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Helping College Students with Substance Abuse
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College Alcohol and Drug Addiction and Treatment

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Heading off to college is a significant rite of passage for almost every young student. College means freedom and independence in ways not previously experienced. But with that freedom come responsibilities not previously experienced as well. New freedom, new responsibility, and inexperience – that’s a combination rife with potential danger – particularly when it comes to drug and alcohol abuse. This guide is designed to provide students – and their families and friends – with important information and useful advice to help them avoid the substance abuse pitfalls that typically accompany life on a college or university campus.

EXPERTS

Kristine De Jesus
View Bio

Heading off to college is a significant rite of passage for almost every young student. College means freedom and independence in ways not previously experienced. But with that freedom come responsibilities not previously experienced as well. New freedom, new responsibility, and inexperience – that’s a combination rife with potential danger – particularly when it comes to drug and alcohol abuse. This guide is designed to provide students – and their families and friends – with important information and useful advice to help them avoid the substance abuse pitfalls that typically accompany life on a college or university campus.

Substances Commonly Used by College Students

Alcohol
Marijuana
Prescription Medications
Other Drugs by College Students

It’s no surprise that alcohol is by far the most used and abused substance by college students. It’s also no surprise that college student drinking is excessive. The statistics are frightening. According to the 2015 National Survey on Drug Use and Health:

  • 58 percent of full-time college students (between the ages of 18 and 22) surveyed drank alcohol within the past month, compared to 48.2 percent of others in the same age group.
  • 37.9 percent of college students reported binge drinking in the month prior to the survey, compared to 32.6 percent of others in the same age group.
  • 12.5 percent of those in the same college student group reported heavy drinking in the month prior to the survey, compared to 8.5 percent of others in the same age group.

That’s a lot of alcohol consumption with a lot of negative consequences. For example:

  • In 2005, over 1,800 college students (18-24 years of age) died of unintentional alcohol-related injuries, including motor-vehicle accidents, according to this National Institutes of Health-cited study.
  • Another NIH-cited study reported that in one year nearly 700,000, or 12 percent, of college students (aged 18-24) were assaulted by another drinking student. And nearly 100,000, or 2%, of students in the same group were victims of alcohol-related sexual assault or date rape.
  • Additionally, this national survey found that binge drinkers (those consuming alcohol at least three times per week) were around six times more likely to perform poorly on a test and five times more likely to have missed a class, when compared to students who drank but never binged.
Long-Term Effects of Drinking in College

The long-term effects of alcohol use are numerous and serious. They include:

  • Brain damage.
  • Cancer of the mouth and throat.
  • Gastritis and ulcers.
  • Heart attack and heart-related diseases such as high blood pressure and stroke.
  • Liver-related diseases such as cirrhosis.
  • Malnutrition.
  • Nerve damage.
  • Sexual dysfunction.

College Student Substance Abuse: Warning Signs

First and foremost among the warning signs of substance abuse by college students: poor academic performance, which can take many forms, including missing class, failing to complete assignments, and flunking tests. Left unchecked, the inevitable result is dropping out of school entirely.

Here are some of the other signs of student drug and alcohol abuse:

  • Ambivalence, lethargy, lack of motivation.
  • Anger and agitation.
  • Blackouts.
  • Changes in weight and appearance (clothes, grooming).
  • Criminal activity, such as theft, vandalism, public drunkenness and lewd behavior, public fighting, DUI, etc. – and the resulting legal problems.
  • Drunk driving.
  • Injuries, such as cuts and bruises, broken bones, head trauma, etc.
  • Isolation, decreased social interaction, and depression.
  • Lying and deceptive behavior.
  • Memory loss.
  • Mood swings.
  • New, questionable friends.
  • Risky sexual behavior, sexual assault (both perpetrator and victim).
  • Self-harming.
  • Sleeping problems.
  • Suicidal thoughts.
  • Use of perfumes, air fresheners, and incense to cover up the smell of drugs or smoke.

Changes in appearance or behavior can be obvious or subtle, but they’re there – if you keep a close lookout for them.

Triggers and Risk Factors for College Student Substance Abuse

The first semester of a student’s college career is the most vulnerable period for falling into alcohol and drug use. It’s far from the only time to be concerned about student substance abuse, though. Here are some of the most common risk factors and triggers for drug use that could pop up at any time:

  • Academic demands and stress.
  • Drug availability and accessibility.
  • Experimentation.
  • Homesickness, isolation, depression.
  • Lack of parental control and structure.
  • Peer pressure and social anxiety.
Greek Life

For many, one of the most attractive and exciting aspects to the college experience is Greek life. Fraternity or sorority membership can provide tremendous social, academic and career benefits. But Greek life also presents an environment conducive to overindulgence in drugs and – especially – alcohol. Notable incidents in the news and greater public scrutiny have led to an increase in disciplinary action and restrictions on alcohol-related Greek activities. Nevertheless, substance abuse and Greek life continue to go hand-in-hand on many campuses.

Students interested in pursuing Greek life, but who are also concerned about the acceptance and tolerance of excessive drinking and drugging might want to consider:

  • Living off-campus and away from their fraternity or sorority house.
  • Attending a school, or joining a frat or sorority that strictly forbids alcohol and drug use.

Substance Abuse Treatment Options for College Students

Substance abuse treatment for college students is not all that different from that available to the population at large.

The two major options are:

The two major options are:

Inpatient Drug Treatment for College Students
Outpatient Drug Treatment for College Students

Inpatient programs are those in which the patient resides at the treatment facility for a period of time (usually a minimum of 30 days, but often 60 or 90 days, or longer). The patient receives around-the-clock supervision and participates in a variety of activities, such as one-on-one and group therapy sessions, 12-step meetings, exercise, meditation, and specialized therapies. Patients must adhere to a strict daily schedule and are normally required to remain at the facility throughout the treatment period.

How Rehab Works

There are four major steps in the treatment process:

1. Detoxification:

Detoxification – or detox – refers to the process of withdrawal and the cleansing of the body of the abused substance. The detox process may require anywhere from a few hours to several days – or even weeks – depending on a variety of factors, including the specific substance involved and the level of addiction. Supervised detox is the safest and most effective way to withdraw from a substance addiction, allowing for a mitigation of withdrawal pains and the close monitoring of the patient’s progress.

2. Assessment

Assessment consists of the diagnosis of the substance abuse problem, evaluation of the patient’s current condition, and the creation of an individualized treatment plan.

3. Treatment

Involves the carrying out of the treatment plan through the program’s specialized methods and approaches to treatment.

4. Aftercare

Long-term sobriety depends heavily on the patient’s continued active involvement in his or her recovery process. Successful aftercare includes attendance at 12-step meetings, participation in therapy and group counseling, continued drug testing, and more. Colleges today routinely provide aftercare support by offering on-campus counseling and peer-group meetings, as well as sober housing options.

Efforts at Addressing College Student Substance Abuse

Colleges and universities have become keenly aware of the fact that they cannot simply get by with a written drug policy and introductory student seminar on the dangers of substance use. Along with the on-campus recovery programs and sober housing options mentioned above, schools are continuously establishing and improving policies and programs in an effort to deal with the serious substance abuse problems on their campuses. Here are just a few examples what they’re doing:

  • Strengthening academic requirements.
  • Keeping libraries, study rooms, and other facilities open longer.
  • Sponsoring alcohol-free events and activities, and eliminating alcohol product sponsorship of athletic programs and entertainment events.
  • Establishing tougher penalties for student alcohol and drug violations, and notifying parents of those violations.
  • Monitoring fraternities and sororities to ensure their compliance with drug and alcohol policies.

An Expert’s Perspective: Interview with Kristine De Jesus, Psy.D.

Interview With an Expert

Kristine De Jesus is a Staff Psychologist and the Coordinator of the Alcohol and Other Drugs Program at Montclair State University in Montclair, New Jersey. Kristine holds a B.A. in Psychology from Rutgers University, a M.A. in Organizational Behavior from Alliant International University, and a Doctorate of Psychology degree from the California School of Professional Psychology. She is the co-author of the first Heroin Risk Reduction Plan for a college population in the State of New Jersey. In addition, Kristine serves as Co-Chair of MSU’s Advisory Committee on Alcohol and Other Drugs, Co-Chair of the New Jersey Higher Education Consortium on Alcohol and Drugs, and as a board member of the National Youth Recovery Foundation.

  • What are the most common substance abuse issues that you see coming into your office?

    The most commonly abused substances on a college campus are pretty much the same as in the general population. Alcohol and marijuana are by far the most commonly used, followed by prescription medications like opioids and stimulant drugs.

  • Are there any co-occurring disorders more common than others suffered by students on your campus?

    Anxiety and depression are by far the most common co-occurring disorders among college students presenting with issues of substance use. They’re also the most common issues presenting at college counseling centers in general.

  • Are there challenges to treatment unique to the college student population?

    College can be stressful for any student, but especially for those in early recovery living among peers who are using alcohol or drugs. That use can be triggering.

  • How do you address that challenge?

    There are over 150 colleges across the nation that offer what we call collegiate recovery programs or collegiate recovery communities. Collegiate recovery programs provide academic, recreational and social programs to help students maintain their recovery. With that support, the risk of relapse is greatly reduced. Less than 10% of students in collegiate recovery programs relapse, compared to the relapse rate in the general population which is estimated to be between 40% and 60%, according to the NIDA.

    Every school’s [program] is a little different. Here at Montclair, once a student has 90 days sobriety, they can live in our recovery housing. But to be a part of our collegiate recovery program, you just need to be sober. It doesn’t matter if it’s a day or two. Going to a meeting is great, but people need more than that to support them in their recovery. These programs are really geared towards helping young people maintain their recovery and sobriety so that they can live happy, healthy, purpose-driven lives.

  • Do you have students who are hesitant to come in to see you because they’re afraid doing so might damage their academic career?

    I think there’s an initial hesitation, but most universities today are equipped to work with students to help them understand that they need to get their mental health and substance use in order to be able to really effectively do their coursework. Many times we can help students remain in school while getting the treatment they need.

  • Are there students hesitant to come in because they’re afraid you might contact the police?

    Absolutely. A few years back, MSU implemented a “good Samaritan” policy. We work really hard to educate our student body to let them know that they will not be penalized for asking for help. And since putting our medical advocacy policy in place we’ve seen that when a student overindulges, about 80% to 90% of the time they’re calling and asking for help.

  • So, the bottom line is that if you’re a college student and you think you may have an issue substance use, don’t hesitate to contact someone on campus and find out what can be done about it.

    That’s right. Even if you’re not ready to stop using, that’s OK because we know is that even a reduction in the use of substance has a positive health outcome, as well as a positive academic outcome.

What are the most common substance abuse issues that you see coming into your office?

The most commonly abused substances on a college campus are pretty much the same as in the general population. Alcohol and marijuana are by far the most commonly used, followed by prescription medications like opioids and stimulant drugs.

Are there any co-occurring disorders more common than others suffered by students on your campus?

Anxiety and depression are by far the most common co-occurring disorders among college students presenting with issues of substance use. They’re also the most common issues presenting at college counseling centers in general.

Are there challenges to treatment unique to the college student population?

College can be stressful for any student, but especially for those in early recovery living among peers who are using alcohol or drugs. That use can be triggering.

How do you address that challenge?

There are over 150 colleges across the nation that offer what we call collegiate recovery programs or collegiate recovery communities. Collegiate recovery programs provide academic, recreational and social programs to help students maintain their recovery. With that support, the risk of relapse is greatly reduced. Less than 10% of students in collegiate recovery programs relapse, compared to the relapse rate in the general population which is estimated to be between 40% and 60%, according to the NIDA.

Every school’s [program] is a little different. Here at Montclair, once a student has 90 days sobriety, they can live in our recovery housing. But to be a part of our collegiate recovery program, you just need to be sober. It doesn’t matter if it’s a day or two. Going to a meeting is great, but people need more than that to support them in their recovery. These programs are really geared towards helping young people maintain their recovery and sobriety so that they can live happy, healthy, purpose-driven lives.

Do you have students who are hesitant to come in to see you because they’re afraid doing so might damage their academic career?

I think there’s an initial hesitation, but most universities today are equipped to work with students to help them understand that they need to get their mental health and substance use in order to be able to really effectively do their coursework. Many times we can help students remain in school while getting the treatment they need.

Are there students hesitant to come in because they’re afraid you might contact the police?

Absolutely. A few years back, MSU implemented a “good Samaritan” policy. We work really hard to educate our student body to let them know that they will not be penalized for asking for help. And since putting our medical advocacy policy in place we’ve seen that when a student overindulges, about 80% to 90% of the time they’re calling and asking for help.

So, the bottom line is that if you’re a college student and you think you may have an issue substance use, don’t hesitate to contact someone on campus and find out what can be done about it.

That’s right. Even if you’re not ready to stop using, that’s OK because we know is that even a reduction in the use of substance has a positive health outcome, as well as a positive academic outcome.

College Substance Abuse: FAQ’s for Students

What is Alcohol Poisoning?

Alcohol poisoning is what happens when an individual consumes too much alcohol in a short period of time resulting in a dangerously high blood alcohol level that can lead to serious and even deadly consequences. Signs of alcohol poisoning include mental confusion, vomiting, stupor, hypothermia, irregular or slow breathing, blue-tinged or pale skin, seizures, and unconsciousness.

What should I do if I’m with someone who may be suffering from alcohol poisoning?

It’s important to seek medical care immediately. The best bet is to call 911. Before help arrives:

  • Do not leave the person alone. Try to keep them awake.
  • Try to keep the person in a sitting position. Do not lie the person on their back or make them walk. If the person must lie down, be sure that their head is turned to the side.
  • Help them if they are vomiting or need to vomit. Again, try to keep them in a sitting position or, if lying down, with their head turned to the side.
  • Provide them with water, if they can drink it. Do not give them coffee or another type of caffeinated drink. And do not allow them to drink more alcohol.
Is Marijuana Addictive?

There are lots of pot users out there that will tell you that marijuana is not addictive. There are, however, lots of experts who beg to differ, including the NIDA. This study published in the journal JAMA Psychiatry offered data indicating that 30% of marijuana users may have some degree of marijuana use disorder, which in severe cases appears in the form of addiction. Many people are under the false belief that, without significant withdrawal symptoms, there is no addiction. Indications of addiction include an inability to abstain from the substance, impairment of behavioral control, dysfunctional emotional response, cycles of relapse, and more.

So, while the vast majority of marijuana users are not – and will not – become addicted, for some, marijuana use will take on the characteristics of addiction described here, and will likely require professional help to stop.

What should I do if I think I might have a drug or alcohol problem?

Get help as soon as possible. Contact you campus’s health center, a local hospital, or your personal physician. Talk to your dorm’s resident assistant. Get in touch with your local Alcoholics Anonymous, Narcotics Anonymous, or other help group. Or simply confide in a close friend or family member. The point is to reach out for help. Sharing your concerns is the first step toward resolving them.

Will I get into trouble with the law or my college if I seek help for my drug or alcohol use?

Every college has different policies regarding the use of drugs and alcohol on its campus, so it’s important to know what’s in your school’s Student Code of Conduct. Any information you share with your campus’ health services program, however, is confidential, so if you’re worried about admitting a problem with drugs or alcohol, consider contacting health services first.

College Substance Abuse: FAQ’s for Parents

How can I talk to my college kid about drugs and alcohol?

Here are a few tips:

  • Be well informed of the facts: This guide is a great place to start, but also read up on the most recent facts and figures online. You’re more likely to get through to your student if you can provide them with objective data.
  • Don’t preach: Don’t be pushy with your opinions and don’t make threats. Let your child know that your primary concern is his/her health and well being. Approach your talk as a two-way discussion, which includes asking your student how he or she feels about the issue. And – most importantly – listen to their answers.
  • Keep in touch: Especially during the first several weeks they’re away at school. Set up regular times to talk. If you think you recognize something out of the ordinary, encourage your student seek out help through his/her campus’s resources.
Don’t all college students drink?

No. While a large percentage of college students (60% to 80%, depending on the survey) consume alcohol, and a substantial minority binge drink, that’s not all students.

What if my child refuses to go to rehab?

Oftentimes, a child or young adult will not agree to treatment unless compelled to do so, either through family pressure or the legal system. However, there’s no evidence that a confrontational approach (like the kind of intervention depicted on TV or the media) is especially helpful. A better approach is to offer incentives to seek treatment or consult a physician. Counseling by a professional often brings about the best results. Also, reassuring your child that he/she will be kept as safe and comfortable as possible during detox and treatment is a big plus.

Will insurance pay for my college student’s treatment?

If your student is currently covered under your insurance plan then some level of treatment is likely included. Check your policy or call your agent for details. If not covered under your plan, your student has probably obtained coverage on his/her own, since health insurance coverage is a requirement for admission by most colleges and universities. In addition, the cost of any treatment-related programs or services provided on-campus by the school’s health services department is likely included in the annual student health fee.

If my college student seeks help or confides in a doctor regarding a drug or alcohol problem, can I find out about it?

In most cases, only if your child agrees. Privacy laws forbid health care professionals – including those specializing in substance abuse treatment – from sharing such information without your child’s written permission. In certain cases, where the health care professional believes that your child might be a danger to him or herself, they may be able to share health information with you. More information on this exception can be found here.