Guides to Substance Abuse on College Campuses

A Guide to Helping Your College Friend Get Help for Addiction

During your college years, you will likely encounter many different situations and challenges, one of which may be figuring out how to help a friend, classmate, or romantic partner who you think might be heading down a dangerous path with alcohol or substance abuse. If you think one of your peers in college is abusing drugs and don’t know what to do, you’re not alone. College substance abuse is a serious problem, and friends of those who are addicted to substances have the opportunity to start a conversation that could save a life.

When you see someone struggling with substance abuse, it can be difficult to know what to do or say. Below is information to help you prepare before the conversation.

When you see someone struggling with substance abuse, it can be difficult to know what to do or say. Call us today at to learn more about diagnosing addiction and what treatment options are available for college students.

Is Your Friend Addicted?

If you think that your friend might be addicted to drugs or alcohol, consider these questions to better help you assess the severity of the problem and determine your next steps.

Does Your Friend’s Substance Abuse Affect You?

  • Have you felt embarrassed about what the person did or said while under the influence?
  • Is their drug or alcohol use making you unhappy?
  • Has your friend’s use of drugs or alcohol caused you to take time away from your studying or classes?
  • Have you had to take care of your friend after they used alcohol or drugs?
  • Have you been worried about your friend’s safety?

Addiction is often referred to as a family disease because it affects the people closest to the addicted individual. If someone close to you is abusing substances, you’ve likely experienced one or even all the above situations.

Questions to Help You Identify Substance Abuse

  • Does your friend pound lots of drinks very quickly?
  • Does your friend always want to stay out after last call?
  • Has your friend experienced trouble on campus (i.e., public intoxication citations) because of drinking or drug use?
  • Does your friend frequently black out while drinking?
  • Are drugs or alcohol affecting your friend’s academic performance?
  • Does your friend use alcohol or drugs to cope with stress?
  • Does your friend drink in the morning?
  • Do they have cravings and urges to use alcohol or drugs?

You may have asked why your friend can’t just stop using drugs or alcohol. Addiction researchers now know that quitting is much harder than simply saying “no” to drugs and alcohol. Studies show that addiction development is accompanied by changes in the brain. These changes can impact a person’s self-control—which makes quitting drugs or alcohol difficult.1

Is Your Friend Dependent or Addicted?

Substance dependence and addiction are serious medical conditions, but for college students it may be difficult to recognize the signs of problem behavior—especially when it seems like “everybody’s doing it.” If you are concerned for your friend or classmate, it will help to know the criteria doctors use to diagnose dependence and addiction. Does your friend exhibit two or more of the following characteristics?2,3

  • Made repeated attempts to cut down or stop their alcohol or drug use, but could not.
  • Wanted to use drugs or alcohol so badly they couldn’t think of anything else.
  • Increased the amount of drugs or alcohol they use to get the same effects as they once did (i.e., developed tolerance to the substance).
  • Spent a lot of time drinking or using drugs, or being sick/recovering from the effects of their drug or alcohol use (i.e., hangovers).
  • Spent increasing amounts of time trying to get more drugs or alcohol.
  • Used more than one drug at a time.
  • Continued using substances despite experiencing social or relationship problems because of their drug or alcohol use.
  • Stopped doing things they once enjoyed (i.e., sports, clubs, hanging out with certain friends) because of their drug or alcohol use.
  • Felt withdrawal symptoms (felt sick) when they stopped using drugs or alcohol.
  • Experienced medical issues because of drug or alcohol use, such as memory loss, bleeding, black outs, convulsions, cardiovascular injury, liver damage, contracting viruses or other infectious diseases, etc.
  • Engaged in illegal activities to obtain alcohol or drugs.
  • Neglected responsibilities such as school assignments, going to class, or going to work because of drug or alcohol use.


I’ve heard the terms dependence, tolerance, and addiction—what’s the difference?


Physical dependence refers to the body adapting to the substance, to the extent that people who are dependent need to take the substance just to function normally. With continued use over time, it may require more of the substance in order to feel the same effects—this is tolerance. Both dependence and tolerance accompany addiction. Addiction is marked by a compulsion to use substances despite social or medical consequences (i.e., dropping out of school, failing classes, getting arrested, break-ups, overdose, and even death).4

Risky Behaviors That My Friend Would Display if They Were Addicted?

When a person is struggling with addiction, they may exhibit changes in behavior or appearance. Single incidents of such changes are not necessarily cause for concern, but if you notice the changes listed below over a period of time (especially in combination with other changes on the list), it might be time to talk to your friend about their substance abuse.

Physical signs:

  • Unintended weight loss or gain.
  • Bloodshot eyes.
  • Pupils larger or smaller than usual.
  • Itching.
  • Sniffing.
  • Bloated face.
  • Dry mouth or nose.
  • Needle marks.
  • Sweating.
  • Vomiting.
  • Changes in hygiene/personal appearance.
  • Finding drug paraphernalia.

Behavioral signs:5

  • Changes in sleeping patterns.
  • Secretive behavior.
  • Drinking or using drugs alone, or in the mornings.
  • Missing class.
  • Dropping out of school.
  • Financial problems.
  • Changes in friends or hobbies.
  • Fighting.
  • Irritability.
  • Mood swings.
  • Lack of motivation.
  • Detachment.
  • Complacency.
  • Isolation.
  • Drunk driving.
  • Unprotected sex.

The more times you answered “yes” to the questions and signs of abuse listed above, the more likely it is that your friend might be struggling with a substance use disorder. However, the information on this page is not intended to reliably diagnose a drug or alcohol problem. If you think your friend has a substance abuse problem in college, you should urge them to seek a full evaluation by a healthcare professional.

Addiction is often referred to as a family disease because it affects the people closest to the addicted individual. If someone close to you is abusing substances, you’ve likely experienced one or even all the above situations.

Should I Speak Up?

Many college students are likely living on their own for the first time, without parental oversight, and friends become a major source of support. Getting a peer’s help for addiction in college is different than getting help from a family member. Peers can have a great deal of influence in the college environment—while some may normalize harmful substance abuse behaviors, others may encourage their friends to get the help they need.

If you are worried about someone close to you, someone you’ve seen out at parties, or a classmate who is frequently missing from class, it’s best to approach them in a caring way. Talking to the person about your concerns and offering support can help them feel like they are not alone. Before you talk to the person, it’s best to prepare by:

Choosing an appropriate location:

Try to find a neutral place on or off campus that is in a public place so your friend won’t feel cornered or trapped. Avoid talking about drug abuse and alcohol abuse in a dorm room or private location. Coffee shops, campus dining halls, and restaurants are excellent options.

Preparing a list of what you want to talk about:

Having a list handy can help you stay on track. You may need to refer to specific moments or events when you noticed that your peer’s substance abuse was having a negative consequence on their life. Examples could include missing a class, going out drinking before a big exam, getting kicked off a sports team, getting caught drinking or using drugs by police or other authority figure (campus security, professor, etc.), being ticketed for public intoxication, risky sexual behavior, or driving while under the influence.

Learn about addiction:

The more you understand about how drug use affects the brain, the easier it will be to understand what is going on with your peer. Addiction is complex and there are many components that contribute to it, including environmental, cultural, and biological factors.

Know That You Are Not Alone

Substance use and abuse is more widespread on college campuses than you may realize. Every day, young people across the country enter rehab or other treatment programs for issues related to addiction. There are resources available on campus and in your community to help students like you connect to others who are worried about their friends’ drug use or drinking.

While it’s important to talk to your friend and encourage them to get help, it’s just as important to take care of yourself. Talk to a counselor or peer support group about what you’re going through—you’ll find that there are many people in your same situation who are facing the same fears.

Don’t Be Afraid to Speak to Your Peer

If you are feeling hesitant or nervous about approaching your friend about alcohol and drug problems, it’s totally normal. Most people try to avoid confrontation at all costs—and talking about a person’s substance abuse can be extremely uncomfortable. Many people wait until it’s too late to have this conversation. As scary as it seems, don’t wait until the person has hit rock-bottom to bring up your concerns about college substance abuse.

If you need help finding treatment options for fellow college students who may be struggling with addiction, give us a call today at 1-888-520-6748. Our support representatives are available 24/7 to help you find the best care possible.

Studies show that addiction development is accompanied by changes in the brain. These changes can impact a person’s self-control—which makes quitting drugs or alcohol difficult.1

How Do I Talk to My Friend

When approaching a friend about abusing alcohol or other drugs, there are recommended strategies to keep the conversation productive and positive. It’s a good idea to familiarize yourself with these strategies beforehand so that you feel prepared.

The following are recommendations on how and when to approach your peer:

Talk to your friend when they are sober:

Never approach your peer when they are under the influence. It can be helpful to talk in the morning following a big partying episode, while they are feeling the after-effects of their substance use.

Avoid generalizations:

Only talk about your experience with your friend’s behavior. Don’t say, “Everyone thinks that you have a problem,” or “All of us are worried.”

Avoid accusatory language:

Try to use “I” statements such as “I noticed” or “I am worried.” Use phrases such as “This is where I’m coming from,” or “This is how I’m feeling,” or “I am worried.”

Reinforce how much you care about the individual:

You can say, “Our friendship means a lot to me and I don’t want you to get hurt,” or “I’m worried about you and I understand that addiction is a disease. I want to help you in whatever way I can.”

Bring up specific examples:

If you make claims about your friend missing class or getting sick from drugs or alcohol, make sure to have examples to support this. For example, “It scared me when you drove home drunk from Mary’s party on Friday,” or “I am worried when you tell me that you get so drunk you don’t remember having sex with strangers.”

Locate resources in your community that offer support or treatment:

Encourage your friend to seek professional help. You can offer to go with them to the counseling office, or drive them to a 12-step meeting like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).

As much as you can, try to place yourself in their shoes. How would you want to be approached? What type of words or language would trigger a reaction in you? When you can empathize with what they are going through, you will be better able to offer non-judgmental support.

Why Is Having a Conversation So Important?

There is a lot of shame, guilt, and stigma surrounding addiction. People are scared to talk about it, which is why it’s crucial that you find the courage to convey what you feel and what you have experienced of your friend’s behavior. Chances are, when you talk to your classmate you’ll find that they have already been beating themselves up in their head about their substance use. They may feel hopeless and know that they need help. By reaching out and empathizing with what they are going through, you can help alleviate the stigma of addiction.

It might feel awkward to bring these topics up, given that college is an environment that normalizes binge drinking. If you drink or use drugs yourself, but do not struggle with the same level of addiction as your friend, you may be unsure of how to approach things. Just remember, addiction can lead to death due to overdose, long-term health complications, or accidents involving drunk driving or other dangerous situations. Even though talking can be uncomfortable, it can help prevent more serious outcomes down the line.

By bringing up your concerns, you will avoid enabling your peer’s drug and alcohol use in college. Enabling is when you think you are helping someone, but you are making their addiction worse. Examples of enabling include:

  • Covering up or lying for your friend’s behavior when they are under the influence.
  • Giving them answers to tests or homework.
  • Giving them money for food or helping them pay bills when they are still actively using their own money to support their addiction.
  • Helping them find or get drugs.

How to Have the Conversation About Their Addiction

Before heading into the conversation, it’s important that you feel balanced and centered. Make sure to get enough sleep the night before and have your notes ready. You may want to take 5 minutes to meditate before meeting so that your mind feels clear.

Meditation Techniques:

  • Sit or lie down in a comfortable position.
  • Breathe in through your nose.
  • Exhale through your mouth.
  • Continue to breathe in through your nose and out through your mouth.
  • Focus on your breath.
  • Try to slow down your breathing.
  • Pay attention to how your body feels.

You can do this for as long as you want or feels comfortable.

Do your best to:

  • Stand your ground.
  • Always use direct, clear language.
  • Be consistent.
  • Be comforting.
  • Come from an empathetic place.
  • Be there to understand.


  • Being condescending.
  • Saying, “I know what you’re going through” or “I know how you feel.”

Use phrases like:

  • “I’m here for you.”
  • “What can I do to help?”
  • “Nothing is wrong with you as a person.”
  • “I care about you.”
  • “I see where this is going and it doesn’t seem like it’s a good place.”
  • “You have a disease that you can’t really control, and as a friend I want to be here and get you the help you need.”

Reactions to Expect

If your friend becomes defensive during the conversation, do your best to stay calm. They may deny that they have a problem, or say hurtful things to you in retaliation. Although it’s easier said than done, don’t take what they say personally. They will probably say a lot of things that they don’t mean.

Depending on the substance of abuse, side effects of addiction may include mood changes like irritability and anger. Many addicts also struggle with depression and anxiety. If your friend is anxious, they are likely already worried about what you think about them, and this conversation could trigger a defensive response.

If they are acting defensive, try to keep your communication as clear and direct as possible. Keep your words and actions consistent. Use phrases such as, “I feel…, “or “I see…,” to describe your experience of your friend’s substance use.

If your friend becomes emotional, try to be comforting and let them know that you are there to help. Creating a safe place where the person feels comfortable to speak freely about what they’re going through will go a long way. A big part of being supportive is listening without judgement. Do not be condescending or offer sympathy.

If your friend denies that they have a problem, stand your ground. Your friend may say, “I don’t know what you’re talking about,” or “I don’t have a problem,” or “You use the same amount of drugs or alcohol as me.” This is when the list that you created beforehand will come in handy. You can refer to specific examples that you outlined ahead of time.

The best case scenario is that your friend hears what you are saying and asks for help. If they are ready to get help, be prepared to discuss resources that are available at your college, including student-led support groups and on-campus counseling services. In addition, you can check to see what types of 12-step meetings are available in the community surrounding campus.

If your friend doesn’t feel comfortable going to meetings, there are other ways to get involved in a recovery community. Talking to people online who have dealt with addiction and are now sober can be helpful. Facebook groups like these can could be a great place to start:

Behavioral Health and Addictions

Addicted Minds

No Matter What

Addiction Talks

Resources for Those Suffering from Addiction

There are also apps available to help you find meetings, avoid relapse, and track your progress.

Sober Grid

Quit That



One Day at a Time

Step Away

If your friend begins talking about harming themselves or others, or taking their own life, seek professional help immediately. Call 911, campus security, or the counseling center so that you can get into a safe environment.

How Can I Help My Friend?

If your friend is ready to take the next step and get help for their drug or alcohol use, the next step is to connect them with the addiction treatment resources they need.

Utilize Websites Like to Find Treatment in Your Area

Offer to help your friend locate a rehab facility or detox center. Together, you can browse through user reviews, photos, and details about the facility and treatment process.

Seek On-Campus Resources for Helping Students with Treatment Options

Contact your university’s student counseling office and make an appointment with a counselor to help your friend work through the underlying issues fueling their addiction. All counseling services are confidential so students can feel free to share what’s going on with them openly. If the counselor thinks your friend would benefit from further treatment, they can provide referrals for these services.

If you need help finding treatment options for fellow college students who may be struggling with addiction, give us a call today. Our support representatives are available 24/7 to help you find the best care possible.

How Can I Support My Friend?

Transitioning back to daily life after spending time in a rehab facility is difficult for many people who undergo addiction treatment. You can help ease your friend’s anxiety about returning to school and social functions by continuing to offer support and listening to what they’re going through.

How to Help Your Friend Stay Sober Once They Return to School

If your friend or classmate takes time away from school to focus on their recovery, you can help them transition back into the academic environment by remaining mindful of what they have experienced.

To help a friend who is returning from rehab, you can:

  • Listen.
  • Make time for them.
  • Ask them about their experience in rehab or in recovery groups.
  • Plan activities that are not centered around drugs or alcohol. Try exploring places near campus, movie nights, hikes, yoga, meditation, taking a dance class or other new activity, try new restaurants or cafes, go for walks or bike rides, make art, start a club.
  • Host sober parties or get-togethers so your friend won’t feel like an outcast.

Resources for Friends and Family of People Suffering from Addiction?

Recovery meetings and 12-step programs are available to help the friends and family of people who suffer from substance abuse. These resources can help you navigate the challenges of coping with your friend’s addiction and provide you with a supportive community of your own.

Check out:


Al-Anon, and its sister program Alateen that’s specifically for teenagers, is a 12-step program designed for relatives and friends of alcoholics. Meetings are free and offered most days of the week.


This is a support group for friends and families of people who use narcotics. Nar-Anon is also based on the 12-step model, like Alcoholics Anonymous. Nar-Anon is free and provides advice on how to approach a loved one and deal with their addiction.

How to Identify Relapse Behaviors

If you notice that the student is exhibiting any or all of these behaviors, they may be at risk for relapse.

  • Are they romanticizing past drug use?
  • Do they talk about partying?
  • Do they want to use drugs or alcohol?
  • Do they say, “I’ll just have one drink,” or “I’ll just take one hit?”
  • Are they hanging out with friends they used to drink or do drugs with?
  • Are they slipping back into old patterns?
  • Are they in denial?
  • Are they defensive?
  • Have you noticed a sudden change in their attitude?
  • Are they feeling lonely or depressed?

What Should I Do If My Friend Relapses?

Relapse is difficult for both the people suffering from addiction and those who care about them. Returning to drug or alcohol use can be an indication that a person has more work to do in addiction treatment, but this shouldn’t feed into the notion that all the hard work they’ve already done has been for nothing. Here are some strategies you can try if you notice that your friend is slipping back into old patterns of substance abuse in college:

  • Openly communicate about your concerns in a non-judgmental and empathetic way. Let them know how much you care about them.
  • Talk about how far they’ve come. Remind them of their progress, emphasizing that all is not lost.
  • Help them make a list of the things that make them happy without drugs or alcohol.
  • Encourage them to go to a 12-step meeting if they haven’t yet.
  • Call their sponsor and let them know what your concerns are.

Relapse is a serious issue, but it shouldn’t be taken as a sign of failure or embraced as a reason to continue using drugs or alcohol. Instead, relapse episodes should be viewed as a signal that it’s time to make some changes in the person’s recovery plan and perhaps even revisit certain components of the initial treatment process. With commitment and hard work, the person’s recovery progress can pick back up right where it left off.

If you are feeling exhausted or hopeless, make sure to go to an Al-Anon or Nar-Anon meeting for support. You have to remember to take care of yourself during this time and also create boundaries.

Substance abuse among college students is dangerous, and the sooner you can have the conversation about recovery, the safer your friend will be. Odds are they are waiting for someone to reach out about their alcohol and drug problems.

  1. National Institute on Drug Abuse. (2016). What to Do If Your Adult Friend or Loved One Has a Problem with Drugs.
  2. National Council on Alcoholism and Drug Dependence. (2015). Am I Drug Addicted?
  3. National Institutes of Health. (2014). Alcohol Use Disorder: A Comparison Between DSM-IV and DSM-5.
  4. National Institute on Drug Abuse. (2012). Is there a difference between physical dependence and addiction?
  5. National Council on Alcoholism and Drug Dependence. (2016). Signs and Symptoms.