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When they go to college, students are forced to adapt to a radically new lifestyle—one with less structure and more pressure. When the difficulty of managing college life becomes overwhelming, some students may turn to alcohol and drugs to cope. In fact, 1 in 4 college students meets the standard for substance abuse according to the American College Personnel Association (ACPA).
Sadly, alcohol and drug use are highly prevalent among young adults and college students. And the influence of social media cannot be understated. With binge-drinking trends like “BORG (blackout rage gallons) drinking” gaining traction on TikTok, trending content on social media can encourage students to abuse alcohol and drugs. The National Survey on Drug Use and Health (NSDUH) found that:
- 12 million young adults aged 18 to 22 drank alcohol (54.8%)
- 7.8 million engaged in binge drinking (35.3%)
- More than 4.5 million used cannabis (20.7%)
- 299,000 used cocaine (1.4%)
- Nearly 6 million smoked cigarettes (26.7%)
A Psychiatric Times special report on substance misuse in college students notes that, over the past two decades, substance use trends have increased among college students. However, societal attitudes toward illicit substances have lessened at the same time. The brains of young adults are still developing during this stage of life, “leaving students at a heightened susceptibility to abnormalities on measures of brain functioning,” which increases risk factors for substance use disorders (SUD).
What causes college students to misuse alcohol and drugs
The shift in how illicit substances are viewed in society paired with the challenges associated with college life—separation from family, participation in new social networks, and intense academic pressures—can contribute to increased college drinking and drug misuse. The American Addiction Centers outlines several stressors that can cause college students to turn to different substances as a way of managing negative feelings.
- Social reasons: Drinking or drugs are commonly used in social situations. Some students use substances to reduce tension or social anxiety or to relax in social situations.
- Family history: Students have an increased risk of addiction when they have family members who have illicit/prescription drug or alcohol consumption issues.
- Beliefs about substance use: Some college students experience peer pressure or think it’s acceptable or normal to abuse substances as part of the college experience.
- Greek life: Studies have shown that members of fraternities and sororities have a much higher rate of binge drinking, substance abuse, and cigarette smoking.
- Academic performance: Poor academic performance can be both a cause and consequence of substance use.
- The difficult transition to college: For many people, college is a transition time between childhood and adulthood and can be the first time in life without parental supervision.
- Availability of drugs and alcohol: Often, substances can be easily accessed on college campuses. This easy access to drugs or alcohol can lead to an increased risk of substance abuse.
Discover how virtual health supports students seeking help
What substances do college students abuse most frequently?
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that many students see alcohol use as a ritualistic part of college. Some students, however, come to campus with pre-existing drinking and illicit drug use habits as well. The drugs most commonly abused by college students include:
Marijuana
Abuse of marijuana is highest among people aged 21–22. Vaping marijuana is highest among people in their early 20s. There’s considerable evidence of the short-term impact of heavy cannabis use on memory and learning, and it plays a negative role in academic and health outcomes on college campuses. The likelihood of cannabis use increases during the college years, with some studies demonstrating an escalation in prevalence with each successive year.
Psychedelics
Drugs like MDMA (Ecstasy), LSD, and other hallucinogens have gained popularity in recent years, with many students using them out of curiosity, to have the experience, or to escape. Micro-dosing, the act of using small doses of hallucinogens to achieve a slight effect, has also increased among college students in recent years.
Stimulants
One in 10 college students reported nonmedical use of Adderall in a 12-month period. Adderall and other “study drugs,” including Ritalin, Concerta, Vyvanse, and Modafinil are often used for cognitive enhancement purposes. The risk of abuse is especially elevated for female college students, who are twice as likely as their noncollege female counterparts to use stimulant medications for nonmedical purposes. The risk is also higher among college students with lower GPAs and those who have skipped more classes.
Cocaine
A longitudinal study of 1,253 college students found that more than 4% had used cocaine in the past 12 months, and 20% were exposed to opportunities for cocaine use in the past year.
Opioids
A high percentage of young adults between the ages of 18–25 suffer from prescription painkiller abuse or prescription opioid abuse. Vicodin, Percocet, and OxyContin are often the first painkillers or opioids students turn to—sometimes after legitimate use for an injury. Opioid and painkiller abuse can often escalate to street drugs such as heroin or fentanyl, which are a significant cause of unintentional death and injury among people in this age range.
The impact of alcohol and drug misuse on college students
Substance abuse causes a variety of consequences for college students. There are many short- and long-term impacts of drug and alcohol abuse on college students.
1. Physical health
Students who abuse drugs or alcohol for a long time often see a decline in their physical health. One of the biggest health risks is damage to essential organs like the lungs, heart, brain, and liver. Physical effects include:
- Weakened immune system
- Increased risk of certain cancers
- Skin and hair problems
- Infertility or erectile dysfunction
- Vision and oral problems
- Unhealthy weight loss or weight gain
2. Mental health
The chance of having a psychiatric disorder or mental illness along with substance abuse is 3.6%. Not only are these highly comorbid behaviors, but drugs and alcohol can also affect the daily mental health of individuals not diagnosed with or dealing with long-term mental illness. Common effects include:
- Low self-esteem
- Trouble focusing
- Lack of motivation
- Unclear or illogical thinking
- Increased aggression
- Depression and mood swings
- Anxious thoughts
3. Social issues
Substance abuse has been shown to increase feelings of loneliness and isolation. As a user becomes more dependent, they may withdraw more into themselves. Avoiding social activities can result in losing important relationships. Another social issue that can be the cause or consequence of substance abuse is falling in with a negative social circle. For example, if a student has a binge drinking disorder and is part of a group of people who enjoy drinking, it makes it harder to get away from alcohol and curb binge drinking. Drugs and alcohol can also cause dangerous behaviors like driving under the influence, assaulting others, stealing, or engaging in unhealthy or unsafe sexual behaviors.
4. Academic issues
The primary goal of attending college is to further education and expand on knowledge. However, addiction can derail that goal and cause students to:
- Skip classes
- Forget or fail tests
- Spend less time studying
- Miss out on opportunities
- Lose focus and motivation
- Be put on academic probation
- Get expelled
5. Death and assault
According to recent statistics from the NIAAA, about 1,519 college students aged 18 to 24 die from alcohol-related unintentional injuries, including motor vehicle crashes. Statistics also estimate that approximately 696,000 students of the same age group are assaulted by another student who has been drinking, and researchers confirm that 1 in 5 college women experience sexual assault during their time in college—a majority of which result from alcohol or other substance use.
What can colleges and universities do to support students?
Successful efforts to address alcohol addiction and drug abuse during college involve a mix of initiatives that target individual students, the student body as a whole, and the broader college community.
Individual-level interventions target students, including those in higher risk groups, such as first-year students, student-athletes, and members of Greek organizations. Interventions should be designed to change student knowledge, attitudes, and behaviors related to alcohol and illicit drugs so they drink less, take fewer risks, and experience fewer harmful consequences. Individual-level interventions include the following:
- Education and awareness programs
- Cognitive-behavioral skills-based approaches
- Motivation and feedback-related support groups
- Behavioral interventions by health professionals
Environmental-level strategies target the campus community and student body as a whole. They’re designed to change the campus and community environments where student drinking or drug use occurs. Often, a major goal is to reduce the availability of alcohol or enforce consequences for substance abuse.
For more information on individual- and environmental-level strategies, visit NIAAA’s College Alcohol Intervention Matrix (CollegeAIM). It rates over 60 alcohol interventions for effectiveness, cost, and other factors.
Many colleges and universities offer peer-driven Collegiate Recovery Programs (CRPs), which enable students to continue their recovery process alongside their studies. For example, the Association of Recovery in Higher Education (ARHE) counts at least 152 U.S. institutions among its members with CRP treatment programs. However, students who need a CRP often don’t know they even exist. A 2021 study by the American College Health Association found that only 1.6% of students reported being in recovery for substance abuse, and only 1.1% were diagnosed with an alcohol use disorder or drug addiction. Even so, studies also show that nearly 88% of alumni of CRPs had not relapsed since their graduation. The positive impact of CRPs is clear, meaning higher education institutions must help students with substance abuse problems connect more effectively to CRPs.
Using health coaching to combat alcohol and substance abuse
Health coaching is another way colleges and universities can help students make healthy lifestyle choices to change unhealthy behaviors or maintain sobriety as a complement to addiction treatment. The American Medical Association (AMA) defines health coaching as “a patient-centered approach where patients determine their goals, use self-discovery or active learning processes together with content education to work toward their goals, and self-monitor behaviors to increase accountability, all within the context of an interpersonal relationship with a coach.”
Health coaching is proven to be effective in improving short- and long-term physiological, psychological, and behavioral health outcomes. It’s also a cost-saving approach that reduces healthcare utilization by helping students live healthier lives.
Through virtual health and well-being programs, such as TimelyCare, higher education institutions can provide virtual health coaching to their students. This virtual access to health coaching offers immediate access to health coaches who can collaborate with your campus health center to support students in meeting their health and well-being goals. With evidence-informed strategies, TimelyCare’s providers can help influence positive health behaviors, using behavior change theory to guide students through health-enhancing journeys
TimelyCare’s health coaches provide student-centric health coaching services on relevant topics, including stress management, time management, healthy eating habits, healthy relationships, substance use/misuse, physical activity, and sleep improvement. As a complement to the campus clinic and/ or counseling center, TimelyCare’s virtual health and well-being platform provides medical and mental health support along with health coaching, psychiatry, and care coordination support.
Contact TimelyCare to learn more about health coaching services to support college students facing alcohol and substance abuse on your campus.