Two hundred twenty-six first-year students enrolled at a large, public Midwest university and deemed to require an emergency transport for a potential alcohol overdose completed a brief questionnaire on the student's perceptions of why the event occurred, what might have happened to prevent the overdose situation, and personal assessment of experience with alcohol. The explanations for the event revolve around personal decision making (made decision to drink too much, absence of drinking control behaviors) as opposed to peer influence. Similarly, factors selected as preventing an alcohol overdose focused on knowing one's own tolerance, plus having a buddy system to slow down consumption. Other external interventions, whether in a drinking establishment or emanating from the university, were generally not subscribed to. Regardless of self-assessment as an experienced or inexperienced drinker, students felt they knew how to intervene, would intervene, and knew the signs of an alcohol overdose and personal risk.