One would think that doctors would address potential risks involved with drinking and drugging on college campuses with college students, but a new survey administered by the National Institutes of Health found otherwise.

The survey involved about 2,100 college students and other young adults from across the country. They were asked between 2012 and 2013 if they’d seen a doctor within the past year and if they were counseled about their drinking and drug use during that visit.

The results of the survey were surprising, said Dr. Ralph Hingson of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in Bethesda, Md. What was found was college students are much less likely than their non-college peers to be warned by doctors about the pitfalls of substance abuse and excessive drinking.

Less than half of those in a two- or four-year college had been advised about the risks of excessive drinking behaviors, compared to 53 to 57% of those not enrolled in college.

Yet, on college campuses the prevalence of binge drinking, drug use, and driving under the influence is far higher than among those who are not in college. The surveys findings along with a letter were published in JAMA Pediatrics, and the authors write that this lack of counsel by doctors is concerning.

Underage drinking is responsible for 4,000 to 5,000 deaths annually, the authors write, so it is imperative that doctors screen for potential risk factors related to substance abuse.

Hingson at NIAAA said that it was possible participants did not tell their doctors the truth about their drinking habits, for fear of judgment, which may be part of the problem. Even so, said Hingson, the lack of advice in general may send a message that heavy drinking is okay.