By Amanda Mears

May 8, 2008 | For many college students, drinking is a rite of passage and a common sight at 21st birthday celebrations.

However, for Karen Johnson, a junior majoring in graphic design, it turned into something much more dangerous.

Johnson, who asked that her real name not be used to protect her identity, was celebrating a friend's 21st birthday when she noticed he was unresponsive and passing out.

"He got really, really sick, like the sickest I have seen someone," Johnson said. "It was scary. We called 911, but some of us were underage so we ran."

The night didn't end there for 20-year-old Johnson, who said she later got a phone call from a friend who had been put in jail and needed to be bailed out.

"I had to go round up enough money to bail him out and the whole time I was stressed about our friend who had to go to the hospital," Johnson said. "It was probably the worst night of my life."

Johnson said she later heard that her friend was attempting to take 21 shots that night in honor of his birthday.

"I've heard about people doing it, but I didn't think he would be so stupid," Johnson said, referring to the drinking ritual that is gaining notoriety amongst college crowds.

One look at the popular networking site Facebook reveals exactly how prevalent the game is becoming on college campuses. Photo albums put up daily feature freshly-21 girls taking their first shot at 8:31 a.m. and not stopping until late that evening. Others display smiling boys pounding drink after drink until the final picture of them, red-eyed and sick looking, flashes in progression. With titles like "21 for my 21st!!!!!!!!!!!" and "So Drunk I Almost Died", these pictures downplay the seriousness of students taking binge drinking to a whole new level.

Web sites like YouTube and MySpace are also popularizing the drinking ritual by hosting dozens of videos that feature drunken students attempting to consume 21 drinks in an hour. A quick search for "21 shots" returns over 3,200 hits, a tribute to the rising trend that could prove to be much more dangerous than just binge drinking.

In an article for the New York Times, Tara Parker-Pope tells the story of 21-year-old Jesse Drews who passed away on his birthday due to binge drinking. Although reports of how much alcohol Drews consumed vary, friends say he was most likely attempting to take 21 shots. At the time of his death, Drews was unresponsive and a hospital test showed a blood alcohol level of 0.38.

Although Drews story is tragic, research shows that the circumstance is not an unlikely one. According to one study done at the University of Missouri-Columbia that was published in The Journal of Consulting and Clinical Psychology, 34 percent of the men and 24 percent of the women who are in college and drank alcohol to celebrate their 21st birthdays reported consuming 21 or more drinks in the span of one night.

Johnson said that even though some of her friends choose to space out the 21 shots throughout the day, she noted that others try to fit as many in as possible on the night of their birthday.

"It's stupid," Johnson said, "but I'm still going to drink on my 21st birthday. I just don't want to get so drunk that people have to take care of me."

Although Johnson said she would not be doing 21 shots on her upcoming birthday, she admits that she is worried about going overboard and ending up in a risky situation. "I tell myself I won't drink that much, but it's hard to remember that when you get caught up in partying," Johnson said.

After watching her friends participate in dangerous behavior, Johnson said she is more likely to be conscious about how much she drinks.

"It's scary to watch people in danger of alcohol poisoning and I don't ever want that to be me," Johnson said.

According to Parker-Pope, alcohol poisoning is one of the biggest worries about the ritual of "21 on 21". She writes that the body's ability to metabolize alcohol depends on several factors, including gender, weight, the type of alcohol, whether the person vomits during the binge and the time period during which the drinks are consumed. But in some cases, as few as 10 drinks can cause blood- alcohol levels to reach 0.30, at which point the respiratory system slows so much that death is a very real possibility.

Clayton Neighbors, associate professor of psychiatry and behavioral sciences at the University of Washington Center for the Study of Health and Risk Behaviors in Seattle, created a study similar to the study conducted at the University of Missouri-Columbia.

"We asked everyone who was turning 21 to be in the study, and incorporated a web-based feedback program in which the students log on and we ask them questions relating to their 21st birthday," Neighbors said. "We show them that it's not as common as they think it is."

Neighbors said he sent the questionnaire out a few days before the students' 21st birthdays and randomly provided additional information to some of the participants who were more likely to drink. The information included drinking statistics and info on the dangers of excessive drinking.

What he found was that the students who received feedback were more likely to have a change or difference in opinion about binge drinking on their 21st birthdays. "We gave them info on how much people actually drink, and found that it's not as much as they think they do," he said. "We're not trying to get students not to drink, but to just be safe."

Neighbors said one of the goals of the study is to try and stop students from drinking too much on their 21st birthdays since it can lead to severe consequences.

In an article for the University of Delaware Review, Neighbors said when he started the study he saw a young man end up in a coma on his 21st. That very same week, a woman ended up in the hospital with alcohol poisoning.

"Students don't realize that a certain amount of alcohol can kill you. A lot of what we're trying to do is educate them about blood alcohol concentration, and it worked," Neighbors said.

Torri Sant, a senior at USU, said she has seen plenty of her friends celebrate by drinking but has not witnessed anyone participating in the ritual of taking 21 shots on their 21st birthday.

With the drinking ritual on the rise, however, she agrees that it is probably not long before it hits campus in a big way.

In order to have a safe 21st birthday celebration, students should watch how many drinks they consume and even do a little bit of research to find out how much alcohol they can safely and legally have.

Charts such as the one found at http://www.brad21.com, measure how many drinks it takes for someone of a certain weight to reach the legal limit. For example, it takes a 120-pound woman only 10 drinks to reach a dangerous 0.38 blood alcohol level and the same number of drinks to incapacitate a 140-pound man and result in a 0.27 blood alcohol level.

The site was founded in honor of Bradley McCue, a Michigan State University junior who died of alcohol poisoning after celebrating his 21st birthday, and is just one more reason for students to watch how much they are drinking.

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