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College students face a number of challenges: learning to live away from the cocoon of their family and preparing to become the next generation of adults, all while attending parties and still turning up to class on time. Stress can come from a number of different sources, but too many freshmen and seniors are turning to drugs and alcohol to help them cope or simply to live dangerously. Substance abuse among college students is a significant problem, one with long-term consequences, but also with a number of options for treatment.
Drinking (and taking drugs) on college campuses is not a new phenomenon. The annual spring break tradition has long been considered a rite of passage for college-aged adults, celebrating the end of a cold and dark winter with travel, beaches, parties, sex, and alcohol. While college itself presents an opportunity to be independent from parents and guardians (perhaps for the first time in a person’s life), spring break goes even further, providing a couple weeks of freedom from resident advisors and campus authorities.
With that, the American College of Health reports that college males on spring break consume upwards of 18 drinks in a day, while the National Institute of Drug Abuse describes how a quarter of college students between the ages of 18 and 20 travel to spring break destinations (Panama City, Florida, and Tijuana, Mexico, being the most popular choices) to consume alcohol and drugs, such as marijuana and MDMA, more commonly known as Molly. A 2001 article in TIME magazine reported that 15 percent of American college students confessed to trying MDMA (although the number has declined in recent years), at the risk of suffering a stroke because of how the drug makes the body overheat. 1, 2, 3
Panama City is such a focal point of spring break hedonism that the city sees an influx of 500,000 college students every year, buying cheap alcohol and contributing to the local crime rate every March.4 In 2012, 35,000 college students descended on Tijuana, putting police and neighborhood patrols on high alert for fears of vandalism, littering, and opportunistic organized crime syndicates.5
The risk of spring break is that it can go far beyond a simple case of college kids acting out and having fun.
Psychology of Addictive Behaviors writes of the connection between getting drunk on spring break and the consequences:
What happens on spring break may look drastic, but the prevalence of alcohol in the college years is undeniable and likely unchangeable. The Quinnipiac Chronicle writes of the “excessive use of alcohol” being a “key ingredient” of the campus experience. There is even an idea among college students, reported on by the Journal of Drug Education, that alcohol consumption is seen as an integral part of their identity – a cultural obligation that being in college means drinking, drug use, and casual sexual practices.7, 8
To that effect, a survey conducted by Alcohol 101 Plus found that 84 percent of college students drank alcohol in the year preceding the survey, and 72 percent drank alcohol in the month preceding the survey. The figures are corroborated by the National Institute on Alcohol Abuse and Alcoholism, which writes that while four out of five college students (or 80 percent of them) consumed alcohol, half of them do so by binge drinking (consuming an excessive amount of alcohol in a short period of time). 9, 10
The problems caused by these practices include, but are certainly not limited to:
Despite the many dangers of rampant alcohol consumption among young people geared to think in terms of living to excess, universities are reluctant to police their students’ drinking habits (except in cases of egregious medical or legal consequences). For example, Quinnipiac University’s Chief of Public Safety acknowledged that alcohol is a typical catalyst behind acts of vandalism or assault on the university’s campus, but there is no concept of looking to cut the problem off at the source. Similarly, Washington University “embraces alcohol as a social lubricant,” wary that cracking down on on-campus consumption might create a lucrative and unregulated black market (the same way that Prohibition in the early 20th century spectacularly backfired).11
For that reason, many schools across the United States have shifted their focus away from preventing substance abuse among college students. Institutions are leaning towards offering amnesty to students who show dangerous drinking habits, such as binge drinking, showing violent or abusive tendencies while inebriated, missing classes or suffering academically as a result of their drinking, or drinking to self-medicate instead of seeking counseling. Other schools have allowed on-campus establishments to serve liquor or permit limited alcohol consumption in dorms.
In the face of rituals that usually involve drinking to excess, and where some older students feel obliged to keep the tradition going, controlling the damage (by offering amnesty and controlled drinking environments) is one way that college authorities are thinking outside the box to curb alcohol abuse.12
The idea of alcohol being a “social lubricant” takes on a new dynamic in a college setting, where the pressure to fit in and assimilate with peers, cliques, and groups can be a source of stress. In a study on “Peer Pressure and Alcohol Use Amongst College Students,” a researcher posits that the college students who binge drink do so because of the college environment. Before college, people depended on their parents; in college, they depend on their peers to guide and support them through the transitions of moving away from home, being responsible for themselves, and having the weight of academic expectations placed on their shoulders. This is especially true for freshmen who are unfamiliar with the college environment and looking to establish themselves as people who can fit in.13
The alternative, as explained by the Journal of Applied Communication Research, is the risk of being seen as “deviant” from the norm and losing face among their friends. Students who want to abstain from drinking, or who merely want to drink moderately, have to rely on a deft mix of politeness, humor, confrontation, deception, or outright avoidance in order to maintain their social standing, while not giving in to the pressure to drink (or to drink excessively).14
Of course, alcohol is not the only substance that is abused on college campuses. More students use marijuana on a daily basis than has ever been the case over the last 30 years. While that may be partially attributable to the social pressures and stress mentioned above, another reason is due to how marijuana has become more accepted in the mainstream over that same time period of 30 years. A 1969 Gallup poll on the question of legalizing marijuana found that only 12 percent of Americans were in favor; in 2013, 58 percent responded positively to that question. Similarly, another 1969 Gallup poll asked respondents if they had ever tried marijuana, and 4 percent said yes; in 2013, 38 percent replied in the affirmative. Gallup puts the increase down to how social mores evolved in the 44 years between the polls, which would also account for why more and more college students use marijuana – either as a social lubricant, because it is more acceptable to smoke now than it has been in the past, or for its relaxant effects.15, 16, 17
The principal investigator of a Monitoring the Future Study that reported on college students’ increased marijuana intake told University News, of the University of Michigan, that the figure of 39 percent of students smoking weed amounts to 1 in 20 students lighting up on a daily (or near-daily) basis for the year 2013, when the study was released. By contrast, less than 1 in 50 students used marijuana that frequently for the four years between 1990 and 1994. In fact, more college students smoke cannabis than cigarettes. Current figures estimate that 5 percent of students identified as “heavy cigarette smokers,” a drastic drop from 1999, when 19 percent identified themselves as such. This suggests that while warnings about the dangers of cigarettes have been largely successful, a growing number of students consider marijuana harmless or to carry negligible risks.18
As a further contribution to the “college experience,” the Journal of Studies on Alcohol and Drugs found not only that students who used marijuana tended to engage in sexual intercourse on the days that they used marijuana, but also reported on other studies that suggested a link between the consumption of drugs and alcohol, and “risky sexual behavior.” Students who engaged in binge drinking were less likely to use a condom while having sex.19
Research put together by the National Institute on Drug Abuse warns of other concerns that college students should have when it comes to smoking marijuana. Negative effects on memory, attention, and learning, according to the Current Drug Abuse Reviews journal.20 Forty-eight studies on the subject found that marijuana use was connected to a reduced chance of graduating, and heavy marijuana use has been associated with the development of a dependence on cannabis, using other (potentially more damaging) drugs, and even suicide.
Even more research has pointed to heavy marijuana consumption leading to lower income, lower life satisfaction, greater dependence on welfare, unemployment, and criminal behavior.21, 22
In the same way that there exists a degree of, perhaps willful, misunderstanding and ignorance of the full reality of marijuana use among college students, another drug that is similarly taken by college students, without full appreciation for its ramifications, is Adderall.
Adderall is a stimulant for the central nervous system. It is a combination of two drugs, amphetamine and dextroamphetamine, that works by inducing the brain to release a neurotransmitter called dopamine, which is a chemical that the brain produces to stimulate feelings of pleasure, satisfaction, and reward (and the anticipation thereof).23
Forcing the brain to produce excessive and dangerous amounts of dopamine is the mechanic behind many illegal (and even some legal) drugs, which is how and why the methamphetamine family of chemicals is such a tightly controlled one in the United States. That also explains why Adderall (the brand name for the combination of amphetamine and dextroamphetamine) is a Schedule II drug in the United States; the Drug Enforcement Administration accepts that there are medical applications behind its use, but considers the high likelihood of causing physical and psychological dependence in its users prohibitive. For that reason, the drug can only be distributed to the general public by a doctor’s prescription; Adderall cannot be legally purchased as an over-the-counter medicine.24
The medical applications for prescribing Adderall are found primarily in people suffering from attention deficit hyper disorder. The dopamine boost that follows consumption of an Adderall dose helps people who have ADHD by giving them a sense of focus and concentration that they would not otherwise have. Since Adderall can be addictive, it has to be taken and prescribed at exactly the right dosage.25
The effects of Adderall – the increased concentration and mental acuity, and the intense rush of pleasure and satisfaction – are not lost on college students. While a 2014 survey by the Partnership for Drug Free Kids reported that 20 percent of college students have taken prescription medication “off-label” (that is, for recreational or otherwise nonmedical purposes), 44 percent of the people who responded to the survey took Adderall, not for treatment of ADHD, but because they thought they would do better academically if they did so. Thirty-one percent of respondents took Adderall to stay awake during all-night study sessions.26
The Partnership for Drug Free Kids writes that such is the level and misunderstanding of using Adderall off-label, that its use is becoming “normalized” among college students. The effect of this can be seen in the results of a survey published by researchers writing in the journal of Substance Use and Misuse, who report that a majority of students at a “large, urban research university” believed that “Adderall is definitely not a drug,” and that using Adderall to enhance their academic performance was neither harmful nor unethical.27
The belief that there is nothing wrong with taking Adderall is reinforced by how easy it is to obtain the drug. Like most prescription drugs, college students know a friend or relative with a valid prescription, and either steal their contacts’ supply or simply ask for it. If both parties believe that, since Adderall is medically prescribed, it can’t cause any lasting harm, or that the effects of Adderall (increased focus and concentration) are desirable, then there exists the possibility of a medication like Adderall being shared and used off-label. On other occasions, students may mimic ADHD or narcolepsy symptoms, since both conditions are often treated with an Adderall prescription. There even exists a black market for Adderall on some college campuses, turning some students into drug dealers.28
Such is the scope of the problem that a research project at West Virginia University called Adderall “the drug next door,” in direct contradiction to the idea that “Adderall is definitely not a drug.”29 A 2012 study published in the Journal of American College Health found that 74 percent of students who get off-label Adderall were given the drug by friends with prescriptions.30
However, the idea that Adderall cannot be all that harmful could not be more wrong. The Substance Abuse and Mental Health Services Administration reports that between 2005 and 2010, emergency room visits due to off-label uses of ADHD stimulants (such as Adderall and Ritalin) increased from 5,212 to 15,585.31
Even more distressing is that some students drink alcohol while taking Adderall, a combination that can cause heart problems, psychosis, seizures, and lack of motor control.
Adderall is a stimulant, and alcohol is a relaxant; mixing the two can cause the user to be unaware of the effects of either, resulting in taking in more Adderall or alcohol. In reality, however, both substances continue to have their respective effects, but the individual is unaware of this.32
Nonetheless, some students snort crushed Adderall tablets (like cocaine) and head out for a night of partying, eagerly anticipating the rush of energy that helps them stay out longer, party harder, and get “drunk faster and harder.”33
Substance abuse among college students is, obviously, a significant source of concern for campus authorities, and it is not going to go away soon. Forbes magazine quotes the National Institute of Alcohol Abuse and Alcoholism as saying that rates of binge drinking have gone from bad to worse.34
Some schools are turning toward helping struggling students rather than penalizing them. As stated above, many colleges and universities have decided (or realized) that since alcohol is here to stay, providing regulation for the larger student body, and rehabilitation for the students who need it, is a better way of curbing incidents of substance abuse and overdose, than trying to crack down on contraband consumption across the board.
As an example, the StepUP program at Minneapolis’s Augsburg College welcomes students who struggle with issues of addiction by giving them mandatory urine tests and requiring them to stay away from nightclubs, bars, casinos, or other environments where alcoholic consumption and risky, impulsive behavior are encouraged for their first year. In return, the program develops team-building exercises for its students, helping them channel the nervous energy of being new to campus in a safe, positive, and supportive manner.35
Campus programs to help students struggling with substance abuse issues, or students who want to have fun without the pressure to drink, have their work cut out for them. A study published in the Journal of Drug Education found that students who drink believe that alcohol is an inherent part of their college life, and even students who drink in moderation do so as part of the cultural idea that drinking and the college years are synonymous. 36, 37
That’s why programs like the University of Missouri’s Sober in College provide students a safe space to talk about their recovery, and gives them sober events and meet-ups, where they can still have fun and enjoy their college years without buying into the idea that the only way to truly engage with college life is to get drunk. That the program even exists says a lot. The college ranking website Niche gave the University of Missouri a grade of A+ for its “party scene,” where “the weekends start on Thursdays” and downtown establishes offer “insane drink specials.”38,39
College should be a fun time for a young man or woman stepping out into the world as an adult for the first time. The reality, however, is that more and more students are developing mental health issues (such as clinical depression and anxiety), and the temptation and pressure to have a drink or light a joint to make the problems go away could well be the spark for a substance use disorder.40 In trying to answer the question of “why colleges haven’t stopped binge drinking” (despite there being “decades of research” on the topic), The New York Times writes that:
Substance abuse among college students remains a source of concern for parents, students, and campus authorities. In the same way that the establishment has made way for the inexorable presence of alcohol in college life (the National Journal writes that since its foundation, American society has been at war with itself on how to control alcohol), a greater understanding of the needs of recovering students has also led to programs and policies that protect vulnerable students, to ensure that they can graduate clean, on time, and as happy and balanced as the rest of their class.42