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Helping Students with Addiction

Note: This story originally appeared on the American Federation of Teachers’ member blog, AFT Voices. For more information visit:  www.aftvoices.org.

The opioid crisis has made headlines throughout the nation. More than 64,000 people died of overdoses this past year, and many of those individuals were current or recent college students. As a faculty member who has taught about and researched addiction for several decades at Temple University, I am deeply concerned about how universities are impacted by this crisis and what kind of response is needed on college campuses.

I also have family members and friends who have struggled with addiction; this is not just an academic matter to me, but profoundly personal as well.

What I know about drug addiction from my academic work pales in comparison to what I’ve learned while dealing with this disease in my personal life, as I’ve helped people I care about get the help they need. Being a parent of college students gives me additional “skin in the game.”

The exchanges I’ve had with my students have also deepened my concern, but at the same time have given me hope. I have learned so much from them during frank and open dialogue in my Drugs in Urban Society course, a class I’ve taught on campus as well as inside various prisons as part of the Inside-Out Prison Exchange Program. The incarcerated students are often surprised at how much their “privileged” college classmates have also been affected by this disease.

Do not ignore this problem

It is far too easy for colleges and universities to ignore addiction problems on campus, or pretend they aren’t an issue. Unlike many other medical conditions, substance use is hidden for many reasons, but particularly because of stigma. So many parents have told me that they were the last people to know about their child’s drug problem, often because people who are using are really good at hiding it; plus, it is difficult to assume the worst when your child is telling you everything is OK. Unfortunately, this tends to also be true for colleges and universities, until there is a devastating overdose death on campus.

It is far too easy for colleges and universities to ignore addiction problems on campus, or pretend they aren’t an issue.

The opioid crisis has heightened the urgency around addiction — using such opioid painkillers as OxyContin, Vicodin, and Percocet often leads to misuse, can lead to fatal overdose, and is often the gateway to heroin and fentanyl, drugs that are also notorious for their high risk of fatal overdose. But it is difficult to accurately estimate how many students at a college or university have died from overdose. When a student’s addiction begins to spiral out of control, an overdose may occur after the student has left school. Plus, many students live off campus, and the cause of death is often not shared with colleges and universities. Bereaved parents may not wish to share the cause of death with their child’s school.

I know of one student who had a nonfatal overdose, dropped out of college, and then overdosed again, this time fatally. Another student I knew developed an addiction problem while in college, went into treatment and was doing well, only to come home and later die of an overdose. The parents were so devastated that they could not talk about the death much less share the tragedy with university administrators. Of course, the student’s death would never be counted in the school’s overdose statistics.

All these factors make it all too easy for colleges and universities to underestimate the problem. Plus, a drug overdose death is really the extreme and final tip of the iceberg in terms of addiction problems on campus.

Beyond opioids

Opioid overdose deaths are horrific and far too common; even one death is too many. But concern over them should not obscure other problems on campus, such as binge drinking and addiction to other drugs like cocaine, benzodiazepines (like Xanax), and yes, even marijuana. Because of my teaching and research interests in this area, I often have students and even colleagues approach me to speak privately about their concerns for a sibling, friend or relative with a drug problem; they don’t know whom to talk to or ask for help. The stigma keeps the problem hidden. Most people I’ve talked to about addiction are suffering and have no idea what to do or who to go to for help.

So what should colleges do? What should their responsibility be?

In my view, colleges need to develop comprehensive plans. There are many models that schools already employ, often under the umbrella of collegiate recovery programs. But too often services operate in separate silos. A comprehensive plan can help address this problem, especially if it is developed by a university wide task force with representation from a diverse a group of stakeholders: Student health, housing, campus safety, student life, other administrative bodies, faculty, students and parents should all have input.

I often have students and even colleagues approach me to speak privately about their concerns for a sibling, friend or relative with a drug problem; they don’t know whom to talk to or ask for help.

There are also several layers of response that colleges and universities must address. The first is pure emergency response — having sufficient numbers of campus safety personnel, dormitory staff and security guards with naloxone (Narcan) and the training to use it. When someone has stopped breathing from an overdose, there are only a few minutes available to save that student’s life, and although it doesn’t happen often, I know our campus police, equipped with Narcan, have saved lives.

Another layer is responding to students in crisis. It’s not uncommon that students leave school because of substance abuse disorders; when that happens, the student and his or her family need a single point of contact with the university, someone who is familiar with all the issues involved with addiction. This contact person can help broker whatever university services are needed, facilitate the paperwork for a medical withdrawal, serve as an ombudsperson with instructors, perhaps even help the student continue with classwork through distance learning if that is feasible.

One Penn State parent described how the coordinator of the Collegiate Recovery Community stayed in touch with her son throughout his treatment and was essential for his successful college re-entry and eventual recovery.

Students in crisis also need college counseling centers. Frequently, students use illicit drugs to self-medicate for depression and anxiety, and co-occurring mental health and addiction problems are common. Counselors who understand and are trained in addiction counseling are essential.

Unfortunately, long waiting lists for campus counseling services are common, and a particular problem for someone addicted to opioids. While any student with acute substance abuse or mental health problems needs to be seen as soon as possible, with opioids, waiting to get help can be fatal because of the dangers of overdose. Having a confidential 24-hour hotline staffed by trained peers may be another useful initiative to help students in crisis, whether drug-related or not.

Having a social life that doesn’t involve drugs or alcohol is a challenge for any college student in recovery.

A third layer for addressing substance abuse and recovery on campus involves providing appropriate living environments for students already in recovery. Most people are quite familiar with dormitory life, complete with alcohol and drugs; if someone in recovery needs a drug-free place to live, where can they go? Having a social life that doesn’t involve drugs or alcohol is a challenge for any college student in recovery.

Recovery housing has to be an option, whether in partnership with external organizations or university managed. Dealing with the finances of this option, as well as the stigma that might be attached, however, requires considerable thought and planning.

Finally, let’s not forget the importance of including student voices and peer support in addressing this issue. Colleges and universities need to facilitate student support groups and organized social activities for those in recovery. They need to mobilize and encourage peer support. And they need to educate students, faculty and staff about the nature of addiction as a disease.

A student in my “drugs” class, Andrew, posted a Facebook message to his Temple University class of 2019 that was inspired by our discussion in class about the opioid crisis. In his message, he recounted some of the horrific statistics concerning overdose deaths in Philadelphia, and then wrote a plea for compassion and understanding for those suffering from the disease of addiction. He then wrote, “I hope everyone is doing OK tonight … and if you’re hurting, I hope you have a support system to turn to, whether that be friends, family or professors. You probably don’t know me, but add me if you wanna talk about this or about anything. Everything is hard right now and no one should have to be/feel alone.” This comment is a testament to the power of peer support among students that universities need to encourage.

We all need to exhibit that kind of compassion. We cannot pretend that colleges and universities do not have students who suffer from substance use disorders, who may be suffering in silence. We also cannot pretend that colleges and universities do not have numerous potential students in recovery who want to either come back to college or enroll in college for the first time, but need a living situation that supports their recovery. It is dangerous to sweep this issue under the rug. I urge all my faculty colleagues to talk to students openly and honestly about this issue. Many will tell you that student lives really are at stake.

Written by Jerry Stahler

Jerry Stahler is a professor in the Department of Geography and Urban Studies at Temple University and a member of the Temple Association of University Professionals. His research focuses on addiction, particularly on developing and evaluating social interventions for addressing substance abuse. To read more about addiction recovery on campus, see the AFT’s news story.

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