College Students & Drug Use: How Universities Can Intervene Before It’s Too Late

By Dr. Charles Smith, Physician at Recovery First Treatment Center, an American Addiction Centers facility

On many campuses across the country, substance use is synonymous with the college experience, especially when it comes to alcohol consumption. Some colleges even seem to promote drinking in their “work hard, play hard” marketing materials and take pride in their rankings as top party schools in the country.

But the reality is, the college years are an extremely vulnerable time for young adults. We know that human brains don’t fully mature until around age 25, nor does the dopamine reward system, making college kids more inclined to chase the “high” with less regard for the consequences.

The combination of biochemistry with newfound autonomy, experimentation and peer pressure creates a breeding ground for substance use. And many kids arrive at college already taking prescribed stimulants for ADD/ADHD or medications for anxiety or depression, which when combined with alcohol or other substances, can create a dangerous cocktail.

More recently, those risk factors have been compounded by the impact of COVID-19. According to the CDC, at the peak of pandemic lockdowns in June 2020, 63% of youth 18-24 reported symptoms of anxiety or depression, 75% had at least one adverse mental or behavioral health symptom, and over 25% had seriously considered suicide within the last 30 days. A quarter of students said they started or increased substance use to cope with pandemic-related stress. Add that to the existing 60% of students who said they’ve used alcohol as a coping mechanism, and it’s easy to see how the turmoil of the last two years is driving higher risks of addiction.

In addition, products intended to make substance use more appealing are cropping up everywhere, from alcoholic beverages being marketed as soft drinks or “low carb” to give the impression of a healthier alternative, to the prevalence of vaping, which makes nicotine and cannabis use socially acceptable even in public.

Against this backdrop, college-age youth are also less likely to seek treatment for substance use disorder. Almost 1 in 4 college age kids meet the criteria for a diagnosable alcohol or illicit drug use disorder—far exceeding the estimates for younger and older age groups—but only 3.6% perceive the need for help, and only 4% have sought treatment for alcohol use.

It’s important that college administrators implement strategies to not only warn students of both the short- and long-term dangers of substance use, but also to discourage the behavior and provide alternative options and resources. Here are ways to help: 

  1. Don’t preach, teach. College-aged adults are experiencing independence for the first time and relishing the opportunity to make their own decisions. So let them – based on the facts. Provide education on the effects drugs and alcohol have on the body. Tell them about the prevalence of liver and heart disease, the damage drugs and alcohol have on brain function and capacity, and how this impacts academic and/or athletic performance.
  1. Explain the risks of tainted drugs. The prevalence of fentanyl-laced drugs and fentanyl overdoses have skyrocketed over the past few years, not to mention the risk of “roofie”-tainted alcoholic beverages. Administrators should provide clear information on the risks and statistics to urge students to be more cautious and careful.
  2. Improve access to help. Colleges should extend their on-campus resources by providing web/online resources, staffing hotlines where students can reach out in a crisis, and engaging students through chat or text messages. When schools make help more accessible, students are more likely to reach out when they need it.
  3. Teach the warning signs. Substance use typically manifests in telltale warning signs among the college-age group. Poor academic performance, sleeping too much or not enough, a change in social groups, skipping classes, taking on more debt than expected and reckless behavior are all red flags. Teaching students to be on the lookout for these signs within themselves and their peers provides an opportunity for early interventions before substance use gets too far out of control.
  4. Promote overall health. Aside from cautioning students about the risks of substance use, campuses can do more to promote overall mental and physical health. Especially in the wake of the pandemic, many people struggle with mental health issues, and quite a few let their health habits slide as gyms closed and sports and fitness-related events were cancelled. Provide sober activities, sober dormitories, and health-focused fun activities on campus. By making sobriety the norm, campuses can change their party-school reputations.
  5. Encourage students to broaden their horizons. Behavior change works best when you replace unhealthy behaviors with healthier alternatives. As our elders used to say, “Idle hands are the devil’s playground.” Those in recovery know this all to well—one of the keys to staying clean and sober is to fill the void left when you remove the substance. Encourage campus students to try new hobbies, to find something they have a passion for—maybe it’s learning to play an instrument or an intramural sport, volunteering, or an internship. This will also introduce them to new social circles that provide healthier support than the happy-hour crowd.
  6. Educate students that addiction is a lifelong disease. Part of the fallacy of youth is thinking, “That’ll never happen to me.” But the reality is, the earlier substance use begins, the more likely it will develop into addiction—a chronic illness that requires lifelong management. It’s also true that the earlier you seek treatment, the better your prognosis. Making students aware of these realities can provide strong discouragement against substance use and encourage those who may be developing addiction to seek treatment now to improve their likelihood of sobriety in adulthood.

Too often, colleges and universities are hesitant to address the issues of alcohol and substance use directly because they fear it will highlight a problem on their campus. But acknowledging the reality and taking aggressive steps to discourage it is a much more effective strategy. The college years are a formative time when many lifelong habits are formed. By helping students to make healthy choices now, administrators can better prepare students for a lifetime of smart decisions.