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- A Guide to Managing Substance Addiction at College
A Guide to Managing Substance Addiction at College
College can be a challenging and stressful time for any student. Alongside the excitement and opportunity of this period lies a range of potential challenges including homesickness, course pressures, and financial woes that can heighten an already emotionally charged time. These challenges are even greater for those struggling with addiction.
Whether it’s alcohol, drugs, or a combination of both, substance addiction can be detrimental to a student’s college experience, affecting their emotional well-being, academic performance, and relationships. Thankfully, with the right support, guidance, and strategies, overcoming addiction at college can be achieved.
In this guide, Epiphany Wellness provides practical advice and insights to help students navigate substance addiction and regain control of their personal and academic lives. Whether you’re struggling personally or supporting a friend or loved one, understanding these challenges and knowing where to turn can be the vital first step toward recovery.
An Introduction to Addiction in Students
Addiction is defined as any chronic relapsing disorder driven by compulsive behavior. Often, addiction leads people to repeat these compulsive behaviors or activities despite the threat of negative physical, mental, or social consequences.
College can be a time when addictive behaviors begin or accelerate for some students. For many, going to college is their first taste of independent living and a time when they’re more likely to be exposed to the hedonistic pastimes associated with addiction. While for most people, these pastimes are just a dose of fun that can be enjoyed in moderation; they can quickly become compulsive behaviors for those with addictive tendencies.
The typical challenges associated with college life can also trigger or exasperate addictive behaviors. The stress caused by academic pressures, managing finances, and adjusting to new surroundings can be challenging enough for students who are typically aged between 18 and 24.
These, combined with any existing mental health issues or life concerns, can result in some students seeking escapism in the form of an addictive substance.
Understanding Addiction in Students
Why do students drink alcohol and do drugs?
As with much of society, there are numerous reasons why students choose to experiment with alcohol and drugs, from reducing stress to enhancing social situations.
A study from Health Education Research found that relaxation was the most popular reason cited by young people for using alcohol and drugs. Over nine in 10 (96.7%) young alcohol and drug users claimed they used these substances to relax – 0.3% more than the number who use them to become intoxicated (96.4%)
(Source: Health Education Research)
Staying awake while socializing was the third most common reason, with just under 96% claiming they used drugs or alcohol for this reason. This was over 7% more than the number who used drugs or alcohol to enhance an activity (88.5%) and nearly 10% more than those who used to alleviate a depressed mood.
How frequent is drug/alcohol use in college students?
A 2023 study covered by the National Institute on Alcohol Abuse and Health found that nearly half (49%) of students aged between 18 and 25 had drunk alcohol over the previous month.
The same study reported that around 30% had engaged in binge drinking over that period. Binge drinking is considered to be five or more drinks over a two-hour period for men and four or more drinks for women.
Over 1,500 college students aged 18 to 24 die from alcohol-related unintentional injuries each year, with a huge 696,000 being assaulted by another student who has been drinking. This highlights the dangers of excessive drinking.
Though not quite as prevalent as alcohol, drug use is common in college. The 2024 Monitoring the Future Survey found that 39.5% of students had used marijuana in 2023, with over one in 20 (5.3%) using cocaine and one in 40 using MDMA (2.9%).
Additionally, a study referenced in Science Direct found that 5.6% of college students reported non-medical use of prescription drugs in 2023.
How common is addiction in college students?
A 2023 study from the Substance Abuse and Mental Health Administration (SAMHSA) found that 19.1% (or 54.2 million) of people aged 12 or older were classified as ‘needing substance use treatment’ over the previous year.
This figure rose to nearly 29% (9.8 million) for people aged 18-25, suggesting that people in the typical age group for college are more likely to struggle with substance abuse.
Despite this, just 1.1 million (4.7%) 18-25-year-olds received substance use treatment in 2023 – less than a fifth (16.6%) of the number who were classified as needing treatment.
Elsewhere, a report from the National Institute of Alcohol Abuse and Alcoholism found that 14% of students aged 18-22 met the criteria for having an alcohol use disorder (AUD).
The likelihood of alcohol and substance abuse can be influenced by the path you take in college. For example, a report from Ballard Brief found that four in five students in fraternities or sororities engaged in binge drinking, compared to just two in five students outside of these organizations.
Similarly, while marijuana use was common in both fraternities and sororities, those in fraternities were more likely to use illegal drugs like cocaine and LSD, compared to sorority students and those in neither group.
The most common substances students are getting addicted to
While numerous different substances can lead to addiction at college, some are more common than others. Some of the substances students most frequently struggle with include:
Alcohol
Alcohol use has long been viewed as a right of passage for generations of students. From frat parties to course nights out, heavy alcohol use is encouraged and often glamorized by thousands of students, making regular use inevitable for many.
As well as being used as a tool for socializing, some students turn to alcohol as a way of managing the stresses of college and everyday life.
The widespread alcohol use among students is backed by national survey data that found nearly two-fifths (39%) of students engaged in binge drinking in 2023.
While it’s difficult to track the exact number of students dealing with alcohol addiction, SAMHSA reported that over 15% of people in the 18-25 age group met the criteria for needing substance use treatment for alcohol, with an additional 5.5% needing treatment for both alcohol and drugs.
Over 15% of people in the 18-25 age group met the criteria for needing substance use treatment for alcohol, with an additional 5.5% needing treatment for both alcohol and drugs.
Cannabis
Cannabis or marijuana often has the perception of being one of the least dangerous recreational drugs. As such, smoking cannabis can be a regular pass time for many students, both socially and at home. Many students turn to the drug as a relaxation method or to manage insomnia.
With cannabis now legal for recreational use across 24 states, the appeal and accessibility of the drug has only grown. According to the 2024 Monitoring the Future Survey, the use of cannabis and vaping cannabis were at historically high levels among 19-30-year-olds in 2023. Over two-fifths (42.4%) of surveyed young adults reported using the drug in the previous year, with nearly 29% using it in the last 30 days.
Despite the increasing public tolerance around cannabis use, it remains an addictive and potentially harmful drug when used to excess. American Addiction Centers
- Depression
- Anxiety
- Impaired memory and attention span
- Worsening of symptoms for existing mental illnesses (like schizophrenia)
- Respiratory difficulties
Yale Medicine claims that around 10% of people who begin smoking cannabis will develop an addiction.
Around 10% of people who began smoking cannbis will develop will an addiction.
Source:Yale medicine
Cocaine
Like alcohol, cocaine use among students can be influenced by the party culture present in many colleges and fraternities. The 2024 Monitor The Future Survey found that 5.3% of 19-30-year-olds had taken the drug in 2023.
A 2022 study found that approximately 2.2 million people in the US used cocaine regularly, with 1.5 million meeting the criteria for having a cocaine use disorder (CUD). With the ages of 18-25 being the most common age when people begin experimenting with the drug, college can be a time when cocaine addiction can manifest.
Approximately 2.2 million people in the US used cocaine regularly in 2022, with 1.5 million meeting the criteria for having a cocaine use disorder .
Excessive use of cocaine can cause numerous short-term and long-term health problems, including:
- Cardiovascular problems
- Anxiety
- Depression
- Symptoms of paranoia and psychosis
- Cognitive Decline
- Organ damage
Other illegal drugs
Numerous other recreational drugs can be prevalent in various college and social groups. The use of hallucinogenic drugs (e.g., magic mushrooms and LSD) was reported by 8.9% of surveyed young adults in 2023 – more than double the total in 2018 (3.4%).
At the same time, 2.9% reported using MDMA in 2023, with a further 1.8% using ketamine. Since the highest rates for many of these drugs are among those aged 18-25, it’s no surprise that some students find themselves experimenting with these substances during their college years, sometimes leading to misuse or even addiction.
Legal drugs and stimulants
Drug misuse can go beyond illegal drugs, with some students experimenting with certain medically approved drugs and stimulants without a prescription. While some people experiment with these drugs for recreational purposes, others use them to aid focus when studying.
The 2024 Monitor the Future Survey found:
- 4.5% of young adults (aged 19-30) used amphetamine for non-medical use in 2023
- 3.7% reported using Adderal, an amphetamine-based stimulant used to treat ADHD, for non-medical purposes
- Ritalin, another ADHD medication, was used by 1.2% of young adults for non-medical reasons.
While these drugs are legally approved, improper use can result in addiction as well as many of the physical and mental health problems associated with recreational drugs.
Common causes of addiction in college students
Numerous genetic and social factors can contribute to addiction. The National Institute on Drug Abuse (NIDA) lists the following risk factors for developing substance addiction:
Aggressive behavior in childhood
Lack of parental supervision
Low peer refusal skills
Drug experimentation
Availability of drugs at school
Community poverty
While these factors can influence addictive behaviors, many people with these traits and experiences will not go on to develop an addiction. Equally, there are some people with none or very few of these traits who go on to develop substance problems.
The likelihood of addiction can vary from person to person, with someone’s genetic makeup, mental health, and life events playing a significant part.
Genetics
Genetics can play a key part in your risk of developing alcohol and substance addiction.
The NIDA reported that genes, including the environmental factors that alter genetics (epigenetics), account for 40 to 60% of a person's susceptibility to addiction.
Mental health
Mood issues and anxiety disorders have been found to go hand-in-hand with addiction for many people, with the presence of one directly influencing the other.
A 2023 report from SAMHSA found that just under half of the 2.2 million adolescents with substance abuse issues also had a major depressive episode (MDE) within the last year. Additionally, adolescents who had experienced an MDE were over twice as likely to have used illegal drugs over the same period.
As such, students experimenting with drugs and alcohol while dealing with existing mental health issues may be more prone to developing addiction.
Nearly half of the adults with substance abuse issues in 2023 had experienced a major depressive episode within the last year
Source:SAMSHA
Life Events
Your personal experiences can play a significant role in shaping your susceptibility to addiction. Traumatic events and experiences are often linked to poor mental health, resulting in some seeking escapism through drugs and alcohol.
The NIDA cites violence, abuse, neglect, and family/social conflict as driving factors linked to developing a substance use disorder. For students already dealing with the pressures of college life, managing the intensity of emotional trauma can drive some to use substances as a coping mechanism.
What Does Addiction Look Like in College Students
Common signs of an addiction problem
People handle addiction in different ways. While for some, addiction may present itself in risky and erratic behaviors that cause immediate concern for friends and family; others may display more subtle signs that are harder to detect.
The way a person deals with addiction can be influenced by several factors, including:
- Their personality type
- The substance they’re using
- Their level of use
- The presence of other mental health conditions
While there’s no way of telling exactly how someone will react to addiction while at college, there are some key signs you can look out for if you believe a friend, coursemate, or loved one is struggling, such as:
Diminished interest in hobbies and activities
Students battling substance addiction are less likely to engage in other hobbies or activities. The constant mental drain that comes with an active addiction can make hobbies that were once a priority feel pointless.
This can result in students who were regular participants in certain sports or societies beginning to withdraw from these pastimes.
Falling grades
Addiction can cause a student’s academic performance to drop suddenly and unexpectedly. As addiction can cause students to miss classes, they can quickly fall behind in key course areas, resulting in a reduction in their exam performance and assignment quality.
Even if a student continues to attend classes, the constant distraction caused by addiction can make concentrating on studies feel impossible.
Missing Class
Addiction can make other priorities fall by the wayside. For students, this can mean missing more and more classes and lectures. As addiction can cause and accentuate mood and anxiety disorders, many people suffer from low motivation and apathy while dealing with addiction.
Also, excessive alcohol and drug use can lead to poor health and sleep quality, meaning students may often not feel well enough to attend college.
Losing Friends
Addiction in college can have an adverse effect on a student’s relationships and social life. Many people may act out of character when in the throws of addiction, demonstrating antisocial or unkind behaviors that put a strain on their friendships.
Conversely, others may just lose interest in socializing altogether, resulting in them withdrawing from their social group and drifting apart from friends.
Personality changes
Personality changes during addiction can range from subtle to profound, depending on the person, substance, and extent of addiction. Some people may display signs of erratic or aggressive behavior and engage in risky actions that can put both their and other people's health in danger.
For others, however, addiction may have the opposite effect, resulting in them becoming quieter, withdrawn, and more reclusive.
How to Speak to Someone About Getting Help
If you have a friend or loved one showing signs of addiction at college, knowing how to broach the issue can feel daunting. While the fear of offending or alienating the person may make it seem like a bad idea, a conversation with a trusted friend or family member can be the catalyst many people need to seek help.
When approaching the issue of alcohol or substance addiction, it’s important to ensure the person doesn’t feel judged or attacked. Where possible, have the conversation on a day when you have plenty of time to talk and neither of you is in a rush. This will give you enough time to explain your concerns thoroughly while allowing the person to digest and respond.
There is no telling how someone will react when questioned about their addiction. Some people may already be aware of their struggles, making them more susceptible to having a constructive conversation. Others may be unaware or in denial about the extent of their addiction, resulting in confused, emotional, and sometimes volatile reactions.
While there’s no way to control how someone will respond fully, there are ways you can communicate that can help you achieve the best possible outcome, such as:
Avoid being overly direct in your language.
Instead of saying, ‘I think you have a problem.’ or ‘You need help.’ try approaching the topic more subtly: ‘I've noticed something lately, and I'd like it if we could chat about it.'
Listen Carefully
Listening is a crucial part of helping someone struggling with addiction. By allowing them to express their feelings, you make the conversation feel less like a lecture or critique and increase your understanding of your friend or loved one’s struggles.
Reference specific times that have caused concern
The person may not realize that anything is wrong, so giving specific examples of times their use or behavior has caused concern can help them better understand your worries. When doing this, try not to sound overly judgmental or like you’ve been monitoring their every move.
Ask open-ended questions
Open-ended questions give people more chance to express themselves, and they can feel less direct and confrontational. For example, rather than asking, ‘Do you think you have a cocaine problem?’, instead ask something like, ‘How have you been feeling when you’ve cocaine lately?’.
This approach reduces the likelihood of the person feeling judged. It encourages them to share more about their emotions, helping you better understand how you can support them.
How to seek help
Though dealing with addiction at college can feel lonely and daunting, there are numerous avenues you can explore to get the help you need.
Below, we’ll cover some key help options available to help support you through addiction and get you back on the right track:
Free helplines
Free addiction helplines can be a great first step for getting help with addiction. Many people dealing with addiction may find it overwhelming to confide in a friend or loved one initially and fear how they might react.
Free helplines allow you to discuss your concerns with someone outside of your everyday life, allowing you to speak freely and get the help you need. Whether you’re looking for treatment referral information, advice, or just a listening ear, helplines can aid you every step of the way.
American Addictions Center’s Alcohol Drug Hotline page lists a range of free, confidential national hotlines that offer support to those struggling with drug or alcohol addiction.
Friends/family
Friends and family can be crucial pillars of support when battling addiction. They can provide you with emotional support and encouragement during the most difficult periods, decreasing the feelings of loneliness that can go hand in hand with addiction.
As well as emotional support, friends and family can also provide you with a level of accountability. Accountability can help you stay motivated during your recovery, and your loved ones will be better placed to offer the support you need once you’ve told them about your struggles.
Rehab
Rehab can be a powerful option for anyone who feels unable to manage their addiction on their own. While many see rehab as a last resort, it can be a lifeline for those who feel their alcohol or substance use is spiraling out of control.
Rehab allows you to get around-the-clock addiction support in a structured setting, away from the triggers and temptations of the outside world. As a designated place to aid recovery, you’ll have professional support to help you manage your addiction in the short term while planning ahead for long-term recovery.
If you’re considering rehab for yourself or a loved one, the best thing to do is contact a doctor or healthcare professional. They can assess your needs, recommend rehab facilities, and provide referrals.
Speaking with your college
Speaking with your college about your addiction can help in numerous ways. College often have access to helpful support services like counseling, health centers, and addiction support programs.
As well as support services, college may also be able to help you manage your academic responsibilities during addiction. For example, if you’ve found yourself falling behind in certain classes, informing your college may allow them to make allowances such as deadline extensions, schedule changes, and deferrals.
Even if these types of allowances aren’t possible, informing your college of your struggles can allow them to offer more support to help you cope better with academic pressures.
Addiction Treatment Options for College Students
Trying to get sober on your own
With the right structure and support network, some people can get sober without the need for professional help. Most people will try to get sober on their own at first, before exploring medical options if they’re unsuccessful.
Keep a journal
Managing addiction alone requires a combination of structure and willpower. Keeping an addiction journal can be a good way to monitor your progress, and identify any common triggers and themes. This can help you develop coping mechanisms and restructure your life in ways that will minimize the chances of relapse.
Rely on your support network
Using your support network is another key element of managing addiction. Whether you confide in your wider peer group, or just a couple of close friends or family members, the emotional support of loved ones can be key to helping you resist temptation during the toughest times.
Use self-help resources
There are a range of self-help services you can use to help you manage addiction while at college. Whether it be books, apps, or online forums, these services can be great ways of getting expert advice and communicating with people going through the same thing.
Russel Webster lists a range of designated apps for addiction recovery, while Washington Physchwellness’ 12 Best Books for Adult Addiction list contains several acclaimed books for dealing with alcohol and drug use.
Partial Hospitalisation Programs (PHP)
Partial Hospitalisation Programs (PHP) are tailored treatment plans providing intensive professional care for numerous mental health conditions, including addiction.
PHPs typically last 4-6 weeks and require the patient to spend multiple hours at a designated treatment facility for between 5 and 7 days per week. In the program, patients will work with a trained team of professionals including psychiatrists, therapists, and social workers.
PHPs are excellent choices for people who require a more intensive program and have been unsuccessful with other treatment plans.
Intensive Outpatient Programs (IOP)
Intensive Outpatient Programs (IOP) are structured training programs that offer a higher level of care than standard outpatient programs (OP). While less intensive than PHPs, IOPs are designed for patients who require more support than weekly therapy but don’t need the everyday care offered by rehab and PHPs.
IOP patients typically receive several hours of treatment multiple days per week in either the morning or evening.
IOPs can be a great choice for students struggling with addiction as they’re more flexible and less time-consuming than PHPs. This means that they’re easier to work around course commitments, affording you more time to focus on your studies.
Outpatient Programs (OP)
Standard outpatient programs are a similar but less intensive form of treatment to IOPs. These treatment plans typically involve the patient seeing a therapist or addiction support counselor between one and three times weekly, usually for around an hour each time.
These programs can be hugely beneficial for addicts who’ve not had professional support previously, as they can provide them with key coping strategies to help them better manage their alcohol or substance use.
The minimal time commitments for outpatient programs mean they can be easily organized around a typical college schedule.
Sober Living Houses (SLH)
Sober living houses (SLH) are designated houses for people to live in while recovering from alcohol or drug addiction. These places are typically privately run and require residents to pay rent like a standard accommodation.
SLHs are typically accessed by people who have recently finished drug rehabilitation programs but don’t feel ready to live in a typical environment. These households are structured in a way to encourage sobriety and often include rules such as regular meetings and drug tests.
An SLH can be beneficial for a student battling addiction as it allows them to live in an environment free from the hedonistic temptations often present in student accommodation. Also, rules such as drug testing and compulsory meeting attendance add a degree of accountability that can encourage sobriety.
The supportive community in an SLH can also provide emotional support and commonality as students find themselves in an environment with other people going through the same struggles.
Addiction Support for Students
The addiction support available for students can vary based on their college or college. Thankfully, most students should be able to access one or more of the treatment services covered in this article with a referral from a medical professional.
Additionally, SAMHSA’s National Substance Use and Treatment Helpline is a free 24/4 service that can connect students to local treatment facilities and support groups. The trained, helpful operators can assist with any questions you have relating to various treatment options and direct you to the right people and places for support.
For online assistance, the Department of Health and Human Services offer a Find a Treatment Facility service that connects users to relevant treatment centers near their postcode area.
As well as these national services, some colleges and universities offer student-specific services including counseling, therapy, and designated addiction support services. These services can be a great way to get fast, tailored addiction support from an institution well-versed in the demands of student life.
The best way to find out what student addiction support is available to you is to contact your college directly.
Factors that Maximize The Likelihood of Success
Addiction can be an intimidating and unpredictable challenge for any student. While many factors can affect a student’s ability to manage alcohol or substance addiction, a study from the Journal of Research in Health Sciences highlighted four key variables that can influence someone's motivation to seek addiction treatment. They were:
Family support
Strong family relationships were identified as a common motivational factor for people starting addiction treatment. Over 80% of respondents said that family encouragement had made them want to seek treatment, with over three-quarters (77%) citing family support as a reason for continuing treatment.
Therefore, if you have good relationships with family members, involving them while you deal with your addiction can offer the support you need to maximize your chances of recovery.
The fear of negative consequences
Fear of negative consequences from substance use was a major factor in people seeking addiction treatment. Around 82% of people said that the fear of putting their romantic relationships at risk was a motivating factor, with over two-thirds (68%) citing the fear of physical or mental diseases.
(Source:Journal in Research in Health Sciences
There were four other potential negative consequences referenced by over 60% of respondents, they were:
- Fear of job loss or unemployment (67%)
- Damage to honor/reputation (66%)
- Abandonment from family (64%)
- Appearance changes (63%)
For students dealing with addiction, identifying the main negative consequences that could occur from your addiction can be a great way to keep yourself accountable. This can help motivate you during difficult times and enable you to maintain the willpower needed for a successful recovery.
Friend support
Like family support, the active involvement of close friends was seen as a motivating factor for seeking addiction treatment. Nearly 84% of respondents claimed that their friends were insisting they sought addiction treatment, with a similar number (82%) feeling that they can fully trust their friends to talk about addiction issues.
As with family support, confiding in friends can be a great way to foster vital emotional support that increases your chances of successfully managing addiction
Self-Belief
Self-belief can be a vital tool when battling addiction. A negative outlook can make managing substance use feel impossible from the start, so it’s only natural that those with greater self-belief tend to be more motivated in their attempt to recover.
The power of self-belief is backed by numbers, with around 70% of people seeking addiction treatment believing they were well prepared for the treatment and a similar number (69%) feeling they were able to follow up on their treatment objectives.
Additionally, around two-thirds (66%) said they were confident that they were going to stop using drugs, with 63% believing they were capable of controlling relationships with drug-using friends.
Around two-thirds (66%) said they were confident that they were going to stop using drugs, with 63% believing they were capable of controlling relationships with drug-using friends.
Source: Journal of Research in Health Sciences
While the power of self-belief when dealing with addiction is undeniable, this trait comes more naturally to some people than others. As with addiction, confiding in loved ones or seeking therapy can be a great way to cope with these issues and build your self-esteem over time.
(Source: Journal of Research in Health Sciences)
For immediate help, Mile High Psychiatry has put together this helpful list of steps and tips to help you build self-esteem and boost confidence.
Support Groups and Helpful Resources
We hope this page has given you the information to help yourself or a loved one take the first steps to managing their addiction at college. Below, we’ll cover some of the key support services available alongside some helpful resources:
Alcoholics Anonymous
Like family support, the active involvement of close friends was seen as a motivating factor for seeking addiction treatment. Nearly 84% of respondents claimed that their friends were insisting they sought addiction treatment, with a similar number (82%) feeling that they can fully trust their friends to talk about addiction issues.
As with family support, confiding in friends can be a great way to foster vital emotional support that increases your chances of successfully managing addiction.
Narcotics Anonymous
Like Alcoholics Anonymous, Narcotics Anonymous is a support and meetup organization for those dealing with drug addiction.
Findtreatment.gov
Put together by SAMHSA and the U.S. Department of Health & Human Services, FindTreatment.gov allows you to search for treatment for mental and substance use disorders in your area. All you need to do is enter details about your location and requirements, and the website will provide links to all of the relevant mental health facilities and care centers within your area.
Pyramid Healthcare
Pyramid Healthcare has put together a helpful resource for finding addiction support online. Their page contains links to a range of virtual support groups, mobile apps, and podcasts aimed at helping people battling alcohol and substance addiction.
To guarantee that all of our information is accurate, we ensure that all our sources are reputable. That means every source is authenticated and verified to be backed only by medical science.
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