College can be an exciting time. It means starting life in an unfamiliar place and your first taste of freedom. For many students, it’s also a time of self-exploration and experimentation. Along with newfound independence come academic stressors, homesickness, peer pressure — and increased access to alcohol or other substances.
According to recent studies, about 50% of college students regularly consume alcohol, and 44% use marijuana. Additionally, some students may use stimulants to enhance their studies. Others may experiment with prescription opioids or cocaine. However, substance use in college has several potential downsides. Some drugs can be dangerous or fatal, even on the first use. And students who use substances regularly are at risk of developing substance abuse disorders.
Knowing the potential risks and how to spot substance abuse can empower you to make good choices for yourself and others. In this guide, we’ll help you learn more about the factors that lead to substance abuse, signs someone you know might be struggling, and ways to support a friend’s recovery.
Risk Factors & Prevention Strategies for Substance Abuse
Substance abuse can happen to anyone, but certain individuals are at an elevated risk of developing substance abuse issues compared to their peers. Let’s take a closer look at some factors that could put someone at high risk. We’ll also discuss prevention measures that schools and individuals can take to mitigate these risks. Knowledge is power, and knowing how to combat these risk factors can help you avoid developing addictive behaviors.
Stress
College is full of new experiences, but it can be a stressful time. You’re away from home, making new friends, and adapting to academic expectations. That’s a lot of pressure! Many turn to drugs and alcohol to provide stress relief – but don’t know about the strong links between stress and alcohol abuse or substance abuse.
Avoid developing a dependency by practicing healthy stress management techniques. Make time for exercise, plenty of sleep and proper nutrition to help combat overwhelming feelings.
Mental Health Issues
There’s a known link between mental health issues and a greater risk of substance abuse. In fact, more than one in four adults with serious mental health problems also struggle with substance abuse. While alcohol and drugs provide a break from your brain, they can worsen your mental health over time.
Raising awareness for better mental health in college is critical. Normalizing awareness and support encourages everyone to get help when they need it.
Family History
According to the American Psychological Association, almost half of a person’s likelihood of drug addiction is determined by genetics. Students with family histories of substance abuse are eight times more likely to have the same issues.
While it can be scary to face a higher risk due to circumstances outside of your control, knowing your family health history can be a powerful prevention tool. Parents can help college students make informed choices by sharing relevant family history.
Trauma or Abuse
If you’ve had a traumatic experience, you face an elevated risk of substance abuse disorder. Trauma can potentially impact your mental health, behavior, and reactions to stress. If you rely on drugs and alcohol as a coping mechanism, you could form a dependency.
Colleges can provide trauma-informed care and support services to help students access support. If you’ve experienced trauma, seek mental health counseling or support services from someone who can help you heal and build healthy coping strategies.
Poor Academic Performance
Even the best high school students may have trouble keeping up with college’s academic expectations during their first year. Blowing off steam with drugs and alcohol can quickly become a spiral of bad grades and substance abuse long after graduation.
Colleges can minimize the risk to students by providing strong academic support programs and tutoring services. If you need help to keep up, seek out these programs or support from a trusted mentor.
Peer Pressure
Every college student faces peer pressure, and most will experience substance-related pressure at one time or another. The tricky thing is it might be overt, like someone offering you edibles, or more subtle, like seeing your friends binge drink every weekend.
Parents and counselors can prepare students with strategies for understanding their limits and saying no to peer pressure. If you’re a college student, find friends who support your choices, even when you say no to partying.
Isolation and Loneliness
As you transition to college, you might feel lonely or isolated. Those feelings have an overall negative effect on mental well-being and might make substance use look appealing. Unfortunately, the stronger a substance dependency becomes, the more isolated someone might be.
Try joining clubs, organizations, and intramural sports to find new friends. Taking part in social activities on your own can be intimidating, but usually, everyone else is looking for new connections, too.
How to Identify Substance Abuse Issues
How can you tell the difference between someone having fun and it becoming a problem? There are common warning signs that a person is struggling with substance abuse. In this section, we’ll cover some of the significant ways to know if someone is misusing substances or experiencing addiction.
Changes in Behavior
As substance dependency sets in, people may begin to act erratically. For instance, they might blow off assignments or work shifts accidentally or intentionally. Some people struggle to keep up with regular hygiene habits like bathing or getting dressed regularly. When they go out, they might wear dirty clothing or be ungroomed.
Physical Signs
Substance abuse can cause marked physical changes, like rapid weight gain or loss. People who are dealing with a disorder often miss out on quality rest, resulting in a lack of energy or a tired appearance. Depending on the substances used, a person may have additional symptoms, like red eyes, impaired physical ability, or slurred speech.
Psychological Signs
Substance addiction takes a psychological toll on those who are affected. Some warning signs of addiction include mood swings, irritability, and poor concentration. Those struggling with substance abuse may be quick to lash out at people in anger, become withdrawn, or take on a melancholy disposition.
Social & Relationship Issues
When someone is struggling with substance abuse, they tend to drive away people who were previously close to them. This might look like avoiding their regular friend group or phone calls from family. They might pick arguments with people they’re usually close to or stop showing up for classes and activities they once enjoyed.
Financial Problems
While frugal living is a part of college life for many, extreme poverty can be a sign that someone is struggling with substance abuse. Alternately, if someone is spending funds excessively or carelessly, they may have a substance use problem. To pay for their addiction, they might ask to borrow money, miss payments, or steal.
Changes in Academic or Work Performance
While many students struggle with challenging classes, a drastic drop-off in motivation is a red flag. Sudden changes in someone’s academic performance or work ethic can signal an underlying substance use issue. If you notice someone racking up absences, missing assignments, and skipping every study session, there might be an addiction below the surface.
Secretive Behavior
If someone starts hiding their whereabouts or actions, they might be struggling with addiction. Shame over substance abuse is powerful and causes some to become excessively private or start sneaking around. They might become overly sensitive to people near their belongings or asking questions about their plans.
Common Substances Abused in College
Knowledge is power, and being aware of the substances on college campuses can be lifesaving. Below, we’ve listed some of the most commonly used substances and their side effects. This list will help you determine if someone you know could be misusing these substances. Note that while some of these substances are legal or medically manufactured, they can still be harmful if misused.
- Alcohol: Alcohol use is common in colleges, and can have deadly consequences. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) also cites assault, academic problems and other health issues associated with college drinking. Heavy drinking can impair judgment, and alcohol poisoning can happen in just one night. Abuse might look like binge drinking multiple drinks within a couple of hours, having multiple drinks each day, or drinking to the point of passing out or vomiting.
- Marijuana: Marijuana is widely used on college campuses and is legal in some states. While weed isn’t as dangerous as some drugs, it’s possible to form a dependency that interferes with everyday life. If that’s the case, you might notice heightened anxiety, memory problems, or poor decision-making skills.
- Prescription Drugs:Doctors prescribe opioids like Vicodin, Percocet, and OxyContin to relieve pain after surgery or broken bones. When used outside of responsible, prescribed instances, they can be highly addictive and dangerous. Prescription opioid dependence can also lead to more dangerous drug use: 80% of people addicted to heroin began with prescription opioids.
- Adderall: Adderall is a prescription stimulant that aids in the management of conditions like ADHD or narcolepsy. At many colleges, students turn to stimulants as study aids to help them stay awake or boost focus. However, misuse can lead to dependence and withdrawal symptoms. Side effects include difficulty sleeping, headaches, uncontrollable shaking, and nausea.
- Heroin: Heroin is a highly addictive non-medical opioid. While it creates a rush of pleasure, the after-effects can be dangerous or even deadly. Heroin users are often drowsy, and experience decreased mental, cardiac, and respiratory function after use. In addition to the risk of overdose, repeated heroin use changes the brain in ways that are difficult to reverse.
- Cocaine: Cocaine temporarily offers increased energy and a feeling of productivity. The problem is that it can severely damage physical and mental health, both immediately and in the long term. There’s a risk of overdosing on cocaine when used alone, but it can be even more dangerous when mixed with more common depressants like Adderall or marijuana.
- Methamphetamine: Meth is a very addictive stimulant that causes an intense high. It also comes with an elevated risk of overdose and injury or death from stroke or heart attack. Users might experience uncontrollable convulsions or aggressive behavior. Even more alarming, the adverse effects of meth can happen on the very first use.
- Fentanyl: A note/warning – Fentanyl was originally developed as a painkiller for surgical patients and can be fatal even in small doses. In recent years, many other drugs have been laced with fentanyl. The user may not even know until they’ve overdosed. Fentanyl lacing is an additional reason to avoid drugs like heroin, cocaine, meth, and prescription opioids.
How to Support Someone Struggling with Substance Abuse
It can be challenging to watch someone you care about struggle with a substance abuse disorder. You are naturally worried about them, have compassion for their situation, and want to help them recover. Below are some suggestions on how to have productive conversations and offer tangible support that leads to recovery.
Express Concern (but not Judgment)
When you’re concerned about someone, finding constructive ways to express your feelings can be difficult. Strive to express concern for your friend without passing judgment. A good way to do this is to point out specific changes you’ve noticed and mention that you’re concerned for their well-being. Remember, it’s not your job to convince them they have a problem with hard facts; you’re just trying to open lines of communication about what you’ve noticed and communicate concern.
Be a Good Listener
Having a two-way conversation goes a long way in reaching out to someone struggling with substance abuse. So, ask open-ended questions and actively listen to what they say. Allow them to share their thoughts and feelings, free of judgment. Do your best to avoid interruption or leap into problem-solving mode. At this point, the most important thing is that they feel heard. That’s when they will feel safest confiding in you and accepting support.
Encourage Professional Help
Once you’ve expressed your concerns and offered an open ear, suggest that your friend seeks support from a professional, such as a healthcare provider, counselor, or addiction specialist. Most professionals will begin with a substance abuse screening and a series of questions about the amount and frequency of substance use. Then, the patient receives feedback from a medical professional and practical support in setting goals and finding a program that will work for them.
Offer Practical Assistance
Even when someone wants help, making a change takes hard work. It means taking the first steps, continuous accountability, and attending multiple appointments to receive support. You can offer to sit with your friend while they call a helpline or give them rides to doctor’s appointments and counseling sessions. You may even be able to attend group support meetings with them as a show of accountability and support.
Set Boundaries
Establishing clear boundaries is crucial to walking through addiction recovery with someone. Let them know what your expectations are and what the consequences will be if they don’t follow what you’ve outlined. Some examples of boundaries might be no drug use around you, not loaning money, and not lying to cover up their substance use. Once you’ve set boundaries, the most important thing to do is show you’re serious by following through with consequences if they cross the line.
Avoid Enabling
While you’re invested in someone’s well-being and recovery, some things feel supportive but only help to maintain someone’s addictions. If you find yourself protecting people from the consequences of their actions, you might be enabling them instead of helping them heal. This might look like making excuses for them, taking on responsibilities when they fail to meet them, or providing financial assistance. Ultimately, enabling will only further people’s substance abuse and self-destructive behavior.
Attend Support Groups
Recovery is taxing on emotions and mental well-being, both for the people in recovery and for the people who support them. Consider attending support groups or individual therapy for yourself and encourage your friend to seek similar support. Therapy can strengthen coping mechanisms and provide tools for recovery. Support groups also offer a sense of community and understanding, either from people who are recovering from substance abuse behaviors or from those who have supported a former addict.
Intervene in Emergencies
There are many potential mental and physical side effects when someone is recovering. They may experience withdrawal symptoms, overdoses, drastic changes in mental well-being, or a worsening of mental health conditions that were suppressed by substance use. If someone’s health or safety is at immediate risk, intervene. If someone loses consciousness or has seizures after taking a substance, expresses that they are considering suicide, or experiences severe withdrawal symptoms, call 911 or bring them to the nearest emergency health center for help.
Helpful Substance Abuse Resources
This section contains 10 helpful substance abuse resources for college students. Whether you need support or want to encourage a friend to take steps toward addiction recovery, the following links can help you locate organizations and resources that will help.
Active Minds
Active Minds supports mental health awareness and education of college-aged young adults and suicide prevention in this demographic.
Alcoholics Anonymous
AA is a leading alcoholism recovery group program that holds meetings nationwide. Meetings are free and open to all ages and educational levels.
Association of Recovery in Higher Education
ARHE is the official and only association for collegiate recovery programs (CRPs) and collegiate recovery communities (CRCs). They provide education, resources, and communities for students in recovery.
findtreatment.gov
This site offers a confidential and anonymous source for people seeking treatment for mental and substance abuse disorders. The search function makes finding a treatment facility convenient and easy.
Narcotics Anonymous
NA provides recovery services to people with an addiction. Members meet regularly to support one another and help each other stay clean.
National Institute on Drug Abuse
This resource provides the latest scientific research on drug use and addiction. You can find articles on addiction prevention, treatment, and education on the website.
SAMHSA
The Substance Abuse and Mental Health Services Administration provides resources for those who need aid and support with substance abuse and mental health issues.
The Steve Fund
The Steve Fund is the nation’s foremost organization promoting the mental health of young people of color on college campuses.
Students Against Destructive Decisions
SADD supports resiliency and advocacy for students to make positive life decisions, including substance abuse prevention. This student-led organization sponsors chapters in schools across the nation.
Talking with Your College-Bound Young Adult About Alcohol
This online pamphlet offers parents a valuable guide to starting conversations about responsible alcohol use with their children. Here, parents will find talking points and valuable statistics.
Interview with an Expert
Dr. Andrew Daigle
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How prevalent is substance abuse on college campuses and in college towns? Are there specific substances that tend to be more commonly abused?
The college campus has long been known for the newly more independent ‘barely adults’ to experiment with substances and activities. There is nothing new under the sun, however the intensity and lethal consequences are clearly intensified in this current generation. A very sobering statistic is that the number one cause of death in the US for 18 to 48-year-olds is opioid overdose.
As substance use increases on college campuses, substance abuse is both more common and more problematic. Alcohol remains the most common and most ‘socially acceptable’ substance, followed by marijuana. Legal age and legal status in any particular state do not seem to impact the negative consequences of both. Interestingly, the other ‘legal’ substances commonly abused are prescription drugs. Amphetamines rival coffee as the go-to for study nights, and large numbers of students arrive on campus with their stimulants after being diagnosed with ADHD, etc. Parties and peer gatherings are expected activities, and since both alcohol and opioids are depressants, alternatives (or additions) include MDMA, methamphetamine, Adderall, etc.
It’s perhaps not as helpful to focus on which drug may be increasing in use in the college communities as much as noting both the increase and expected use and subsequent abuse of the cornucopia of options.
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Aside from college-related pressures, what are some other common factors and triggers that might result in substance abuse in college students?
There are few rivals for the number of additive stressors that are part of the 18-year-old relocating to the college environment. New room, new roommates, new town, new friends, new sleep schedule, new diet, new expectations of self-monitoring and self-scheduling, new pressures or opportunities for social activities, and potentially new part-time work. All of these join the commonly found expectations of alcohol, marijuana, stimulant abuse, and ‘party drugs’ – and the challenge of ‘not’ joining peers in drug activity and becoming an outlier is a notable stressor.
Perhaps the leading factor and predictor of substance abuse in everyone, including college students, is acute and chronic emotional and mental unhealthiness. The degree of this unhealthiness is typically mild or moderate for the individual who has the wherewithal to achieve acceptance to college. However, if not recognized, then a worsening downward spiral is compounded by the aforementioned factors. The temporary relief of getting ‘mind altered’ is difficult to resist; and for a clear and consistent minority, ongoing substance abuse begins its inevitable path of destruction and death.
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Are there any prevention programs or strategies that have proven especially effective in reducing substance abuse among college students?
Statistical proof of the specific benefits of preventative programs is difficult to document. However, beneficial strategies for all at risk of substance abuse include education about the prevalence and personal consequence of substance use and opportunities & encouragement for accepting sobriety, especially for activities traditionally fraught with substance use.
Ultimately, the stressors of college life will be addressed by the student – either in a negative and harmful way or in a positive and healthy way. Campuses where substance use and abuse are acknowledged AND healthy and beneficial alternatives, are encouraged to model a better-functioning society. Certainly, early detection of substance abuse in the individual allows for intervention and support, as otherwise ongoing substance abuse has a very predictable course.
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Can you provide an overview of the types of resources and counseling services that may typically be available for college students who are struggling with substance abuse?
The resources college campuses supply often include counseling and mental health support, as substance abuse is often a symptom of deeper needs. Quickly addressing rule breakers with tolerable consequences avoids having only extreme discipline options (for instance, expulsion or condoning/minimizing poor behavior.) As substance abuse is a relationship destroyer, all of the student’s supportive friends and family should be appropriately involved. The nuances of individual privacy can be addressed while encouraging and supporting the student to be more transparent with those supportive friends and family. Waiting until dire consequences occur is typically a disservice and a missed opportunity to provide help.
Some well-established programs such as AA and NA are open to college students and should be a known resource to college advisors.
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How might the college environment impact the recovery process for students seeking help for substance abuse?
For students, all aspects of life impact their ongoing recovery. These students seek sober alternatives for after-class time and typically have notable insight into themselves from a social and spiritual perspective. They seek to remain in recovery and sober not only by avoiding substances but more importantly, by seeking healthy and productive situations and activities.
For the student struggling with substance abuse, seeing and knowing peers who are successful in their sobriety is tremendously important. A hallmark of addiction is worsening hopelessness, defeat, and slavery to addiction. Understanding intellectually that ‘I am not doomed’ can lead to the experience of successful sobriety.
A clearly documented factor that highly correlates with maintaining sobriety is for one to remain in the sobriety and recovery community. Having peers in the condition of recovery on the college campus can be a benefit for those struggling with substances.
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In your experience, have you noticed any trends or shifts in substance abuse patterns among college students in recent years?
My experience in my practice of addiction medicine is primarily with men ages 18 and up. Those in the 18- mid-20s age group are either persistently immature and adolescent or remarkably experienced in substance abuse and struggling with negative consequences such as damaged relationships, hobbled opportunities for advancement, and potential or experienced legal situations. Shifting patterns include an almost universal presence of marijuana use and a troubling rapid escalation of opioid use involving fentanyl abuse. Tragically, many young substance abusers also have personal knowledge of family or friends who died from substance abuse.
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Are there any emerging substances or methods of substance use that colleges should be aware of in their efforts to combat substance abuse?
There is a real concern that substance abuse is being overly defined as a disease and therefore management is seen through a traditional Western medicine approach of “if the condition is a medical disease, the remedy is disease modifier or “cure”. Also, substance abuse can be overly defined as a mental health problem only, with the thought that counseling and medication is the only path forward. As was historically seen, if substance abuse is overly or only defined as a moral failure, we will see limited success in treatment. Addressing the mental health struggles while supporting and acknowledging the spiritual nature of the struggling abuser will then support the help of appropriate medications. There is a concern when another potentially addicting medication is used to treat someone with addiction, such as buprenorphine for opioid addiction. A true multifaceted approach is always the best path forward in a complex and critical problem.
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What role can peer support play in preventing and addressing substance abuse, especially within the college community?
As I noted above, peer support is essential both for the one receiving the support and for the one giving. The peer support group with the longest and arguably the most successful record is Alcoholics Anonymous. All ‘programs’ have their weaknesses, but honest relationships acknowledging individual weaknesses can consistently yield healthy recovery. A vital aspect of recovery is recognizing ‘a beneficent spiritual power greater than me’ who empowers the individual toward hope and away from hopelessness. Weakness is accepted, and support through grace and mercy is accepted. The peer community emanates acceptance, mercy, and grace because they have experienced acceptance, mercy, and grace. Imagine if campuses had sobriety and addiction recovery groups to rival the overt and covert substance abuse groups!
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How can colleges effectively engage parents and families in supporting college students who may be dealing with substance abuse issues?
Because addiction and substance abuse are relationship destroyers, support needs to be given to all the important relationships of the individual. Clearly parents are impactful in the life of the college student, whether that is a positive, negative, or varying impact. An experienced counselor’s involvement can be helpful for the ‘newly adult’ student in their relationships and recovery. Colleges should focus on encouraging support from family and friends rather than isolating the struggling student. Addiction and substance abuse that is revealed, overt, and ‘on the table’ prevents the smoldering progression that is inevitable with the temptation to hide due to shame, guilt, or embarrassment.
