Drug and Alcohol Abuse

Alcohol, tobacco, and other drugs used in American colleges and universities represents a public health problem of critical proportions. Institutions of higher education are under increased scrutiny due to policy developments from the public health, governmental, and higher education sectors in the 1990s that place revised importance on initiatives addressing student substance use. Despite variation in campus use rates, no institution of higher education is immune to substance use and its related adverse consequences. The negative effects reach beyond the parameters of the campus, catapulting this issue into the forefront of the national agenda. It is in the interest of society to design and implement policies and programs that aim to curb college student substance use and abuse.

Extent of Use

Alcohol, tobacco, and other drug use represents a ubiquitous problem for American colleges. Alcohol and other drug use on college campuses radically increased between 1993 and 1997, then stabilized between 1997 and 1999. This trend produces great concern as college student use rates are expected to climb due to a radical increase in drug use among those aged twelve to seventeen.

Alcohol, tobacco, and marijuana represent the most frequently used drugs on college campuses. Nationwide, 84 percent of college students report having drunk alcohol within the last year, 68 percent within the previous month, and 3.6 percent on a daily basis, according to Henry Wechsler (1996). Tobacco use shares a student use rate similar to alcohol. Schools indicate a significant increase of 28 percent in student smoking during the 1990s, with nearly one-third of college students having smoked within the past year. Drug use rates are rising on campuses; Arthur Levine and Jeanette S. Cureton estimated that 25 percent of students indicated that they had used some form of illegal drug within the past year. The prevalence of marijuana use rose 22 percent between 1993 and 1999–an increase that occurred among most student demographic groups and at almost all kinds of colleges. Marijuana is used by 24 percent of college students, cocaine by 4 percent, and hallucinogens by nearly 5 percent.

Alcohol

Alcohol is the number one drug of choice for college students of both two-year and four-year institutions, and continues to pose tremendous challenges to higher education. On average, college students consume about 4.5 drinks per week and about two in five college students engage in high-risk or binge drinking at least once in an average two-week period. Binge drinking, consuming five or more drinks in succession for men and four for women, is on a substantial increase, affecting about two fifths of the college population. It accounts for the majority of alcohol consumed and is associated with the bulk of problems encountered on campuses, impacting students' social lives, health, and education.

The negative consequences of student alcohol use span well beyond the parameters of the college campus and affect students, the institution, and the community. Alcohol is associated with increased absenteeism from class and poor academic performance, which results in a lower grade point average. The majority of injuries, accidents, vandalism, sexual assaults and rape, fighting, and other crime, on and off college campuses, are linked to alcohol and other drug use. Unplanned and uninhibited sexual behavior may lead to pregnancy and exposure to sexually transmitted diseases and HIV/AIDS. Alcohol use can be associated with injury and death from drinking and driving, alcohol poisoning, and suicide.

Tobacco

Many students perceive the college years as a time of experimentation, although in fact it is a period heavily shaped by environmental factors, social norms, and peer influences. During these years, it is common for intermittent tobacco use to quickly manifest into a life-long habit. For college students, tobacco in the form of cigarettes, smokeless tobacco, and cigars presents a legal and accessible alternative to other drug use. Its use is linked to various cancers, emphysema, heart disease, and other life-threatening illnesses.

Other Drugs

By their nature, illicit drugs do not carry a legal age for purchase, consumption, or distribution. Therefore, colleges must address the problem somewhat differently than they do alcohol and tobacco. Students are entering higher education with increased exposure to drugs, which predisposes them to substance dependency. Variation exists among college and universities as to the rate and type of substances used. Marijuana, amphetamines, hallucinogens, inhalants, cocaine, steroids, and designer drugs represent but a few general forms entering the higher education arena. Marijuana is reported as the illicit drug of choice on campuses. Illicit drug use factors into tragedies that include rape, overdose, vandalism, violence, and death. Memory loss, diminished concentration and attention, increased absenteeism, impaired academic performance, and physical illness are also associated with drug use.

Secondhand Effects

The secondhand effects of substance use on campus are often overlooked and underappreciated for the deleterious effects they may have on students and the quality of their collegiate experience. Students who abstain, use legally, or in moderation often suffer secondhand effects from the behaviors of students that use substances in excess. Nonbinging and abstaining students may become the targets of insults and arguments, physical assaults, unwanted sexual advances, vandalism, and humiliation. Sleep deprivation and study interruption results when these students find themselves caring for intoxicated students. Passive smoke is associated with life-threatening health risks, and smoking within residence halls places people at risk due to fire.

Campus Environment

Perceptions of campus use, campus climate, substance availability, awareness of campus policies and enforcement, and students' family histories of substance abuse impact the extent of substance use on any given campus. The campus and surrounding community exert profound influence on innumerable facets of student life. Establishments encircling college campuses that cater specifically to college students contribute to the substance use climate by selling to underage or intoxicated students. The social, academic, and cocurricular milieux are often shaped by the social norms and perceptions related to campus alcohol, tobacco, and other drug use.

Students typically overestimate the amount and the extent of high-risk drinking, tobacco use, and illicit drug use on their campus and on college campuses in general. These misconceptions lead students to feel pressured and justified in their increased substance use. By exploring how students perceive substance use, policies, and rule enforcement on campus, college administrators are better able to discern and roughly predict how students will react to the perceptions of social norms.

Social fraternities, sororities, and athletics typify student groups at high risk for substance abuse. Fraternities and sororities often find themselves at the center of growing concern as their mere presence on campus is associated with higher campus-wide levels of substance use, particularly alcohol consumption. Leaders of Greek organizations, particularly male members, accounted for the highest alcohol consumption on many college campuses. Due to the integral social role these organizations occupy on most college campuses, the practices they espouse often advocate the use of alcohol, tobacco, and other drugs.

Intercollegiate athletics represents an important aspect of the college experience. However, the college athlete may experience anxiety associated with the dual roles and conflicting expectations of being both an athlete and a student. Attempting to rectify this discourse, college athletes may become increasingly susceptible to substance dependency. Collegiate athletes are more likely to use alcohol and smokeless tobacco, and experience binge drinking more than nonparticipating students. Colleges and universities compound the problem by sending students mixed messages concerning substance use by endorsing alcohol and tobacco industry advertising at collegiate sporting events.

Policies

Affecting the campus environment relies heavily on the pervasive commitment of the college or university. Focused policy, procedures, prevention strategies, data gathering, counseling, and referral approaches enable schools to effectively address this problem. Institutions often find themselves caught in a legal quagmire when they attempt to combat rising substance use and are confronted with issues of legal responsibility and institutional liability while simultaneously acknowledging the behavioral and health implications related to substance abuse.

Local, state, and federal governments play a central role in assisting and bolstering higher education's efforts to reduce substance use and the resulting problems that plague American college campuses. Federal legislative such as the 1986 amendments to the Higher Education Act of 1965, Drug-Free Schools and Communities Act of 1989, and the Crime Awareness and Campus Security Act of 1990 represent such initiatives. The 1998 Parental Notification law permits schools to inform parents if their child violates the rules or laws governing alcohol or controlled substances. The Drug-Free Schools and Campuses regulations mandate that schools prepare a biennial report, which certifies that the school has implemented and assessed prevention policy and programs and documents the consistency of policy enforcement. This report must be made available to anyone who requests it.

With increasing cost pressures on colleges, it is difficult to assure adequate and continuous funding for substance-related programs and policy enforcement. In 1993, the Higher Education Center for Alcohol and Other Drug Prevention was established by the United States Department of Education to assist in developing and carrying out substance prevention policies and programs. The U.S. Department of Education and other granting organizations provide national funding support in an effort to address this issue. Specialized task forces and advocacy groups, such as the National Institute on Alcoholism and Alcohol Abuse task force on college drinking, illustrate the nation's commitment to this problem.

Substance abuse is not a campus-centered problem but one that impacts the entire community. To effect change, institutions of higher education acknowledge the need to form committees and coalitions, comprised of administration, students, parents, faculty, alumni, campus organizations, governmental and law enforcement agencies, and the community. By activating multiple, campus-wide policy levers, campus leaders ensure that initiatives span all facets of the institution.

Schools are tightening regulations, strengthening academic requirements, adjusting course scheduling, and offering extended hours for library and recreational facilities, while providing alternative alcohol-free campus-sponsored activities. Schools are withdrawing endorsement of alcohol and tobacco industry advertising on campus and establishing substance-free residences. By targeting social groups such as fraternities and sororities for programming and monitoring of policy compliance, schools are attempting to further shape the social climate. Novel disciplinary actions exhibit the decisive consequences of such behavior, provide support services, and offer mandatory alcohol or drug assessment with the possible introduction of counseling, Twelve Step, and treatment services.

Programs

Through a paradigm that conceptualizes students' college experience systemically, substance-related strategies strive to alter the social, physical, intellectual, legal, and economic environment on campus and in surrounding communities. Effective initiatives offer diversified programs that account for students' developmental level year in school, age, and level of readiness to change behavior with special attention to the first-year experience.

A variety of creative and versatile approaches are available to institutions of higher education to address issues related to substance use. Education, prevention, counseling, and treatment programs are the most commonly utilized. Approaches that promote increased understanding about substance use and the related effects, provide suggestions for alternative substance-free activities, and attempt to counter misconceptions around social norms comprise the foundation to effective program initiatives.

Standardized programs, developed and distributed by external vendors, offer schools an alternative method for educating students. Many schools find these programs beneficial because of the variety of issues targeted. With the advent of novel technology, innovative and interactive computer programs add to the program arsenal. Often expensive, standardized programming may not to be a viable option for institutions with limited resources.

Campus-initiated programming offers another option for colleges and universities. These efforts may include programming such as alcohol awareness month, safe spring break, and substance-free social activities. The formation of substance use task forces, student organizations, and committees corrals the campus community around efforts to devise strategies and initiate change in campus norms, perceptions, and climate. Typically cheaper than standardized initiatives, these methods are readily utilized.

Higher education must recognize that alcohol and other drug use and the problems that result from substance abuse are never entirely going to go away. Nevertheless, through continued commitment, campus communities significantly impact the problem through policy and program initiatives that are directed at altering social norms, climate, and practices. To initiate and maintain change in higher education with respect to alcohol, tobacco, and other drugs, programs, policies, and partnerships must become permanent and pervasive fixtures on college and university campuses.