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Substance Abuse in College

According to the National Institute on Alcohol Abuse and Alcoholism, about four out of five college students drink alcohol. Though drinking has long been the most common form of substance abuse in college, the National Institute on Drug Abuse points out that the use of marijuana, prescription drugs and illicit drugs is on the rise. The good news is that students can be proactive in understanding what constitutes substance abuse, how to keep their own habits in check, and how to spot problems in themselves or others. This guide offers a wealth of resources to help students do all of those things and more.

Substance Abuse Snapshot

Substance abuse is defined as the overindulgence in, or dependence upon, any addictive substance, especially alcohol or drugs. This is a rather broad definition that leaves a great deal open to interpretation, so it might be easier to determine “overindulgence” or “dependence” based on a few of the more common symptoms of substance abuse. These include using alcohol or drugs to feel “normal,” having memory loss or mood swings, suffering unpleasant physical and emotional symptoms when trying to stop, struggling with everyday activities (such as going to class or completing homework), and continued use despite these negative consequences.

About25 percent of students report suffering academic consequences related to drinking too much, including skipped classes, lower test scores and lower grades overall.

Half of college students who drink also engage in binge drinking.

In 2013,36% of college students admitted to using marijuana, an increase of 6% since 2006.

More than690,000 student shave been assaulted by someone who has been drinking.

The use of amphetamines, including Ritalin and Adderall, nearly doubled between 2008 and 2013.

*Sources: DrugAbuse.gov, NIAAA

Causes of Substance Abuse

Why do so many college students turn to alcohol or drugs? There are several reasons students cite as reasons they become intoxicated or high.

Everyone else is doing it.

When everyone is doing something, it becomes the “cool” thing to do. Those who don’t do it may start to feel left out.


It’s available everywhere.

College campuses, sometimes even those that are designated as “dry” or are situated in a dry community, are rife with alcohol and other substances. Alcohol tends to flow freely at parties.

They are curious.

Many college students are away from home for the first time, which means they suddenly have the freedom to try things they haven’t experienced before, including alcohol.


They want to relax.

Those who are stressed out by classes, worried about finances, or even going through a breakup might turn to alcohol to take the “edge” off.

It’s the way of Greek life.

Students who are in fraternities or sororities are often exposed to alcohol and drugs and sometimes expected to indulge along with their peers.


They think they’re more fun when they drink.

The “life of the party” is often someone who has indulged a little too much. Students may believe they will be just as popular, as long as they have something in their system to help them lower their inhibitions in order to be more “fun.”

Substance Abuse Effects & Warning Signs

Substance abuse is something that can creep up slowly, until what seemed like just a few good times turns into a problem. Wondering if things have gone too far? Consider these warning signs:

  • You often wind up drinking more than you intended.
  • You have to drink more to get the same effect that you got a few months ago.
  • You have had a memory blackout.
  • You have done things when drunk that increased your chances of getting hurt, such as driving while under the influence or having sex with someone you don’t know.
  • You’ve been sick during or after a long night of drinking.
  • Your family and friends have said you might have a problem.
  • You have put other pleasurable activities aside in order to drink more often.
  • You have tried to cut down on the alcohol, but you can’t.
  • You have faced legal problems as a result of drinking too much.
  • Drinking has led to problems with school, such as being late to class or forgetting important assignments.
  • You’ve felt depressed and anxious about your drinking, so you drank more to make that feeling go away.
  • When you do stop drinking for a while, you suffer from unpleasant side effects, such as serious headaches, trembling, insomnia, sweating, a racing heart, and more.

Getting Help for Substance Abuse

Getting help can be tough, because it means admitting that things have gotten out of control. However, the decision to get help is huge, and deserves the utmost support. That support system includes friends, family, a professional counselor knowledgeable in substance abuse, and possibly even those who have already walked this path.


Assess the situation and determine if help is needed.Use the list above as a guide to determine if you could have a problem. If even one of these warning signs sounds familiar, you may need to get help.


Contact a professional.There are numerous ways to get in touch with someone who can help. The student health clinic will be able to provide an initial consultation and referral to a professional who specializes in substance abuse and addiction.

Contacting your own doctor can also be a good avenue for getting help. Not only will your doctor know who to contact to get you further help, but they’ll know your past medical history and can be alert for additional problems that might result from substance abuse, such as drug interactions.

There is also the possibility of contacting a board-certified substance abuse or addiction specialist or treatment center directly. The American Society of Addiction Medicine has a nationwide directory of doctors who can help someone suffering from addiction or substance abuse. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a Behavioral Health Treatment Services locator.

Remember, support through the process is vital. The Support Group Project’s website can help you find a local support group to help deal with addiction. There are also help lines; one such hotline is the SAMHSA’s National Helpline, which can be reached at 1-800-622-HELP (4357).

Drinking on Campus: How Much Alcohol is Too Much?

In every state in the U.S., the drinking age is 21. In a perfect world, no one under the age of 21 would drink, and those that did drink after that magic number would drink only occasionally, and only to very tolerable limits. However, this is the real world, and college campuses are places where rules are often broken when it comes to drinking.

Understanding how much is too much can go a long way toward helping students understand whether they have a problem or not, and give them incentive to tone down the substance use if necessary.

How Much Is a “Drink?”

What constitutes a drink depends on what is being consumed. You might be surprised by exactly how much constitutes “just one drink.”

BeerWineMalt LiquorDistilled Spirits(such as gin, tequila, whiskey, etc.)
Typical Alcohol concentrationAbout 5%About 12%About 7%About 40%
What is one drink?12 fluid ounces5 fluid ounces8 fluid ounces1.5 fluid ounces

To keep this in perspective, 12 ounces is usually found in one can of beer, while a bottle can usually hold 16 ounces – so one bottle of beer is actually more than a serving. Five ounces is a typical glass of wine, and 1.5 ounces is a typical shot of whiskey. Mixed drinks that include spirits often have much more than one serving in one glass; the same is true of drinks that are mixed with wine as the base.

Number of Drinks in Commonly Found Alcohol Containers

BeerWineMalt LiquorDistilled Spirits
Commonly Found Container Sizes
  • Standard can or bottle = 1 drink
  • “Forty” =
    3 1/3 drinks
  • “Growler” =
    5 1/3 drinks
  • Keg = 165 drinks
  • Standard
    bottle = 5 drinks
  • Magnum
    bottle = 10 drinks
  • “Forty” = 5 drinks
  • Shot = 1 drink
  • Double shot = 2 drinks
  • “Half pint” = 4 ½ drinks
  • “Pint” = 8 ½ drinks
  • “Fifth” = 17 drinks

Source: National Institutes of Health

How Much Alcohol Are You Consuming?

A “low-risk” drinker is someone who consumes alcohol, but does so in a manner that puts them at a lower risk for suffering from alcoholism or abusing alcohol. A low risk drinker is:

A MALE who has no more than four drinks in a single day AND no more than 14 drinks in a week.

A FEMALE who has no more than three drinks in a single day AND no more than 7 drinks in a week.

Even if an individual is a low risk drinker or doesn’t drink enough alcohol to qualify as a low risk drinker, they are still at risk for suffering from alcohol-related problems, alcohol abuse or alcoholism. Regardless of this definition, remember: If someone is under the legal drinking age, intends to operate a motor vehicle or machinery, becomes pregnant, or takes medications that can interact with alcohol, consuming any amount can be extremely dangerous.

Binge Drinking Examined

The simple definition of binge drinking is “drinking an excessive amount of alcohol over a fairly short period of time.” But what is excessive? Generally, consuming four to five drinks over the span of two hours is considered excessive.

Binge drinking occurs quite often in college. Though estimates vary, the National Institute on Alcohol Abuse and Alcoholism reports that two of every five students – or about 40 percent – binge drink. Some reasons might include newfound freedom, the desire to experiment, peer pressure, trying to fit in at parties and purposely getting drunk as fast as possible.

Not only is binge drinking so common it’s almost a rite of passage for college students, it can lead to serious issues, such as physical and sexual assault, accidents, alcohol poisoning and academic problems. As a result, what may seem like fun or necessary behavior to have a social life can be very harmful. Take a look at the following statistics:

More than 97,000 students between the ages of 18 and 24 are the victims of alcohol related date rape or sexual assault.

About 1,825 college students between the ages of 18 and 24 die each year due to accidental, alcohol-related injuries.

More than 150,000 students develop alcohol related health issues.

*Source: NIAAA

Heavy drinking – more than four drinks in a single day and more than 14 drinks in a week for a male and more than three drinks in a single day and more than 7 drinks in a week for a female – can easily lead to binge drinking. That’s why it’s important to keep track of alcohol consumption and understand that problems can easily occur in an atmosphere where drinking is the norm.

A Hard Look at Drugs on Campus

Though not as prevalent as alcohol, drugs are a serious concern on campus. In addition to the use of illicit drugs, prescription drugs are increasingly abused, as well as over-the-counter drugs, such as cough syrups.

Illegal Drugs

Types of illegal drugs used by college students include ecstasy, LSD, cocaine, heroin and marijuana. Marijuana is the most widely used illicit drug by college students – its use tripled between 1994 and 2014. Keep in mind that though marijuana is available legally in some states and jurisdictions, it is still not allowed on college campuses.

Despite the availability of illicit drugs on campus, students tend to veer toward the drugs that are actually legal, such as prescription drugs and over-the-counter products.

Legal Drugs Used Illegally

Prescription drug abuse is a huge problem on college campuses. The Partnership for Drug Free Kids found that at least 20 percent of college students had used prescription drugs in an illegal way – perhaps they took Ritalin that was prescribed for someone else, or used Percocet or OxyContin to get high at parties.

The problem with prescription drug abuse is that most of the drugs are purchased legally, with a prescription from a physician. The drugs are then distributed to others, which is illegal. But it is so prevalent that many college students might not even realize this is a problem. In fact, a 2008 study of 1,800 college students found that 80 percent of them did not consider the illicit use of ADHD medication to be dangerous.

Here are some of the most commonly abused legal drugs on college campuses:

Type of DrugExamples of DrugDrug’s Intended UseWhy the Drug is Abused
Opioid analgesicsOxyContin, Vicodin, morphine and fentanylModerate to severe pain reliefTo obtain a euphoric, high feeling and/or stay up all night without feelings of fatigue
StimulantsAdderall and RitalinPrimarily used to treat attention deficit hyperactivity disorder or narcolepsyTo help concentrate or obtain cognitive enhancement. Sometimes used for feelings of euphoria and increased libido.
SedativesValiumHelp falling asleep or reducing feelings of anxietyTo obtain a euphoric or high feeling, to feel more relaxed

Cutting Back and Changing Substance Abuse Behaviors

Abusing and misusing drugs and alcohol can have many negative consequences. They may be minor and fleeting, such as a “walk of shame” after drinking way too much. But they can also be severe, such as expulsion from school, arrest or even death. Given the potential problems, cutting back on drinking and adopting a healthier attitude is the best way to go.

Steps to Stop, Strategies for Change

Are you ready to stop but not sure where to start? Begin with this list.

  • Know how much you’re drinking.Simply knowing what you’re consuming can mean the difference between a night in the emergency room and sleeping soundly in your own bed.
  • Don’t drink on an empty stomach.Food can reduce the speed in which alcohol is absorbed by the body.
  • Alternate alcoholic and non-alcoholic drinks.This will reduce the amount of alcohol you would have consumed and gives your body time to metabolize what you already drank.
  • Pace your consumption.You don’t have to “shotgun” a beer in 30 seconds. It’s just fine to nurse it over the course of an hour.
  • Find alternatives to drinking.It can be as simple as replacing the second house party of the week with going out to dinner or a movie instead.
  • Avoid drinking or drug use cues.Avoid whatever is usually responsible for your drinking or drug use. Turning down that game of beer pong or hanging out with someone new are a few examples of easy avoidance tactics.
  • Be able to say no.It’s just fine to say no to someone offering you that third drink and conclude you’ve had enough to drink for the night.
  • Don’t be afraid to ask for help.Knowing you need help can be the hardest part. But once you ask for help, you might be surprised by how quickly you can get it.

Legal Ramifications of Substance Abuse

Drunk Driving

Drinking alcohol can lead to bad decisions, including the choice to get behind the wheel when impaired. To make matters worse, substances like alcohol can cloud your judgment to a point where you might not believe you are actually driving drunk – you might feel you are okay to drive, when you are actually far from it.

All states have laws that make drunk driving a criminal offense. Depending on the state, the terms DUI (Driving Under the Influence) and DWI (Driving While Impaired/Intoxicated) can mean the same thing. In most cases, whether you’re driving impaired due to alcohol or drugs makes no difference; the extent of the impairment doesn’t matter, either.

In some states, DWI can refer to a more serious impaired driving offense while DUI refers to a lesser charge. To make matters more complicated, some states delineate between being impaired by alcohol or drugs and attach the DWI label to one offense and the DUI to the other offense. Here’s what can happen if you get pulled over for drinking and driving.

Penalties Based on BAC

Not all criminal drunk driving charges are the same. The law can subdivide the crime of drinking and driving by considering factors such as the age of the driver, who else is in the vehicle, whether the driver holds a commercial driver’s license, the number of prior DUI offenses and how high over the legal limit the driver is. All states have a BAC legal limit of 0.08 percent for regular drivers over 21. In some states, if the driver’s BAC reaches a level beyond that, the driver can face a longer license suspension, higher fines, longer jail or prison time and have to install an ignition interlock device. The specific BAC limit that results in stiffer penalties varies between states, but can be low as 0.10 percent.

  • License SuspensionMost states will suspend a driver’s license for a period of time after being convicted of DUI. Though it varies by the state, the typical license suspension for a first time offense is between three and six months. This means the driver can’t drive at all during that time, and will face additional penalties and longer suspension if he or she does. Drivers with suspended licenses must find alternative transportation including Uber, asking friends for rides, riding a bike, or walking everywhere.
  • Vehicle SanctionsMost states do not have license plate or registration penalties for DUI convictions. However, some states will impound a vehicle for a certain period of time for a DUI offense.

Open Container Laws

These laws refer to state prohibition of open containers of alcohol in certain places, such as a motor vehicle or open public spaces. Most states prohibit open containers of alcohol in motor vehicles, but a few will allow it, as long as the drink is not consumed while operating the vehicle. Even if the driver is sober, if passengers have open containers, for instance an open beer, the driver will face prosecution.

Key Drunk Driving Laws by State

Every state in the United States follows the same legal charge—impaired driving will not be tolerated. But each state can have its own set of laws for deciding how to punish drivers and reduce the risk of drunk driving. The following map offers a summary of each state’s unique criminal punishment for driving while drunk.

Source: Governors Highway Safety Association

High BAC Penalty: Drivers caught with this number or higher BAC face higher penalties including additional jail time, higher fines, longer license suspensions and more.

Lic Suspension 1st Offense: Automatic driver’s license suspension for first offense. No driving allowed during suspension.

Vehicle Sanctions: Vehicles or license plates may be confiscated, and vehicles may be immobilized or impounded.

Open Container Laws: Open alcohol container in car, passenger or driver.

There are other sanctions might come along with drinking and driving. These include:

Driving Privilege Limitations


Even though most states require license suspension for even the first DUI conviction, some states allow limited driving privileges after part of the overall sentence has been served. Driving privileges are usually limited to driving to and from work or other essential trips. Thirty-six states allow for limited driving privileges during license suspension, subject to certain conditions.

Ignition Interlocks


These handy little devices are actually breathalyzers. Once installed in a vehicle, it only allows the vehicle to start if the driver has a BAC below a certain level. Every state has enacted ignition interlock laws. However, states differ on when they are required; in 10 states, the use of interlock devices is discretionary.

Repeat Offender Laws


The federal government encourages states to impose minimum criminal penalties on individuals who are repeat DUI offenders. However, only about 26 states have repeat offender laws on the books that meet the federal government’s minimum requirements.

Alcohol Exclusion Laws


Alcohol exclusion laws allow insurance companies to deny medical insurance coverage for treatment associated with the use of alcohol; you will still be treated, but might have to foot the entire bill for it. Thirty-seven states have alcohol exclusion laws.

Think you can “HOLD YOUR LIQUOR”? You might be surprised how easy it is to reach the 0.08% threshold. Although many variables affect how quickly you get drunk, it can easily take just two drinks. For example, if a 140-lb woman consumes 2 drinks in one hour, her BAC will be around 0.08. A 160-lb man who has three drinks in one hour will also be around 0.08 BAC.

Alternatives to Impaired Driving

What happens if you drink too much? If you even suspect you have had too much to drink, the following options will get you home safe, without danger to yourself or others on the road.

Drink close to home. If you get drunk at a location where you can walk home, you can avoid worrying about driving altogether. However, bad weather or heavy traffic along the way home might require a backup plan.

Turn to a designated driver. This responsible individual will not drink, and thus will keep everyone else safe on the ride home.

Get a cab. If you don’t know of a local cab company, you can dial #TAXI (8294) on your cell phone to contact the nearest one in your area.

Use a transportation network company. Companies such Uber and Lyft now make getting a ride easier, especially in areas where there is no taxi service.

Take public transportation. This gets you home safely and economically. The downside is that it isn’t available in all areas.

Call for a ride. Friends and family want you to be safe. If you’ve had too much, give them a call to come to you and bring you home safe.

Ride home with the police. No, it doesn’t mean you’ve been arrested. Some police departments will give free rides home to those who are too drunk to drive. Generally, these programs are only during certain events, such as the Super Bowl, Memorial Day weekend or New Year’s Eve.

Utilize Sober Ride. The National Highway Traffic Safety Administration has compiled a list of safe ride programs across the United States. Many of the ride services are free.

Designated Driver: The Real MVP

A designated driver agrees to remain sober so that they can safely drive those who have indulged a little too much. Designated drivers are usually friends or family who volunteer for the job, but they may also be professional drivers hired ahead of time from a transportation company.

Because non-professional designated drivers may be tempted to “have just one” drink, or may have the urge to drink because they are surrounded by those who are, the group who decides will be drinking should offer a token of their appreciation: It might be paying for dinner, buying gas, or returning the favor one day soon.

Illegal Drugs or Legal Drugs Obtained Illegally

Alcohol isn’t the only substance that poses a legal danger to college students. Drug abuse, whether it is turning to illegal drugs or using legal drugs in a way not intended, is a serious problem across college campuses nationwide. Drug use can result in jail time, huge legal bills and a criminal record that will follow you for decades.

How much do you know about drugs and the legal ramifications of using them? Take this quiz to find out.

As long as the state where your school is located has legalized marijuana, you can’t get in trouble by using marijuana at school.
If you have a felony drug conviction, you are ineligible to receive federal financial aid.
As long as the drug was obtained by prescription, (like Adderall or Oxycodone), it’s perfectly legal for anyone to possess that prescription drug.
You have a valid prescription for Percocet from an ER visit for a broken arm. Turns out you didn’t need all the Percocet pills, so you want to sell the extra pills for cash. Even though you legally obtained the Percocet, it’s probably illegal for you to sell them.
Even if you only have a little bit of marijuana, it’s unsafe for you to drive.
If I can safely take two legal and properly obtained drugs individually, then taking them both at the same time should be okay.

Medical Amnesty & Good Samaritan Programs Save Lives on Campus

At many colleges, students are not allowed to have or use alcohol on campus, and illicit drugs are always off-limits. Furthermore, a majority of college students are under the age of 21, which means they cannot legally drink. But what if a student does use these substances, goes overboard, and winds up in desperate need of medical assistance?

Unfortunately, many students will try to “wait it out” or treat the problem themselves, thanks to the fear of the penalties they might face for breaking school rules. That’s where the Medical Amnesty and Good Samaritan Programs come into play.

How it Works. Medical Amnesty is a promise to exempt an underage student from punishment when medical assistance is called for an emergency situation. Rather than face harsh penalties, the student gets the help they need during the emergency, and later receives counseling or other follow-up care that focuses on staying safe in the future.

The Good Samaritan Program exempts an intoxicated underage student from punishment if they call for medical assistance due to another student’s emergency. For example, if someone has been drinking at a party but then they notice a friend has overdosed and stopped breathing, they can call for emergency services for that friend without fear of punishment.

Where it Works. Early studies of these programs have proved they work. A 2006 Cornell University study found that when these programs were put in place and pushed with a strong media campaign, the number of alcohol-related emergency calls went up, and the follow-up interventions more than doubled over a two-year period.

Several schools are seeing success with the programs. At Clemson University, students can take advantage of medical amnesty once during a two-year period, and will be referred for counseling services after an incident. Harvard University encourages students to obtain medical assistance for friends, and promises that the person who requested assistance and the person needing the assistance will not face disciplinary action. Similar policies are in place at Southern Methodist University, Emerson University, Emory University, the University of Virginia and many more institutions across the nation.

From the Expert

Dr. Kim Dennis, board-certified psychiatrist and addiction specialist, discusses substance abuse on campus.


Are some college students more prone to substance abuse than others?

We know people under stress and in times of transition are more susceptible to developing substance use disorders. College is such a time of transition from adolescence into more autonomy, independence and self responsibility. People with genetic predisposition, family history of substance use, histories of trauma, low self-esteem, and/or history of depression or anxiety are at higher risk. Those who have not developed healthy methods to handle emotions and stress are also at higher risk.

What are some red flags that could make students realize, “Hey, maybe I have a problem…”?

Warning signs include: using alcohol or other substances more frequently than intended, in greater quantities than intended, or experiencing unintended consequences (injuries, date rape, social embarrassment, missing school or other obligations because of using or recovering from use). If a person finds herself only able to socialize if alcohol is present, that is another warning sign. Sometimes people begin to worry about having a problem if friends or family members express concern. Finally, if another problem is getting worse because of alcohol or drug use (like depression or some medical conditions), and the person continues anyways, this is a signal that a problem is emerging.

What can a student expect when they reach out for help?

I encourage any student wondering if he or she has a problem to reach out. Many fear they will be met with judgment, or even punishment. Many believe that no one can help them anyways. Addiction professionals will not only treat someone reaching out for help with compassion and non-judgment, they will celebrate the person’s courage to ask for help, willingness to receive help and desire to live free of a disorder than can be potentially fatal. Young people with so much talent and promise far too often succumb to the disease of addiction, and far too many end up dying tragically from overdoses, accidents or other substance related causes of death.

  • Residential Life Center  On most campuses, this center focuses on all aspects of housing for students, including the problems that might come along with drugs or alcohol at on-campus or off-campus locations.
  • Student Health Center  Almost every college will have a student health center available to students who have questions or desire assistance. Many are open 24/7 and always available to students in need.
  • Local Hospital  Any hospital or medical center that’s open to the public will have resources and information available to those suffering from substance abuse.
  • Local Church Depending on the spiritual inclination of the individual, a church can be an excellent place to seek support for substance abuse related problems.
  • National Institute on Alcohol Abuse and Alcoholism  Students can find in-depth information on alcohol abuse here, as well as research on related topics, such as alcohol deaths and crimes on campus that are related to overuse.
  • National Institute on Drug Abuse  This reputable organization offers a wealth of information, statistics and studies that are pertinent to those in college, including points on marijuana and stimulants.
  • Opiate Addiction and Treatment Resource  This website provides information about opiate drug abuse, as well as treatment options for those suffering from opiate-related problems.
  • Rethinking Drinking  This site helps students figure out if alcohol is becoming a problem, and what to do in order to cut back or find treatment.
  • Substance Abuse and Mental Health Services Administration    A US government agency tasked with alleviating mental health and substance abuse problems within the United States.


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