Emergency room doctor Louis Profeta wants college students to know what happens the day after someone spends the night drinking too much.

He describes a dorm room where the smell of feces and urine fills the air and how a roommate trips over his fraternity brother, now lying dead on the floor after a night of five vodka slammers, one after another.

"Dead, waxy, with rock-still, clouded eyes ... you could never envision a stare so distant," Profeta writes on his blog. "You played pickup basketball yesterday at the campus rec center and … now, he is so still, laying among the pile of yet-to-be-washed clothes or wrapped up in a blanket on a [urine]-soaked IKEA futon delivered to him last week."

Profeta sees students come through the emergency department of Saint Vincent's Medical Center in Indianapolis too often, he said. He understands the agony parents feel when their child's life is in peril.

"We're the ones who have to tell the parents how these kids die," Profeta said.

So, he talks with groups of young people and writes about extreme drinking and drugs, describing the scene in detail and hoping they will sidestep tragedy.

"I would tell their mom and dad that they were dead, and [explain] how Mom would pull hunks of her hair out until it bled, and Dad would punch the wall, shattering a bone or two," Profeta says to young students.

"Already, Mom and Dad would be blaming [their child's friends] for getting their kid drunk or stoned to the point [vomit] bubbled up in his throat, then plugged his trachea, choking him just as surely as if they had taken their foot and crushed their child's windpipe on their own.

"They will blame you for their child's death until the day you die. Are you ready for that?"

Finally, he describes how the "frat brothers" sit along the wall in the hospital waiting room, and sob.

​Testing the limits

A person who has had too much to drink can choke or asphyxiate on his or her vomit, even while unconscious, and doesn't respond to pinching or shaking. The person's breath is slow or shallow or absent. The skin is blue, and cold or clammy, according to descriptions by the Gordie Center, a nonprofit at the University of Virginia working to prevent substance abuse.

As new freshmen are unleashed from their parents' protection at home, many test the limits of drugs and alcohol. Rites of passage are repeated each year by the uninitiated.

"So, my friends and I played beer pong tonight. Suffice to say it didn't quite go as expected," posted deutscheblake on the Reddit thread AskDocs. "The guy we all thought could handle liquor the best is now piss drunk sleeping on the floor of our house. He's had about 4 beers and the equivalent to 9 shots. My other friend and I are worried he might have alcohol poisoning. Is there something we should be looking for as a sign that he needs to go to the hospital?"

Alcohol abuse is complicated by other substances haunting America and its campuses, Profeta said.

"We are in the middle of a humongous opiate crisis," he said, "and throw in marijuana. ... So many of these kids are on antidepressants. When you combine those with alcohol, you will die. … They are doing this constantly."

And "they," Profeta said, "are not just frat boys. Young people are partying in basements, friends' houses, in high school."

Binge drinking

Nearly 17 percent of students surveyed said that the last time they partied, they had seven or more drinks, according to the Spring 2017 National College Health Assessment, which polls college students randomly each semester about their health behaviors.

Those amounts are well above the "binge drinking" of four or more standard drinks per occasion for women, and five or more standard drinks per occasion for men, as defined by the Centers for Disease Control and Prevention.

Within the past 12 months, college students also reported using antidepressants, erectile dysfunction drugs, painkillers, sedatives and stimulants that were not prescribed to them, and 12.5 percent of the students surveyed said they had used one or more of these drugs together.

"They use Viagra," Profeta said, a drug typically prescribed to older men for erectile dysfunction. "They don't think they need it — it's all about the adrenaline rush — about something new, about something different, either escaping or doing something that's frowned on, it's all about walking the edge, walking the tightrope."

And fueled by the same thrill of other extreme experiences, sometimes students shimmy too close to the edge.

Adults should not be afraid to speak up.

"Sometimes things are not that complex," Profeta said. "Sometimes we have to say, 'Stop this. Things are not right.' You don't have to redefine society. We don't have to change what constitutes masculinity and femininity. That is wrong. Just stop. … just stop."

Hungry for facts

And while many younger people seem to screech toward a dangerous independence out of arm's reach of their elders, some are seeking advice similar to Profeta's.

"There should be a drug-ed class like sex-ed, where they teach you how not to overdose or get alcohol poisoning and stuff," wrote RumpyStiltz_56 on the Reddit thread Shower Thoughts.

"There needs to be a class where you learn about a safe-use system for drugs and alcohol," wrote Justanothermolifer, who also said the fact of the matter is that drugs and alcohol will be involved in a lot of students' lives in one way or another.

"I do not think this is a problem with universities or education," Profeta said. "I'm not sure it is a problem with parents. There is a lot of blame to go around everywhere. It's up to us to navigate those threats."