More Comprehensive Action Needed to Alter Campus Culture Around Substance Use

The responsibility for changing a campus culture that has been accepting of excessive substance use has largely fallen on college presidents, but a new report suggests that a more coordinated approach is necessary to achieve success, with trustees needing to step up their role.

The American Council of Trustees and Alumni (ACTA) intends to send a copy of Addressing College Drinking and Drug Use: A Primer for Trustees, Administrators, and Alumni to 25,000 trustees and others in university communities. “Trustees are the fiduciaries of an institution, and are ultimately responsible for everything that happens,” ACTA president Michael Poliakoff tells Addiction Professional. “They often don't recognize the awesome responsibility that rests with them.”

A critical change in thinking that needs to happen, according to one of the report's co-authors, involves acknowledging the strong link between students' substance-using behavior and academic performance, and no longer seeing substance use prevention as something outside the realm of educational opportunity.

“It is prevention to say that you're going to create a challenging academic environment,” Amelia Arria, PhD, director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health, tells Addiction Professional. That can involve actions as routine as scheduling more classes on Fridays and other student activities on weekends, to counteract a trend toward a student partying cycle that starts revving into gear on Thursday night.

Another reason why trustee involvement becomes critically important, Poliakoff adds, is that “college presidents need to know that the board is behind them, on actions that may well ruffle the community.”

The report shares numerous stories of success at institutions where the university community has overcome what campus leaders call the three most critical barriers to addressing substance use problems on campus: lack of information, limited resources and lack of coordination.

One such example has been the formation of the Maryland Collaborative to Reduce College Drinking and Related Problems, for which Arria has had a leadership role. The collaborative is a network of 15 higher education institutions in the state that use data-driven strategies to reduce alcohol use on campus. The collaborative encourages implementing both environmental- and individual-level strategies to combat alcohol misuse, and has been instrumental in advocacy for initiatives such as Maryland lawmakers' 2015 ban on retail sales of extreme-strength alcohol.

Need for ongoing presence

Arria says that while the report chronicles progress that has been made nationally in addressing substance use on campus, there remains much room for improvement. The presence of higher-potency marijuana and declining perception of its risks among young adults poses a major concern today, she says.

Also, too many college leaders still see substance use prevention as a process of delivering individual-level messages that can be completed in weeks. In reality, leaders discussing prevention approaches should “think sunscreen, not vaccination,” she says, with an ongoing application of strategies and greater vigilance for higher-risk situations.

Environmental-level approaches involve promoting activities that help students develop positive social skills apart from gatherings that mainly involve substance use. Penn State University's Late-Night Penn State alcohol-free programming, for example, resulted in overall declines in drinking and excessive drinking rates among participants compared with non-participants, the report states.

“One of the biggest counterweights to substance use among young adults is academic engagement, and engagement in activities that are rewarding,” Arria says.

Campus recovery programs growing

Comprehensive substance use recovery programs were present on only 29 university campuses in 2013, according to the Association of Recovery in Higher Education, but now number close to 200. “Robust recovery programs that are visible to the campus community help dismantle the standard of a drug- and alcohol-based party culture,” the ACTA report states. “They emphasize healthy choices and give students who are struggling with addiction, and those who are at risk of developing problems, a real chance to succeed academically.”

The report suggests that screening for alcohol or drug problems should be considered as a routine component of campus health center visits. Students should be informed of the research-based link between use of alcohol or marijuana and weaker academic performance.

“Some academic advisers will say, 'I don't want to get personal with my students about their alcohol and drug use,'” Arria says. But they will talk to students about other barriers to success, such as time management challenges and lack of sleep, and in many cases these are directly related to substance-using behavior.

The report states that when a student is identified through screening as having a substance use problem, cognitive-behavioral therapy (CBT) and motivational enhancement therapy (MET) constitute promising therapeutic approaches. However, “Many colleges do not have well-staffed health centers, and if they do, lack the necessary resources to offer these evidence-based interventions systematically,” according to the report.