Florida Colleges Revolutionize On-Campus Drug Prevention, Treatment Resources

Leaving home for college is one of the most exciting times in a person’s life. Many young adults experience a sense of freedom for the first time, and they have the ability to pursue whatever interests them. But they’re still shielded from many adult responsibilities.

For most students, it’s their first chance to try alcohol or other drugs without having to worry about their parents finding out. That’s what Harrison, a 2015 graduate of the University of Florida, realized during his freshman year in Gainesville. He had tried alcohol and marijuana in high school, but his parents kept a close watch on him. Growing up on a military base also made drinking and smoking difficult.

Photo: University of Florida Campus

“College is definitely where my drinking and drug use took off very quickly,” Harrison told DrugRehab.com. “I always had a strong desire to want to do that stuff, but my situation made it difficult.” “I used a lot of substances,” Harrison said. “But alcohol was always the substance that caused the most problems. That was probably what got me to the point that I needed to get sober.” In many ways, Harrison’s story is representative of the college experience portrayed by popular culture. Movies such as “Animal House,” “National Lampoon’s Van Wilder” and “Old School” glorify alcohol and drug use in college. Songs such as “Because I Got High” and “I Love College” portray the college experience as a time to party. For students who have a genetic predisposition for addiction, that narrative is risky. Some students can experiment with alcohol and other drugs and never become addicted. Others possess genetic traits that make it difficult for them to quit once they start.

More than 20 million Americans, 7.8 percent of people ages 12 and older, experienced a substance use disorder in 2015, according to the National Survey on Drug Use and Health. An estimated 5.3 million people with a substance use disorder that year were between the ages of 18 and 25.

Photo: Dr. Maureen Miller, University of Florida Division of Student Affairs

The statistics appear daunting, but for prevention experts like Dr. Maureen Miller, college is a chance to educate students about the risks of alcohol and other drugs. Miller is the director of GatorWell Health Promotion Services at the University of Florida. “One of the exciting things about working within college health promotion is you have the opportunity to work with students who, for the first time, are really establishing behaviors that are probably going to be with them for a pretty long time,” Miller told DrugRehab.com. Miller and prevention specialists on college campuses across the country want to prevent problematic behavior from happening before it occurs. They teach students how to either abstain from alcohol or drug use or to consume alcohol responsibly. But some students come to college actively trying to avoid alcohol and other drugs.

When students in recovery from addiction enter college, they’re exposed to several risk factors for relapse. There’s a high chance that they’ll be offered alcohol or other drugs, experience peer pressure or see someone else drinking or smoking.

A 2009 study published in the Journal of American College Health reported that students in recovery at Texas Tech University identified several challenges to recovery on college campuses. The students said they had difficulty balancing academic tasks with recovery goals. They reported feeling left out of popular activities that involved substances of abuse, and they viewed residence halls as risky environments filled with students who wanted to party. Before 1977, there were no systems in place on college campuses to support recovering students. Today, schools across the country are building revolutionary programs to give those students a chance to succeed.

Alcoholism runs in Harrison’s family. His uncle died from alcohol-related issues. His mother became sober when he was 11, and both of his grandfathers are in recovery. Aware of their family history, his mother warned him about the disease of addiction and cautioned him to avoid alcohol as a teenager.

There was another big deterrent in Harrison’s life. His father was in the Navy, so Harrison grew up on a base where using drugs was a federal offense. He had to drive past a guard every time he came home. Growing up in a military family wasn’t always good for Harrison, though.

Harrison drank alcohol for the first time when he was on a family vacation at age 16. He went to visit his cousins before his parents arrived, and they pressured him to try vodka and beer. “My parents were meeting us the next day, so I had free range to give it a shot,” Harrison said. “Immediately when I drank, I felt like a different person. All of that social anxiety disappeared. I felt that I could be a cool guy, the man that I wanted to be. But I was too nervous without a substance.”

After the vacation, he started looking for ways to drink more often. He also tried marijuana for the first time. His parents learned what was going on and tried to prevent him from drinking and smoking.

“I was pretty much grounded more times than I was not grounded my senior year of high school,” Harrison said. “I didn’t have the chance to use whenever I wanted to.”

Declines in High School Use

Young people are the most vulnerable to addiction because their brains are still developing. The teenage brain is more likely to develop long-term changes from exposure to addictive substances than the adult brain. Thus, teens exposed to alcohol and drugs are more likely to use them as adults.

Fortunately, high school drug use appears to be decreasing nationally. The University of Central Florida director of Alcohol and Other Drug Services, Dr. Tom Hall, told DrugRehab.com that surveys had been reporting decreases in alcohol use for years.

“If we look at the Monitoring the Future survey, despite the narrative on binge drinking, this year we have the lowest rate of binge drinking among high school and college students since 1987,” Hall said in 2015, before the release of the 2016 survey results.

He said the strategy in higher education has revolved around preventing the harm that occurs from binge drinking and getting students to stop binge drinking. “But we’re overlooking the fact that there’s a whole bunch of students coming to the university who really don’t drink or drink infrequently,” Hall said. The 2016 Monitoring the Future survey results were released after Hall spoke to DrugRehab.com. The survey continued to report significant decreases in the number of teens trying alcohol, tobacco and illicit drugs by their senior year of high school.

Lifetime Substance Use by High School Seniors

Source: Monitoring the Future

Marijuana use has dropped at a slower rate than other substances, but the surveys show a gradual decline in lifetime and past-month marijuana use among high schoolers. Fewer freshmen are entering college with a history of exposure to addictive substances, so some schools are changing their drug prevention strategies.

Reinforcing Low-Risk Behavior

Prevention specialists on college campuses are starting to offer sober activities and events to give students an alternative way to have fun. On many campuses, students have developed clubs or societies dedicated to alcohol- or drug-free recreation. “One of the things I’ve been doing over the past year is figuring out how we retool our efforts so we can address the group of students who drink infrequently or not at all,” Hall said. Freshmen at UCF are anonymously surveyed about their behavior when they enter school. Hall discovered that about 75 percent of freshmen at his school either abstain from alcohol or drink infrequently when they enter college. “When I saw that data and I looked at our prevention efforts, a lot of what we were doing was geared toward reducing binge drinking and not reinforcing this no-risk or low-risk drinking,” Hall said. “This year, I put together a program specific to providing support for students [who don’t drink].” About 2,400 of the UCF freshmen surveyed, one-third of the freshman class, said they’d be interested in finding activities that did not involve alcohol. At UCF, a group called Sober Knights has been created to serve that population.

“This is something that students came up with, and it seems to be resonating,” Hall said. “We’ve got activities every week, such as an alcohol-free dance party, comedy shows and stuff where students can go.”

Hall is following the freshman class for two years to see how the behavior of the low-risk students changes during college. His hope is that the group will continue to abstain from alcohol or drink infrequently.

A Unique Prevention Challenge

Educating college students is a unique public health challenge because a quarter of the population changes every year, and every four years there is an almost completely new population on campus. Miller said about 2,000 new students start classes at UF during the last week of June, and an additional 4,000 to 5,000 students start in the fall. Miller and her staff survey students every two to three years to make sure they’re keeping up with the most current trends and beliefs of the students on their campus. The alcohol and drug use trends on UF’s main campus haven’t changed much in recent years. “In terms of substance abuse issues, overall the numbers are either right around where they’ve been for the last few years or maybe a percentage or two below,” Miller said.

More than 5 million full-time college students drink alcohol every month, including 3.5 million who binge drink, according to an average of National Survey on Drug Use and Health results from 2011 to 2014. About 2 million use an illicit drug, primarily marijuana, every month. It’s a major problem, but the popular idea that everyone is doing it isn’t accurate. While 63.2 percent of full-time college students reported drinking alcohol each month in 2015, only 38.4 percent said they got drunk. An even smaller group use drugs regularly. In 2015, about 23 percent of full-time students said they used an illicit drug in the past month, and less than 10 percent used an illicit drug other than marijuana. Students believe those rates are much higher.

Colleges hope that prevention messages get through to students, but they have other programs for students who don’t hear or listen to the warnings. When students are referred to UCF’s Alcohol and Other Drug Services for conduct issues, they’re screened for substance use disorders and given feedback.

“The minimum we will do with anybody we see is BASICS (Brief Alcohol Screening and Intervention for College Students),” Hall said of students referred to his department. “We’ll do a screening and, based on their self-report, we’ll give them personalized feedback on where they fall on the risk continuum. “We found that to be persuasive. Students are truly surprised that they drink more than their peers. In general, they say, ‘All of my friends drink the same as I do.’” In regard to prevention, treatment and recovery programs, schools are required to inform students and staff of the options available to them. Many schools provide only short-term counseling programs that refer students to health providers in the community for long-term care. Other schools have robust programs on campus. “The word I use to talk about how we address alcohol and other drug issues on campus is comprehensive,” Miller said. “We have the prevention side of what we do, all the way to treatment and support for recovery and counseling and wellness and everything in between.” At UF, students can be referred to alcohol and other drug services by housing, student conduct, campus police or other departments. When a student is referred, Coordinator of Alcohol and Other Drug Services Joan Scully receives their name, student ID and a description of the incident that occurred. “We do a 90-minute assessment, which includes a complete social history, a mental status exam and a Substance Abuse Subtle Incident Inventory, which is a self-guided inventory,” Scully told DrugRehab.com. “We put all that together. We sit with the student and talk about the risk factors.” Scully and her team develop recommendations for the student, and it’s usually up to the student to follow the recommendations. If the student is referred a second time, the recommendations can turn into requirements that must be met to stay in school. That’s what happened to Harrison.

Conduct Problems

Although he says he didn’t fulfill his full academic potential, Harrison was able to do well enough to graduate from college. He just had to keep himself from getting kicked out for reckless behavior. “I was pretty well known at the student conduct office for my drinking and drug use,” Harrison said. “I would drink, and I would be a risk. I would very quickly lose control of what I was doing.” Harrison said he did a lot of things that he wasn’t proud of. He’d black out and find out what he did the next day. After one major incident, the student conduct office threatened to call law enforcement if he didn’t admit guilt and accept the consequences. He told the office that his mental health was starting to suffer from his alcohol and drug use. After getting caught sneaking into bars or getting in trouble after blacking out, Harrison decided to stop going out to party. During his freshman year, he often stayed in the fraternity house, where he could drink and use drugs without getting caught. But during the summer before his sophomore year, he was charged as a minor in possession of alcohol while he was out in Gainesville. When he returned to school for the fall semester, he found out university police had notified the student conduct office of his crime. “The conduct officer was pretty upset with me, for good reason,” Harrison said. “I had already had a couple of other charges in the past, and she requested that I stay sober until an official hearing.” But at the next Florida Gators football game, Harrison drank. The same officer that had stopped him over the summer saw him. The officer was busy with another issue, but he emailed the conduct officer and reported Harrison’s behavior once again. At Harrison’s next meeting at the student conduct office, the conduct officer told him he had to complete the Back on Track program or he would be suspended from school.

Back on Track

College intervention programs make a number of recommendations depending on the incident that occurred and the results of mental health screenings. At UF, students with minor conduct problems usually have to attend a program called Alcohol, Other Drugs and the Law.

“They have a shot at Alcohol and the Law or some other educational kind of program,” Scully said. “After the first incident, they go through an educational process.

Back on Track is an intensive outpatient program on UF’s main campus. Students who come to the UF Counseling and Wellness Center can receive a free consultation and enter the program if they have substance use issues. “The difference between our program and a program in the community is that it’s all free,” Scully said. “The only thing a student has to pay for is a drug screen. Students can voluntarily enter that program, or they can be referred.” If students are referred to Back on Track by the student conduct department or campus police, they usually have to complete the program to stay in school. “That’s the whole nature of Back on Track,” Scully said. “It’s the last opportunity for students to kind of get their act together on campus before they have to go outside for services.”

On-Campus Mental Health Services

In Florida, UCF and UF are the only universities with licensed addiction treatment facilities on campus. But other schools employ certified counselors and therapists who provide a variety of mental health services. In Tallahassee, Florida State University provides free evaluations, semiweekly individual counseling and weekly group therapy for students with substance abuse issues. The university’s services are comparable to an outpatient model, and students in need of more intensive services are referred to community providers. After completing a local treatment program, FSU offers relapse prevention and recovery support programs. Similarly, the University of South Florida in Tampa, Florida Atlantic University in Boca Raton and Florida International University in Miami each provide free mental health screenings, short-term individual counseling and online tools for learning about risky alcohol or drug use. Some schools also provide nicotine replacement therapy and relapse prevention therapy through health services. One student went to UCF Student Health Services for help with anxiety and panic attacks. “He had been an ongoing marijuana user, but he was certain that it had nothing to do with his panic or anxiety,” Hall said. “What we found was he had been ordering hash oil online that was about 80 to 85 percent THC, but he had no idea.” Through counseling, the student learned that switching from marijuana to hash oil caused his anxiety problems. He stopped using the hash oil, and his anxiety and panic disappeared. UCF Student Health Services assesses about 650 students every year for substance use disorders.

Hall said UCF continues to provide treatment to students for as long as it takes, and a combination of student fees and insurance cover treatment for any enrolled student.

Committing to Recovery

Once Harrison learned how to beat the drug tests at UF, he started to drink and black out often. This time, he didn’t want to continue living with the consequences he experienced after binge drinking. “I’m still not 100 percent sure why, but after eight months in the Back on Track program I was ready to fully accept that I was an alcoholic,” Harrison said. “I turned myself in to Joan and the rest of the counselors. I confessed that I had been cheating the program, that I had never been sober.” Scully condemned his actions, but she was happy that he told the truth and realized he needed help. Harrison stayed in Back on Track for another four months. He’s continued to attend multiple 12-step meetings each week. He has a sponsor, and he sponsors two other people in the program. “I haven’t relapsed since the day I turned myself in,” Harrison said. “But it’s certainly difficult. They say you have to change everything. That was really tough on a college campus. I got sober during the summer, and I started school again in the fall. I had to figure out what my life was going to be like at UF after making such a drastic change. “My time at UF before that had not been productive. It was just me and people who liked to get intoxicated all of the time. I had to figure out what UF was going to be like without that. That was pretty difficult.”

Campus-Wide Involvement

Students don’t always recognize that they need counseling or other services. Like most adults, students who recognize that they’re having problems with alcohol or drug use believe they can overcome them on their own. They don’t always seek help. That’s why it’s important for departments across college campuses to work together. UCF students receive referrals to the health center from academic departments, housing, student conduct, campus police and other departments. “Probably two-thirds are mandated referral and a third are walk-in or referred though a physician or counseling center,” Hall said. Miller said the Division of Student Affairs at UF places a major expectation on its departments to work together to support all students. Good relationships between departments such as health services, student conduct and campus police are crucial to helping students. Numerous studies show that legal penalties don’t cure substance use disorders, but treatment can. “Students who have problems tend to have continuing problems if they aren’t helped,” Scully said. “Sometimes students come for an assessment, we make a recommendation, and the student doesn’t follow up on it. Then they end up having another incident.” Professionals at UCF and UF praised their police departments for their awareness of mental health issues and their willingness to work with on-campus mental health services. “University police are highly educated in substance use disorders,” Scully said. “They’re certainly our partners in that they care about the students and want them to be successful on campus.” At UCF, Hall said he often works with campus police. He recently trained officers to administer naloxone, an opioid overdose reversal drug. Nationally, first responders have saved countless lives by administering naloxone to opioid overdose victims.

Faking It Through Treatment

Being referred to a last-chance program such as Back on Track isn’t an immediate wake-up call for every student. Like most adults, students have a difficult time understanding that they may have a legitimate mental health condition. “I was very resistant to the idea of doing that kind of program,” Harrison said. “Initially, I felt that I didn’t really belong there. I felt that I just got caught and the rest of my friends didn’t.”

Harrison took weekly drug tests, attended group therapy twice a week and individual therapy once a week.

He would be able to drink once a week or once every two weeks and still beat the tests. “I was actually starting to do better in school,” Harrison said. “I was starting to feel a little better, and life was somewhat more manageable when I was restricted to only blacking out once every few weeks instead of three, four or five times per week.” He felt better, but Harrison still resisted treatment. He wanted to drink more often, so he found other ways to beat the system. He continued drinking and faked his way through the group sessions and counseling. “My parents had put me through the therapy thing in high school,” Harrison said. “I knew what to say and how to get through it.” He said Scully and other staff in the Back on Track program seemed to recognize that he wasn’t telling the truth, but they couldn’t catch him. So they made him take an assessment for addiction. “I was actually on Vyvanse during that test because I had an exam coming up,” Harrison said. “For whatever reason, I felt like being honest.” “That had been on my mind for a while, the idea that I could be an alcoholic,” Harrison said. “Even when she said it, I felt like it was probably true, but I wasn’t willing to listen.” They made him start going to 12-step meetings on campus, and he met other students and young adults in recovery. “I noticed they had very similar stories to mine,” Harrison said. “A lot of the ways they felt about themselves were similar to me. They had felt out of place or that they didn’t belong. The substances were a way of coping with that.” Harrison continued to resist getting sober, but he said the “idea had been planted in my head.”

For decades, few schools had offered programs to support students in recovery from addiction. The vast majority of collegiate efforts focused on preventing drug use and binge drinking. Counseling centers focused on treating students with alcoholism or drug use disorders, but they offered limited support after treatment ended. That put students at a high risk for relapse. They often had to find their own safe ways to manage stress, avoid triggers and have fun. They had to teach themselves how to manage school, work and recovery goals. When teens in recovery entered college as freshmen, they were surrounded by the party narrative. Some students left college to seek treatment. After rehab, they had to choose whether to face the risks of returning to college or decide to stop pursuing higher education. In 2015, an estimated 198,000 teens ages 12 to 17 received treatment for a substance use disorder. An estimated 669,000 adults between the ages of 18 and 25 also received treatment, according to the National Survey on Drug Use and Health. Thus, hundreds of thousands of students need resources to support their recovery.

In the late 1990s and early 2000s, a collegiate recovery movement began building momentum across the United States. Based on models developed at Rutgers and Texas Tech University in the 1980s, schools created collegiate recovery communities.

CRCs are ideal on-campus resources for students in recovery. They comprise students who support each other’s desire to maintain sobriety and staff trained to aid students in recovery. Most CRCs have physical spaces on campus for students to socialize. They host group meetings, weekly activities and mentorship programs.

Many CRCs have either on-campus sober housing for recovering students or roommate matching services so students can live with peers dedicated to sobriety. More than 150 CRCs are in development or operating across the country today. In Florida, CRCs are offered by the University of Florida, the University of Central Florida and Florida Atlantic University.

Creating a CRC at UCF

The recovery movement at UCF began when students created on-campus support group meetings in 2009. For seven years, Hall helped different groups of students create various resources to support recovery. In 2016, the university opened the doors to its CRC. Hall said it’s one of the most exciting things he’s done in the more than 30 years during which he’s worked on college campuses. “They’re really bright people who find themselves in these situations where they could lose their career or get kicked out of school,” Hall said. “Students in recovery who return to college have the highest GPAs among any categorized group of students.” He said that students in recovery from addiction could be the ones who go on to find a cure for cancer or other major illnesses if they’re given a chance to succeed. “Every time we’re able to get a student back on track, we increase the chances that those folks that have those kind of gifts are in the kind of position to use them,” Hall said. A UCF junior named Mark was one of the first students to join the new CRC. He grew up in a meth house, but he decided he didn’t want to continue living that life. After attending rehab, he was advised to move into a halfway house and find a low-paying job.

Instead, Mark decided to work to overcome all of the obstacles in his path and pursue a college education. He was accepted into UCF and immediately joined the CRC program. “They were the most accepting people that I’ve ever met,” Mark told DrugRehab.com. “They really have been there for me.”

Although he was worried about the negative influences that are common on college campuses, he’s been able to maintain sobriety with the help of other students.

“That’s one reason I got involved with Sober Knights,” Mark said. “I want to be around people who are good influences. There’re people everywhere who are bad influences, but it helps to know that you’re strong enough and that you have a support system.”

Joining the Recovery Movement

The University of Florida provides several programs for students in recovery. Harrison joined the collegiate recovery community at UF and found a new life there. It involved distancing himself from old friends. Some of them were supportive, but others didn’t understand his desire to stay sober. “It’s not like they were bad people,” Harrison said. “We were just in different places in our lives that it was dangerous for me to be around that sort of thing. I had to get out of that type of situation.”

He found new friends at the CRC whom he could relate to.

He’s thankful for the programs at UF. He said he doesn’t know what would have happened if the resources hadn’t been there for him when he needed them. “I think a lot about what would have happened if UF didn’t have a CRC,” Harrison said. “If I was at a different school and I did some of those things, I probably would have been suspended. “I hear a lot of other people’s stories, and after they get suspended from school or kicked out of college, they aren’t getting back into school. They’re going to continue using and going down a downward spiral.” He said school was the one thing in life that was keeping him “somewhat responsible.” Without school, he said, he probably would’ve ended up waiting tables, partying and going as far as that life would take him. “I hear a lot of other people’s stories that play out like that, and usually it ends up involving harder drugs, jail or an institution,” Harrison said. The counselors at UF helped him prepare for a future that didn’t involve alcohol or other drugs. “I can’t really put it into words, but it’s clearly changed my life,” Harrison said. “I was saved from a lot of suffering from the programming that UF offered.”

At the time of his interview, Harrison was working an entry-level job to get experience in his field and filling out applications for graduate school. He’s still connected to people in recovery and is pursuing a future in sobriety.

Building on Success

The CRC at UF was established in August 2013. It currently has 20 active members, but Scully expects that number to grow when renovations to the community’s physical space are completed. Her next step is to continue to raise awareness about sober resources on campus. Scully is also working on a four-bedroom pilot program that would be similar to a sober living community with weekly house meetings and drug screenings. But it’s still early in the planning stages, and she isn’t sure of a timeline. “We’re working on it,” Scully said. At UCF, Hall is also raising awareness about the resources available to students. “My goals are to get the word out to the campus that this is here so people understand that access and giving students a second chance is part of what makes UCF stand out,” Hall said. “We’re trying to get that word out across campus, so we embrace students who are highly stigmatized.” Collegiate recovery communities are improving the lives of students with great potential. Receiving treatment at UF changed Harrison’s life. The CRC at UCF is giving Mark a chance to succeed. The programs at colleges across the state offer Floridians a second chance at a bright future.

Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.