Guides to Substance Abuse on College Campuses

A College Student’s Guide to Addiction & Recovery

College students across the country face tremendous struggles when it comes to battling addiction. The combination of stress, peer influence, and the culture of binge drinking and illicit drug use in college can fuel college substance abuse.

In 2015, the annual prevalence of illicit drug use was the same for college students and non-college respondents (41%). The annual prevalence of marijuana use was slightly higher among individuals not in college versus students in college (39% vs. 38%). In contrast, the use of amphetamines is higher among college students compared to non-college individuals (9.7% vs. 8.1%). Alcohol use among college students is much higher than in young adults who are not in college, with 79% of students reporting annual use compared to 71% of non-college students.1

One of the most alarming statistics about drinking patterns in college is the rate of extreme binge drinking among students. About 1 in 8 students (13%) report having 10 drinks or more in a row at least once in the last 2 weeks. And 1 in 20 students (5%) report having 15 drinks or more in a row at least once in the last 2 weeks.1

If you are consistently taking substance use to the limit, getting help could be a life or death situation. Many people struggle with addiction during college, and it’s important to know you are not alone. Getting treatment at a rehab center can help you understand how your mind and body work, and how your family history or early childhood experiences may have led to your addiction.

What are some of the consequences of using drugs or alcohol in college?2

  • Lower GPA from missing classes and poor academic performance.
  • Legal problems related to underage drinking or illicit drug use.
  • Physical and sexual assaults.
  • Health problems and emergency room visits.
  • Risky behaviors such as drunk driving.
  • Damaged relationships.
  • Financial problems.

Many people struggle with addiction during college, and it’s important to know you are not alone. If you are consistently taking substance use to the limit, getting help could be a life or death situation.

What Is Addiction?

Addiction is a complex physiological condition, marked by compulsive drug- or alcohol-seeking behavior, or an intense desire to use drugs or alcohol, despite severe medical or social consequences.3 Genetic, societal, and cultural factors all play a role in who is susceptible to addiction and how it manifests in individuals.

If you are struggling with addiction, it can be helpful to learn how addiction is connected to your genes. Addiction is not a moral failing, and research now confirms that some people are born with a higher chance of becoming addicted than others. So, even though you and your roommate may drink the same amount, you might be more prone to addiction because of your genetic makeup. By looking at addiction through this lens it can help you separate yourself from your addictive behavior and seek the appropriate help.

Is Substance Abuse Something You Can Be ‘Prone’ To?

Is addiction heritable? Yes, your genes could place you at a higher risk for developing an addictive disorder. Our genes carry varying levels of heritability for addiction—ranging from 0.39 for hallucinogens to 0.72 for cocaine.4 In fact, the degree of heritability is higher than other diseases, such as type-2 diabetes, hypertension, and breast cancer. Stress can also increase your risk for addiction.5

The environment you grew up in also plays a role in your relationship to drugs and alcohol. For example, if you go through certain experiences early in life, you are more prone to substance addiction than someone who didn’t. These adverse childhood experiences include:6,7

  • Physical abuse.
  • Emotional abuse.
  • Sexual abuse.
  • Physical neglect.
  • Emotional neglect.
  • Parental separation or divorce.
  • Growing up in a household with:
    • An alcoholic.
    • A drug user.
    • A family member in prison.
    • Someone who is mentally ill.
    • Someone who is chronically depressed.
    • A mother who is treated violently.
    • Absence of both biological parents

Studies have found that when children experience one or more of the above childhood experiences, they are more likely to:7

  • Attempt suicide.
  • Experience depressive disorders.
  • Have a sleep disorder.
  • Engage in high-risk sexual behavior.
  • Have a miscarriage or stillborn birth.
  • Use alcohol use at an early age.
  • Develop an alcohol use problem as an adult.
  • Use tobacco as an adult.
  • Abuse prescription drugs.
  • Develop an addiction.

In addition to genetics and family history, other factors play a role your susceptibility to substance abuse, including:

  • Frequency of drug or alcohol use.
  • The age at which you started using alcohol or drugs.
  • The length of time you’ve been using alcohol or drugs.
  • The quality of your friend and family support systems.

Furthermore, the groups you associate with may also increase your chances of binge drinking. Studies show that binge drinking is most prevalent among:8

  • Men.
  • People in Greek organizations (fraternities or sororities).
  • Athletes.
  • Younger students.

However, protective factors do exist, and your environment can help protect you against binging. These environmental factors include:8

  • Living in substance-free dormitories.
  • Having a sober group of peers whom you trust.

What is the Difference Between Recreational Use and Addiction?

When you use drugs or alcohol your brain’s reward system is activated—reinforcing your substance use behaviors. However, not all students who use drugs or alcohol in college will develop an addiction.

The American Psychiatric Association uses a set of diagnostic criteria when determining whether a person has a diagnosable substance use disorder. Generally speaking, a person is considered to have substance use disorder or addiction if they experience at least 2 of the following criteria in a 12-month period:9

  1. The substance is taken in larger amounts or for a longer period of time than intended.
  2. The person spends a lot of time obtaining, using, or recovering from the effects of the substance.
  3. Unsuccessful attempts to stop or cut down substance use.
  4. Strong cravings or desires to use the substance.
  5. Use of the substance results in failure to fulfill major responsibilities at school, work, or home.
  6. Continued substance use despite these problems.
  7. The person gives up activities they once enjoyed because of substance use.
  8. Substance use persists despite physical or psychological issues.
  9. Continued substance us in situations that are physically dangerous (e.g., while driving).
  10. The person develops a tolerance to the substance, marked by the need to consume larger amounts in order to obtain the same desired effects.
  11. The person experiences withdrawal symptoms when they stop using the substance.

Each addictive substance has a unique set of diagnostic criteria, including withdrawal symptoms and specific patterns of use that cause significant impairment.

If you or someone you love has a problem, it’s important that you get help. Call us today at 1-888-520-6748 to learn more about diagnosing addiction and what treatment options are available for college students.

Is There a Way to Prevent Addiction from Happening?

Preventing substance abuse among college students is tricky because campus life is full of triggers and common factors that contribute to addictive behavior. Positive attitudes toward drinking, the availability of alcohol, increased stress levels, and impulsivity can create a perfect storm that can lead to substance abuse.9 This is why it’s important to seek help as soon as you think you may have a problem.

The college environment can play a major role in your likelihood of using alcohol or drugs. For example, if you have access to cheap or discounted alcohol, you may be more likely to binge drink.8 Bars that are close to college campuses usually promote themselves to students and offer drink specials.

How Do I Know If I’m Addicted?

If you’re wondering whether you have a problem with alcohol or drugs, take a few moments to answer the questions below. This quiz was adapted from the National Council on Alcoholism and Drug Dependence (NCADD).10

  1. Have you used drugs other than as prescribed by a doctor?
  2. Do you feel like you need to use drugs or alcohol every week?
  3. Are you able to stop using drugs/alcohol?
  4. Have you had blackouts or flashbacks due to drugs/alcohol?
  5. Do you use more than one substance at a time?
  6. Have you neglected your school responsibilities because of your drug or alcohol use?
  7. Does your substance use cause problems with your schoolwork (missing class, failing classes, dropping out)?
  8. Have you been in trouble at school because of your drug use or drinking?
  9. Do you fight with others under the influence of drugs?
  10. Have you lost relationships because of drugs or drinking?

Disclaimer:

Answering yes to one or more of these questions could indicate that you have an addiction, but the results of this quiz do not qualify as a medical diagnosis. Seek an assessment from a qualified health professional on campus if you think you may have a problem with substance abuse.

Preventing substance abuse among college students is tricky because campus life is full of triggers and common factors that contribute to addictive behavior.

How Do I Get Help

If you feel overwhelmed about how to get help, take a deep breath. You are not alone and there are many resources to help you get sober. Keep in mind that focusing on your health and safety is more important than anything else—even school. Read on to learn how to seek help for your substance abuse problem.

Reach Out to Family Regarding Your Drug Problem

Letting your close friends and family know what’s going can be scary. Before you reach out to them, you can prepare for the conversation by:

  • Writing down what you want to say.
  • Coming up with 1–3 examples of times when your substance abuse negatively affected your life.
  • Remind yourself of your triggers, especially if they pertain to your relationships with family or friends.

It can be extremely useful to take the time to think about how your friends or family might respond to your drug or alcohol problem. If possible, try to imagine what your response will be. Some family members or friends may not be supportive. If you know this will deter you from treatment or trigger you to want use substances, you can walk away and take however much time you need to process their reaction in a healthy and productive way.

Those who are closest to you love you and should be supportive of your decision to reach out for help, but that doesn’t always happen. Unfortunately, some people still view addiction as a moral failing. Prepare yourself for the worst—you may hear things that are hurtful, such as, “If you are addicted you are a bad person,” or “This means that something is wrong with you.” Remember your own self-worth. You are not your addiction and you can get better.

If your friends rely on drugs and alcohol to socialize, it can be hard to distance yourself from them. They might try to peer pressure you, mock your decision, or put you down. Be prepared to stand your ground. No one knows your situation better than you. Remain confident that you are taking care of yourself and your future. Deep down, if your friends are also struggling with some sort of substance abuse disorder, they may see your decision to get help and rethink their own drug and alcohol use.

Be ready for these possible reactions from your peer group, and ask yourself how you would handle these responses:

  • “You don’t have a problem.”
  • “We drink the same amount every night and I’m not addicted.”
  • “You’re overreacting.”
  • “You are going to fail your classes.”
  • “You drink the same as I do.”
  • “We do the same things at parties, and you still go to class. You don’t need help.”
  • “But you’re still going to work, nothing is wrong.”

Your friends might try to compare to your situation to themselves and minimize the problem. In this case, the notes you created before the conversation will be useful. You can refer to specific situations where your drug or alcohol abuse put you in a dangerous situation. For example, you can say, “I’m endangering my future and my life,” or “everything might look good on the outside, but I see my life in chaos.”

Use “I” statements and focus on how you are feeling, and remind your friends about what has happened in your life because of your drug or alcohol use. It can help them understand the weight of the situation when you remind them of your actions and behaviors are under the influence.

Other useful phrases you can say in response may include:

  • “I really appreciate having you in my life, but right now I am focusing on getting sober.”
  • “I understand that you don’t think it’s a problem, but I think it is”
  • “I don’t feel like I have control of myself anymore.”
  • “I feel hopeless.”
  • “I tried to stop on my own and haven’t been able to.”
  • “I am going to lose my chance to get a degree in college.”
  • “I am going to get arrested and have a charge on my record.”

These conversations are difficult to have even with supportive, caring friends and family members. Keep in mind that this is your life at stake—you don’t need anyone else’s permission to seek the care you need. If you feel like the conversation is upsetting you or your friends and family won’t accept that you need help, feel free to step away and seek guidance from a counselor or someone you know can help you. You can call us at 1-888-520-6748 to speak to a treatment support specialist about your options for entering a rehab program.

Go to Your Campus Counseling Center or Staff

A productive first step toward recovery is scheduling an appointment to speak to a nurse, counselor, or doctor at student health services so you can discuss your concerns with a professional. The medical staff should understand the serious stigma associated with substance use disorders, and how hard it can be to ask for help. All the information you share with them will be confidential—just like any other doctor’s visit. You will not get in trouble for talking about alcohol or substance use. You are seeking help for a serious health concern and there are people who are able to help you. You don’t have to be alone in this battle.

Campus health staff will be able to refer you to recovery centers that provide a range of support services targeted specifically to students and young adults, so you can take the next step in treatment.

Another resource to consider taking advantage of is the guidance department. You can always make an appointment with a guidance counselor to talk about what you’re going through. Your guidance counselor may provide information on 12-step meeting times and locations, resources on campus that can support recovery, and contact information for finding a sponsor to serve as your mentor during recovery.

Ideally, you will be able to transition into treatment easily to minimize your time away from school.

Seek Help from Healthcare Professionals

Although student health services are a good place to start, most campus-based counseling services are not adequate to fully treat addiction, support students in recovery, or help students whose addiction is related to other severe mental health disorders such as depression. Seeking help from a licensed addiction treatment facility in your area is the best way to ensure you get the complete care you need.

Your on-campus health staff will be able to refer you to a local rehab center, or you can start the process by yourself online. This tool allows you to browse a nationwide directory of treatment facilities—complete with user reviews, photos, and contact information.

If special services are important to your recovery, or you just want to take the opportunity to try something new, look for a rehab facility that offers these amenities. Above all else, it’s important that you feel comfortable with the staff and services provided during treatment.

Treatment for Substance Abuse

Seeking help for a drug problem looks different for every student. Your experience in rehab will be influenced by a number of factors, including the drug(s) you abuse, your length of abuse, any other mental health difficulties you may have, and the overall severity of your addiction. There are varying levels of treatment intensity, and your doctor will be able to refer you to the most appropriate type of rehab. Addiction is a chronic struggle.

How to Choose Between Inpatient vs. Outpatient

Addiction is a chronic struggle. It can take a lot of work to stop using drugs or alcohol. Some people need to try treatment a couple of times to find success in staying sober. Luckily, drug abuse treatment for college students is flexible and there are different models of treatment available. It is important you find what works best for you.

Treatment options include:

Inpatient treatment:

These programs are intensive and require that you live at the facility throughout your entire program. When you enter inpatient treatment you will be assessed by a trained medical professional who will work with you to develop a treatment plan—this will serve as a roadmap for your recovery. Inpatient treatment may include individual therapy, family counseling, relapse-prevention classes, aftercare planning, group therapy, and support groups. If you have a severe addiction and require a high level of care, inpatient programs are a great option.

Outpatient treatment:

Most students will complete a period of inpatient treatment and then transition into outpatient treatment so that they can keep up with their schoolwork. In an outpatient setting, you will live at home or on campus and visit the treatment center each week to work with a therapist and participate in group therapy. Outpatient gives you the flexibility to attend therapy while also working on your degree. Every outpatient facility is different, but in general, you will meet 1–2 times per week for 1–2 hours each day.

Drug abuse treatment for college students helps you work through your addiction. And though every treatment center approaches recovery differently, common therapies used in both inpatient and outpatient settings include:

Cognitive-behavioral therapy (CBT):

This form of therapy helps you recognize the situations that trigger you to use drugs or alcohol. When college students recognize their own triggers, they can figure out how to better respond to situations they face on campus and in their daily lives.

Family therapy:

Families can play a big role in supporting students throughout their recovery. If you have the option to work with your family in treatment, it can be beneficial to your long-term success.

Motivational interviewing (MI):

During MI, your therapist may resemble a coach who helps you actualize your own next steps in recovery. You will learn how to use personal motivation to keep yourself clean and sober. As a college student, one of the goals used to motivate you may be finishing your degree and graduating college.

Motivational incentives (contingency management):

Many treatment centers use incentives to motivate you to stay sober. You will receive a reward for reaching treatment benchmarks. Incentives may include prizes (cash vouchers, food, small gifts) or privileges (time outside the treatment center) when you produce drug-free urine samples during treatment.

Other forms of therapy that are used to treat college students include Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Mindfulness-Based Relapse Prevention (MBRP)11. Because mental health problems commonly occur alongside addiction in college students (called comorbidity), treatment centers that specialize in treating comorbidities are ideal. These programs will help you identify what physiological issues are contributing to both your substance use and your mental health problems.

What is the Standard Length of Treatment?

The length of treatment will vary depending on the facility and intensity of care you need. Both inpatient and outpatient programs typically last from 30 to 90 days, but this length can be extended or shortened depending on what your needs are. As a college student, you may have different concerns about the length of treatment compared to other individuals. When looking for programs, you can ask about the facility’s average length and how flexible they are on length of treatment.

Types of Programs and Amenities are Available at Drug Treatment Centers

Rehab centers range in the services they offer. Some facilities offer very basic amenities, while others are more upscale. If you want access to specific things during treatment—such as a pool, workout equipment, private room, or chef-prepared meals—you should investigate all your options before making your final decision. Many programs offer virtual tours so you can get an idea of what the facility will be like.

Other unique program activities that drug rehab facilities might offer include:

  • Swimming.
  • Yoga.
  • Massage therapy.
  • Acupuncture.
  • Horseback riding.
  • Art therapy.
  • Nutritional counseling.
  • Saunas.

If special services are important to your recovery, or you just want to take the opportunity to try something new, look for a rehab facility that offers these amenities. Above all else, it’s important that you feel comfortable with the staff and services provided during treatment.

How to Go Back to School After Seeking Treatment

After you’ve completed an addiction treatment program, it will be up to you to decide when you’re ready to transition back to college life. If you feel ready to return to class, it’s important to understand the risk of relapse and other difficulties you may face.

Going back to school while in early recovery can be dangerous and will require a great deal of self-control to avoid the people, places, and situations that contributed to your addiction the first time. However, it is possible and college students do it every day.

To prepare, talk to your therapist about any fears or concerns you have about returning to the college environment. They can help you by reviewing triggers and even work with you create a relapse prevention map. Together, you can walk through scenarios that you may encounter on campus so that you feel confident to handle whatever urges, stressors, or triggers you may face.

Some people feel too overwhelmed to go straight back to school, and there’s nothing wrong with that. It’s important to listen to your body and take however much time you need.

If you feel like the conversation is upsetting you or your friends and family won’t accept that you need help, feel free to step away and seek guidance from a counselor or someone you know can help you.

Recovery for College Students

Recovery begins the first day you are sober, and it lasts a lifetime. College can present many challenges to your recovery, so it’s important that you develop an aftercare plan that will help you deal with triggers and cravings once you transition back into your normal school routine.

Friends who are supportive and invested in your sobriety will make a huge difference in your recovery. A growing body of research has found that a strong network of supportive peers can help you stay sober after rehab by reducing drinking norms, helping you stay engaged in school, and improving your overall mental health.2

Having a therapist, sponsor, or counselor you can be honest with is going to be a key to your recovery. This is a person you can vent your frustrations to, ask for advice, work through complex feelings with and lean on when temptations and cravings arise.

When you first get sober, you’re going to have cravings; it’s learning how to adapt and deal with those cravings that will be critical to your success. Try taking deep breaths and repeating a mantra in your head, such as:

  • It’s not worth it to go back through the cycle of addiction.
  • There’s always tomorrow—just get through today.

How Do I Have Fun as a Sober Person?

While it might seem like everyone around you only thinks about partying, college is a time when you can access incredible educational and recreational programs that have nothing to with drugs or alcohol. Take advantage of opportunities to study abroad in a foreign country to gain a completely new perspective, or look in to clubs that meet up for activities like soccer matches or weekend hikes for a chance to meet new people and do something healthy for your body. If you’re not the outdoorsy type, try a book club or volunteering at a local nonprofit. There’s no shortage of things to do in sobriety, you just need to get out there and find them!

In college most people just think about partying, but college is a time where you can learn and access incredible educational opportunities. Take advantage of your education and keep a clear mind that is free of drugs and alcohol. Having a therapist, a sponsor, a counselor you can be honest with and go to if you are dealing with issues in recovery is going to be a key to your recovery.

Collegiate Recovery Programs

Many campuses have collegiate recovery programs (CRPs) to support college students who are in recovery. There are CRPs across the country; visit the Association of Recovery in Higher Education’s website to see if your university offers a program.

If your college doesn’t have a recovery program, consider organizing your own group. Once you have gone through addiction and treatment, you know how challenging it can be. It’s important for other students to not feel alone, and to find a community of people who are going through the same issues. You can help others by organizing meetings or mentoring younger students who struggle with substance abuse.

You can also:

  • Build awareness on recovery-related issues.
  • Reduce stigma of recovery on campus.
  • Encourage university administrators to increase support of students going through recovery.
  • Create prevention campaigns about substance use on campus.

Finding a community of sober people can help strengthen your movement and make your message heard. By creating a safe space where students in recovery can share their feelings and connect with one another, you might be saving a life. These types of campus programs can have a major effect on a school’s norms around drinking and drug use.

Sharing your story of addiction with others is incredibly powerful. By getting in involved in a recovery community on campus, you can help destigmatize addiction and encourage other students to get help.

12-Step Programs and Other Recovery Groups for College Students

Some colleges hold 12-step meetings like AA or NA on campus. Ask your guidance counselor for more information about when and where they meet.

If your campus does not offer 12-step programs, you could start your own. Technically, a 12-step meeting is when 2 or more people get together with the aim of helping one another. Here’s what you need to get started:

  • At least 2 people.
  • A space where you can hold meetings (that’s not your dorm room or other private space).
  • Approval through your university.

Once you have the logistics set up, you can share the meeting information so that other students on campus who are in recovery can find you.

12-Step Programs:

Alcoholics Anonymous

Narcotics Anonymous

Celebrate Recovery

Cocaine Anonymous

Gamblers Anonymous

Heroin Anonymous

Co-Dependents Anonymous

Crystal Meth Anonymous

Non-12-step programs:

LifeRing Secular Recovery

SMART Recovery

Women for Sobriety

Moderation Movement

Recovery 2.0

Recovery International

Secular Organizations for Sobriety

A Few Tips to Avoid Relapse and Stay on Track in School

Early sobriety is a delicate time. Once you leave rehab, you are at risk for relapse. It’s important that you take caution and protect yourself during this time. For example, you may want to avoid places where you used to get drunk or buy alcohol.

Other tips for avoiding relapse:

  • Know what people, places, and things to avoid: In rehab, you’ll learn what to avoid, but in general: Stay away from Greek life, don’t use certain utensils that you used to use to get high with, and avoid shows, movies, or books where the characters are using substances until you can handle seeing these images.
  • Change your relationships with people who are unhealthy for you: If there are people you used to party with, you will have to limit your time with them and choose your activities carefully. For instance, you can go out to lunch with them or study for a test together, but don’t go out to the bars or parties with them.
  • Avoid places where you used to use drugs: If you have to walk past a place where you used to drink or buy drugs, take a different route—even if it’s much longer.
  • Keep yourself accountable: Tell as many people as you can that you are in recovery. Having open conversations with friends, family, counselors, roommates, and romantic partners will help keep you accountable. For example, if you have a follow-up with your doctor and you don’t trust yourself to keep the appointment, ask a buddy to go with you.

These are not “forever” tips, but in early sobriety, it’s easy to overwhelm yourself. Practice self-care by surrounding yourself with sober people and minimizing triggers whenever possible. This will help you stay focused on school and stay on track with earning your degree.

What Does Life Look Like Without Drugs?

Actually, life is pretty awesome without using substances. Peer pressure makes this difficult to believe, because you feel like you’re missing out. But, guess what? You’re not missing out; you’re experiencing life in a better, clearer way. You are able to remember things. You don’t need a mind-altering substance to have fun. In treatment you will learn that using drugs and alcohol to have fun is a learned behavior. Having fun in sobriety is possible, but fears hold us back.

Sources
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  2. Perron, B. E., Grahovac, I. D., Uppal, J. S., Granillo, T. M., Shutter, J., & Porter, C. A. (2011). Supporting students in recovery on college campuses: Opportunities for student affairs professionals. Journal of student affairs research and practice, 48(1), 47–64.
  3. Soyka, M. (2017). Treatment of Benzodiazepine Dependence. The New England Journal of Medicine, 376(12), 1147–1157.
  4. Nestler, E. J. (2000). Genes and addiction. Nature genetics, 26(3), 277–281.
  5. Nestler, E. J. (2005). The Neurobiology of Cocaine Addiction. Science & Practice Perspectives.
  6. Felitti, V. J. (2004). The origins of addiction: Evidence from the adverse childhood experiences study.
  7. Substance Abuse and Mental Health Services Administration. (2016). Adverse Childhood Experiences.
  8. Weitzman, E. R., Nelson, T. F., & Wechsler, H. (2003). Taking up binge drinking in college: The influences of person, social group, and environment. Journal of Adolescent Health, 32(1), 26–35.
  9. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Washington, D.C.:  American Psychiatric Publishing.
  10. National Council on Alcoholism and Drug Dependence. (2015). Am I Drug Addicted?
  11. Levin, M. E., Lillis, J., Seeley, J., Hayes, S. C., Pistorello, J., & Biglan, A. (2012). Exploring the relationship between experiential avoidance, alcohol use disorders, and alcohol-related problems among first-year college students. Journal of American College Health, 60(6), 443–448.