Between the end of February and the end of April, 400,000 students will descend on his resort town of just more than 100,000 residents for spring break. And when it is over, Epstein will be burned out from the thousands who come through his emergency department. "We brace emotionally, and I'm very happy when they're all gone."

Spring break is not likely to be eliminated, even as host cities wrestle with its existence. It is a vital part of the local economy. Still, Fort Lauderdale shut down spring break in the late '80s, and Daytona Beach also may be souring on the event.

One study published in the Journal of American College Health (1998;46(6)247-255) found the average male has 18 alcoholic drinks per day, and the average female has 10 drinks per day during their spring holiday. Half of all males, and 40 percent of females drank to the point of vomiting or passing out at least once. Excessive alcohol use is a concern not just for its own sake, but because of the behavior to which it leads, such as unsafe sex. Unpublished research by lead author George Smeaton, Ph.D., and surveys by a condom manufacturer suggest that, although sexual activity during spring break may be lower than on campus, condom use is also significantly less. A sizable number of women surveyed by Smeaton reported being victims of sexual aggression.

Students eventually return to their primary care physicians. "We deal with a lot of orthopedic issues and illnesses that they may have contracted while they were away, sexually transmitted diseases and unwanted, unintended pregnancy," said Dr. Jon Porter of the University of Vermont's student health center. "We try to tell kids to be moderate with alcohol and use sunscreen," said Dr. Patricia Chandler of the University of Texas Southwestern Medical School. "Education is the main thing. That and making condoms available."

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