Addictions on campus


    Adjusting to life as a college student and young adult can be overwhelming. There are more responsibilities to manage along with less routine and structure. Things like budgeting, time management, chores, along with academic pressure and trying to make friends is a lot to juggle. It is little wonder so many students struggle to maintain good mental health.

    When someone is suffering from an addiction, they feel the negative consequences from what they are doing, yet they are unable to stop the addictive behavior by themselves.

    Another common feeling is the notion that you are supposed to have it all together because you are an adult. Feeling stressed out, anxious, or depressed – combined with shame for needing help, can lead to people using drugs, alcohol, or other unhealthy behaviors to cope with these negative feelings. Self-medicating to manage stress and emotions can lead to addiction.

    It is human nature to want to feel good and get relief from bad feelings. No one chooses addiction. What starts out as seeking short term relief can lead to problems over time. When someone is suffering from an addiction, they feel the negative consequences from what they are doing, yet they are unable to stop the addictive behavior by themselves.

    Let us look at some signs that regular partying or coping skills to help manage college life may be getting out of hand.

    Alcohol use disorder

    For many college students, drinking is part of their regular socialization. Nearly 53% of full-time college students report drinking alcohol in the past month and 33% report binge drinking. Having a drink or 2 at a party or a glass of wine or beer at the end of a stressful day is not usually harmful. Getting black out drunk at every party, missing class because you are hungover, or drinking instead of doing homework are all signs that drinking might be past the point of being just part of college life.

    Long term alcohol use can contribute to feelings of low mood. This can make someone want to drink more often to numb this bad feeling.

    Feeling that you must have a drink to have fun, or that people won’t like you unless you are drinking, can indicate that you may have social anxiety. At first it can seem like alcohol gives you energy because it can lower your inhibitions. This reduces feelings of social anxiety and can make you feel like the life of the party. Alcohol can also numb feelings of low mood or homesickness. While it may seem like drinking gives you a boost, it is a depressant. Long term alcohol use can contribute to feelings of low mood. This can make someone want to drink more often to numb this bad feeling. It can be part of a vicious cycle.

    A common sign someone is struggling with alcohol use disorder is that alcohol becomes the priority: decision making is increasingly centered around alcohol. For example, it may present as repeatedly wondering “Can I agree to this project, or will I be hungover?” or “Will there be beer there?”  This can further deteriorate to a point when drinking is no longer about relief or coping, rather that the person needs to drink to not be sick. They become dependent on alcohol to function. People with severe alcohol use disorder often need to be hospitalized to detox from alcohol while under medical care because alcohol withdrawal can be deadly.

    » Read: Signs of depression in college

    Stimulant use disorders (adderall, cocaine, uppers)

    Academic pressure can tempt college students to misuse stimulant medications like those commonly prescribed for ADHD. Stimulants make you stay awake, so they can certainly be tempting when pulling all night study sessions or managing an over-committed schedule. Recent studies show that for college students, the use of stimulants is linked with drinking and using marijuana. This is due to students trying to catch up on schoolwork after partying, not because the medications actually improve academic performance.

    Even though medications prescribed for ADHD sound innocent, if they are not prescribed to you, they can be dangerous. Stimulants or “uppers” can take a toll on your heart. It is common to crash after a period of taking stimulants. These substances can disrupt your sleep-wake pattern causing a cycle of needing uppers to start the day and downers to sleep. A lack of sleep leads to tiredness which can lead to the increased need for stimulants to function. This is another example of how addiction is a powerful cycle.

    Cannabis use disorder (marijuana, pot, weed, dabs)

    Marijuana users often report using to get a feeling of calm, to reduce anxiety, and improve sleep. Some feel it helps with their creativity and productivity. The use of marijuana among college students is at an all time high with 44% of college students using marijuana in the past year compared to only 38% in 2015. This is a significant increase, and it makes sense for many reasons including:

    • many states have decriminalized marijuana use, possibly adding to the perception that it is completely safe
    • marijuana use has become more socially acceptable and normalized than it has been in the past
    • many young adults think of marijuana as being safer than alcohol
    • another contributing factor may be the impact of the COVID19, with 91% of college students reporting pandemic-related mental health issues – hence, using marijuana may potentially be a means of self medicating

    The increased acceptance of marijuana does not mean it is without harmful effects. The part of the marijuana plant that gives users the feeling of being high is called tetrahydrocannabinol or THC. The amount of THC in marijuana given at a dispensary has nearly doubled since researchers began studying it. Researchers do not yet know the long-term effects this will have on the brain because there hasn’t been an adequate timeframe to study it. The brain is still developing until about age 25 or 26, so even though most college students are legal adults, marijuana use could still impact healthy brain development.

    It is possible to become addicted to marijuana. Some signs of addiction are needing to use more to get the same effect, cravings to use marijuana, ignoring responsibilities or things that are important to use marijuana, and feeling withdrawal symptoms when stopping. Withdrawal symptoms include feeling unwell physically and mentally when you stop using after a period of regular use. You might feel stomach pains, shakiness, disrupted sleep or feelings of depression and anxiety. Needing to use a substance to avoid feeling sick is a strong sign of addiction.

    Opiate use disorder (Opiates, Heroin, Oxy, Percocet, Fentanyl)

    Opiates have often been prescribed as a pain killer following surgery or severe injury. Medications prescribed by a doctor can feel safe even if they are not prescribed to you, but the risk of addiction is there. Opiates are highly addictive due to their effect on the brain. They block the perception of pain and increase the good feelings in the brain’s reward center. Users commonly experience a sense of calm along with confusion and sleepiness. Chronic users may refer to this as “nodding out.”

    Not everyone who takes opiates becomes addicted, but it can happen fast. When someone can’t get their medication from their doctor anymore, they may turn to the streets and use illegal drugs because of how bad they feel without it. People may justify their use by how severe it is, for example: “I use pills, but I’ve never crushed them up and snorted them.” Or “I’ve snorted pills, but I’ve never used heroin.”

    Users can develop a tolerance resulting in the need for more of the drugs to treat their pain. If someone is addicted to these medications, they may experience unpleasant withdrawal symptoms when they stop using them. These symptoms can include severe nausea, vomiting, diarrhea, sweating, irritability, decreased sleep, physical aches, and pains. These feelings are so terrible that some people do almost anything they can to make them go away. This can include things they would never normally do, like steal to get money to buy more drugs to not be sick. It can also be the reason that someone who previously used a medication prescribed to them by a doctor is now injecting heroin through a needle.

    Many people in recovery from opiate addiction have found relief with medicated assisted treatment, also known as MAT.

    Opiate addiction is all-consuming. Someone actively using spends most of their time thinking about how they can get more of these drugs to not feel sick. These drugs also make it difficult to feel good or happy about the things that used to give these feelings naturally. People in active addiction often ignore responsibilities and neglect basic hygiene. Living in a house without electricity or running water can feel acceptable if the person has what they need to not feel sick.

    Anyone can become addicted to opiates and it can be fatal. Opiate addiction is not a sign of someone being weak or dirty. It is treatable. Many people in recovery from opiate addiction have found relief with medicated assisted treatment, also known as MAT. Some people look down on this thinking that MAT is just trading one drug for another, but this is not true. MAT involves the use of prescription medication to manage the powerful withdrawal symptoms associated with opiate use. When people are not overwhelmed by withdrawal symptoms, they can begin to better manage other areas of their life, participate in counseling, and function in a healthy way because their brain is no longer obsessed with chasing drugs to not be sick. Opioid use among college students has been declining, but with millions of opioid users in the U.S., it is likely to be something college students encounter whether directly or indirectly with someone they care about.

    Process addictions

    Did you know it is possible to get addicted to almost anything? It is common to think of drugs and alcohol when we hear the word addiction, but there are many things that can give us that feeling of relief and escapism to cope with emotional distress.

    Gambling disorder

    Gambling can give the brain a huge rush of dopamine, which is the feel-good chemical. It usually involves some element of risk and reward. There is a risk when money is on the line and the brain gets rewarded by winning money. It also gets rewarded if gambling is a social activity. Casinos provide a high energy environment with lights and sounds that can be overly exciting. Gambling can also take place during community events through bingo, lotteries, or sports betting. About 75% of college students report gambling in the past year.

    Just as with substances, gambling addiction involves someone initially feeling good about gambling—until this feeling dissipates due to the gambling causing problems. The gambling cycle can look like someone gambling often and risking excessive amounts of money, money they don’t have, or going into debt to gamble. Many games are set up is to make the player feel they are “so close” to winning. That feeling of winning is so good it becomes a feeling to chase. Statistically, players are not close to a win.

    Someone with a gambling addiction may believe they have a system or method that makes them talented at gambling.

    Some forms of gambling also involve the feeling of escape and relief. This is possible through the process of hitting the buttons on a slot machine, or in a game on your phone. For some gamblers it is not the possibility of winning that takes hold as much as the feeling of escape. This becomes a problem when someone is missing school or work or ignoring other responsibilities to participate in gambling.

    Another sign gambling has gotten out of control is going into debt to gamble. Gambling addiction can drive a person steal so that they can cover gambling debts. They might steal to pay for gambling activities believing they will win and can pay the stolen money back before anyone realizes. In addition to this causing extreme stress, this can lead to criminal charges.

    Eating disorders

    Eating disorders are not often thought of as an addiction, but the process is similar. Disordered eating involves elements of control, getting comfort, or numbing negative feelings through food. As a culture we associate a lot of emotions with food which can make something necessary for our survival become something hard to manage. It is estimated that 30 million Americans will struggle with an eating disorder in their lifetime and this usually begins on college campuses.

    Binge eating is not about the calories as much as it the process. Occasional days of overeating are different from binge eating.

    Binge eating disorder involves someone compulsively overeating. It can look like ‘eating anything not nailed down’ – usually eating thousands of calories in a sitting. Eating compulsively can also happen throughout the day adding up to thousands of extra calories. Binge eating is not about the calories as much as it the process. Occasional days of overeating are different from binge eating. During a binge, the person feels out of control. They want to eat just for the sake of eating: it is not about what things taste like.

    Binge eating commonly consist of ready to eat junk foods made up of considerable amounts of sugar, fat, and salt. These foods taste good and are also associated with strong emotions. For example, many common celebrations include cake. We are often rewarded with candy as children. As adults some of these feel-good foods become foods, we know to be unhealthy and therefore forbidden. Binge eating can also be eating singular ingredients in ways they are not meant to be eaten like fistfuls of brown sugar or a canister of breadcrumbs.

    Eating compulsively can numb feelings of loneliness, stress, or anxiety. Overtime this unhealthy relationship with food causes negative consequences. Feeling obese can limit the options to socialize in a healthy manner or contribute to low self-esteem. It can also lead to physical health problems like heart disease or diabetes. Binge eating disorder is like an addiction due to the process involved. The coping mechanism originally sought after to manage negative feelings— i.e., food— becomes something that contributes to and perpetuates negative feelings, and the cycle is difficult to break despite the consequences.

    There are many symptoms of poor health associated with anorexia including hair loss, nutrition deficiencies, heart problems and death.

    Eating disorders that involve calorie restricting can be an addiction related process also. Anorexia nervosa (anorexia) is an emotional disorder characterized by not eating due to an obsessive desire to lose weight. It is often about control. When life is feeling unmanageable and out of control, someone with anorexia may see food and weight loss as something they have control over. They become severely underweight and malnourished, appearing as though they wish they could disappear. There are many symptoms of poor health associated with anorexia including hair loss, nutrition deficiencies, heart problems and death.

    Bulimia nervosa (bulimia) is an emotional disorder that involves the behaviors seen in both binge eating and anorexia. With bulimia nervosa, episodes of binge eating end with self-induced vomiting to rid the body of extra calories. This can be a physical representation of someone trying to purge their feelings of guilt and shame from binge eating. During the binge they feel out of control, so the purge is them trying to regain control. This process can also involve the use of diuretics and laxatives to reduce calorie intake. This cycle is difficult to break despite the negative consequences like bad breath, cavities, and digestive issues.

    Addiction assessment

    We can get addicted to anything. This includes video games, shopping, sex, scrolling on our phones. How much is too much? Do you or someone you care about suffer addiction? How can you know?

    A quick and easy way you can check in with yourself or someone you care about is to answer questions from the CAGE questionnaire. This was originally developed to screen for alcoholism, but you can substitute anything in place of alcohol to ask these questions.

    C- Have you ever felt you needed to cut down on______?

    A- Have people annoyed you by criticizing how much or how often you ______?

    G- Have you ever felt guilty about _______?

    E- Eye opener– Have you ever felt like you needed to ____ first thing in the morning to start your day?

    Another check in is to ask yourself if you ever felt the need to hide what you are doing from someone. This relates to the previous question about feeling annoyed by what others are saying. Answer honestly and ask if what you are doing is impacting your ability to function as a healthy human being. Note, in many cases with an active addiction your brain is likely to lie and say you have everything under control even if you do not. Answering yes to 2 or more questions on the CAGE questionnaire indicates that you should talk to a professional for further discussion and evaluation.

    Getting help

    Drinking and partying often seem like it is part of college life, but it does not have to be. Some organizations are taking notice of the unique mental health needs college students face including those who may be in recovery. Collegiate Recovery Programs (also known as CRP) focus on providing supportive and safe places for students in recovery. They provide access to resources such as counseling, substance free housing, and sober social activities while also promoting standards of academic success. These programs use peer led supports which can be a critical part of socialization and navigating college life. Collegiate Recovery Programs are not limited only to those students in recovery from addiction. They are open to other students seeking to normalize the college experience without substance use. Over 150 colleges have integrated recovery programs on campus. Texas Tech University  and the STEPUP program at Augsburg University are 2 of the most well established collegiate recovery programs in the country boasting a graduation rate of nearly 90% and low rates of relapse.

    Mental health professionals can help you learn healthy coping skills to manage stress along with adjusting to college life.

    It is important to know that, like anything else, there are trends in substance use. Just because you have not heard that a certain drug is dangerous or addictive— does not mean it isn’t. Similarly, just because your friends do something without consequence, this does not mean that it won’t be harmful for you. People react differently based on genetics, chemical reactions, and their environment.

    While addiction is often thought of as someone making the poor choice to use drugs, addiction usually begins from developing an unhealthy relationship with something as a way to manage feelings of emotional distress.  It can also occur when certain chemicals are introduced to the brain and the brain craves more. Early adulthood and the demands of college life can easily set the stage for addiction to take over.

    The good news is there are professionals who understand this and can help you. The first step is to seek help at the counseling center on campus. Mental health professionals can help you learn healthy coping skills to manage stress along with adjusting to college life. Other great options include:

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