Spring Break 2023: The Good, The BORG & the Ugly

It’s Spring Break Season! Parents, if you’re nervous about your college student’s pending #SB2023, you’re not alone. Although spring break partying is nothing new, the cultural normalization of over-the-top alcohol, drug and sexualized excess has taken things to a new level, exponentially magnified across social media. Let’s jump in with a few tips that can hopefully save your favorite young adult harm or heartache.

First, however, let me reassure you that roughly 20-30% of college students happily choose NOT to drink (or have sex or use drugs for that matter), AND approximately a third of college students drink quite responsibly. These young adults who abstain or limit indulgence often carry the somewhat self-imposed but very real burden of dealing with their overly intoxicated friends, which can be overwhelming and frankly, often sucks the fun out of their own experience. Additionally, these conscientious students can easily get in over their head as they try to help– especially because they feel obligated to be the problem-solver. If this is YOUR kid, please remind them they are not responsible for everyone else’s choices, and to seek help immediately when they are uncomfortable or simply unsure what to do. Meanwhile, let’s continue to encourage all young adults not to drink and drive (something this generation is way better about than their parents), and consider tucking an UBER or LYFT gift card to their midterm care package.


  • The scariest trend for SB2023 is the “BORG”- Black Out Rage Gallon. Students take a gallon jug, pour out half the water, then add in alcohol, electrolyte powders, flavoring and caffeine, finishing by writing a catchy “borg” name on the jug that marks it as only theirs. The concept is that this is harm reduction, eliminating shared drinks or opportunities for drink spiking. Now, if they left off the caffeine (which masks the early buzz of alcohol and makes people think they are less intoxicated than they are) AND only added a few (2-4) servings of alcohol, I would agree this is a better choice. Unfortunately, the standard recipe for BORGs includes adding a FIFTH of vodka- which is about 17 SHOTS. I don’t care if you take all day and night to consume that much, this is still very harmful and risky for severe alcohol toxicity, as well as the cascade of poor choices including accidents and sexual intimacy that often follow.
  • BLACK OUT does not mean “passed out” unconscious, it means that you raised your blood alcohol level so high, so quickly, that you turned off your brain’s ability to create long-term memories, so the next day you have permanent memory gaps- “black outs”- of minutes to hours from within your binge drinking. “Black out or back out” is the disturbing battle cry of young adults who routinely drink to excess, with many defiantly saying it doesn’t matter what happens if they don’t remember it. As a physician who has seen innumerable bad outcomes that do indeed matter (STDs, pregnancy, injuries, etc.) I beg to differ.
  • For those who choose to drink, I’d suggest sticking to single serving, self-contained drinks- a can of beer, hard seltzer, or wine (yes, wine comes in cans now.) These drinks have the advantage of knowing exactly what is in them (vs a hand-poured mixed drink) and unless these beverages are aggressively chugged, most people will self-regulate their consumption as they feel slowly buzzed and physically full, thus tending not to get super intoxicated. Shots, however, with their tiny volume, are simply consumed too fast and too often, which shoots your blood alcohol through the roof…and leads to potentially lethal alcohol toxicity and blackouts.
  • BEFORE the party, make an EXIT strategy! Make firm plans about when and with whom you are leaving, plus, have a CODE word within your friend group that means “I want to leave immediately,” no questions asked. If all else fails, “accidentally” spill a drink on yourself (or your overly intoxicated friend) and insist on leaving to get cleaned up.
  • Learn about DRUNKCALC.com where you can enter your gender, weight, hunger level (is your stomach full or not?), and specific drinks you consumed at what time, and get a realistic estimate of your blood alcohol level.


  • NEVER mix alcohol with pain pills like oxycodone or sedatives like Xanax or Valium- this is DEADLY. Learn more through the 525 Foundation.
  • Assume ALL pills you get outside of a pharmacy can be deadly- because most of them contain fentanyl, and you can’t tell which ones do or do not. Know that drug dealers have machines that make their pills look identical to FDA, down to the imprint. That “bar” of Xanax is even more dangerous than you think.
  • Fentanyl test strips may provide some harm reduction but know they do not test for the fentanyl derivative drugs like carfentanil, and they only check the portion of your drug that you tested.
  • Naloxone (Narcan) can be life-saving- learn about it and signs of opioid overdose on the AMA website.ALWAYS call 911 if you see someone unconscious, whether or not you administer naloxone.
  • Cannabis- many young adults have their first experience with THC products, especially edibles, on vacations to places where this is now legal. There is so much to say, I’m doing a whole post on this topic next. Short version- buyer, beware. Today’s weed is not your parents’ pot.


  • CONSENT: Any form of physical intimacy requires not just lack of “no”, but presence of freely given, enthusiastic, ongoing, verbalized consent.
  • If you are drunk, high, cross-faded, or otherwise impaired, you cannot give consent.
  • When someone is “blackout” drunk, they MAY NOT initially appear impaired, meaning they may not have slurred speech, staggering, etc. If you are intimate with this person and their brain is not creating memories, they will also have NO MEMORY of whether or not they gave consent. 
  • Take home message, as well-stated by attorney Jonathan Cristall, author of “What They Don’t Teach Teens”, is that if you are even remotely questioning whether or not someone might be intoxicated, assume they ARE impaired and therefore, unable to consent.
  • Birth control pills are most effective when taken the same time every day. Many pills are missed, delayed, or even vomited in prolonged party situations like spring break.
  • Condoms are excellent protection against STDs…when they are used, and used consistently. The most common failure of condoms is not breakage but lack of use. This includes oral sex (yes, that’s why flavored condoms were invented.) And yes, you can get STDs like genital herpes from receiving oral sex if there is no barrier.
  • Young adults are generally very fertile. If you choose to be sexually active, use two forms of birth control if conception is possible (like the pill and condoms).

BOTTOM LINE: Wishing every college student a fun, SAFE and relaxing Spring Break 2023- an ounce of prevention is worth at least a pound of cure!

  1. If you’d like to learn more about any of these topics or the many injuries, accidents and anxieties that relate to young adults, please check out the 2nd edition of my award-winning passion project, The ULTIMATE College Student Health Handbook, which is celebrating its book birthday today!

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