Sober support: What works for students in recovery?

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What if students have gone through treatment for alcohol addiction or drug abuse, and now they’re back on track, focusing on their education and future? Their success in school depends on managing their sobriety. But college comes with stress, academic challenges, and exposure to alcohol or drugs—factors that can raise the risk of relapsing, studies show. Increasingly, substance dependency (or addiction) is understood as a chronic condition that requires ongoing management. For sober students, this is the dilemma: How can they steer clear of those triggers and manage their addiction while also having a fulfilling college experience?

Students are joining recovery programs on campusClose up of hands

“I have found a fantastic group of friends within our recovery organization, and my relationships with them extend far beyond the meetings and events we hold. We hang out on the weekends, we do fun stuff like any other group of college students, we just don’t drink or drug in the process.”Increasingly, students who are “in recovery”—working to maintain their sobriety—are finding the solution in dedicated recovery programs on campuses. These programs vary, but may include drug-free housing, sober hangout space, social events with supportive peers, and meetings, counseling, and academic supports tailored to address the pressures and triggers associated with staying free of alcohol and/or drugs.

More than 170 university campuses now offer some level of recovery programming, according to Transforming Youth Recovery, a nonprofit that provides schools with funding and other resources for this purpose. The organization has a pilot project underway to expand capacity for recovery services at 100 community colleges.

“People are starting to know there is recovery support on college campuses and are looking around for it,” says John Ruyak, an alcohol, drug, and recovery specialist at Oregon State University. In a 2016 study involving nearly 500 students at 29 campus recovery programs, one in three said they would not be in college were it not for that program (Journal of American College Health).

Shifting medical and societal attitudes toward addiction appear to be helping. “There’s a trend to recognize dependency/addiction as a chronic illness, like diabetes or Crohn’s disease,” says Dr. Davis Smith, a staff physician at the University of Connecticut Student Health Center, and medical director of Student Health 101. “Like those physical conditions, substance dependency behaves differently in different individuals, is not a marker of physical or spiritual weakness, and requires ongoing attention/treatment to manage it.”

This increasingly empathic understanding of drug dependency makes it easier for people to seek the resources that could help them. “Students have changed enough that they are not so worried about anonymity as they are about finding the support,” says Dr. Ann Quinn-Zobeck, former senior director of BACCHUS initiatives and training at NASPA (Student Affairs Administrators in Higher Education), a leader in peer-education initiatives addressing alcohol use at US colleges.

It also helps that students in recovery are not the only ones who are avoiding alcohol and drugs. “The data on student alcohol and other drug use makes it clear that while many students do use at some level, more and more are abstaining for a variety of reasons,” says Dr. Beth DeRicco, director of higher education outreach for Caron Treatment Centers, who has extensive experience developing policies and programs that address dangerous drinking and drug use on campuses and in our broader communities. Among more than 29,000 US students who responded to a national, anonymous survey, 20 percent reported that they had never drunk alcohol, and 16 percent said they had drunk alcohol but not in the past 30 days (National College Health Assessment, spring 2016).

Campus recovery programs help students succeed and graduateTeacher and student at computer

Early research suggests that these programs can help students succeed academically and graduate from college. A 2014 study involving 29 collegiate recovery communities found that their students had higher GPAs and graduation rates than the general student populations at the same colleges (Journal of Social Work Practice in the Addictions).

That success reflects the determination of these students to move forward, says Joan Masters, senior coordinator at Partners in Prevention, a consortium addressing substance abuse on Missouri campuses. “Students in recovery take every choice seriously and day-by-day. Going back into higher education is a commitment, their second chance.” The relapse rates of students in these programs appears to be well below those of adults accessing community-based recovery services, according to the same 2014 study.

Peer support is key to recovery“Certain aspects of college life tend to feel inappropriate for traditional 12-step groups. It doesn’t feel right for me to walk into a 12-step meeting and express my struggles with the stress of midterms, or the paper that I’m not as prepared for as I’d like to be, when there is a newcomer in the room who is struggling to put days of sobriety together.”

Recovery supports work better when they are designed to meet the needs associated with specific life stages and environments, research shows (SAMHSA, 2009). “For most students in recovery, collegiate recovery programs provide the social support and peer network critical to maintaining recovery,” says Dr. DeRicco.

The key components of campus programs may be peer-based groups, 12-step recovery supports, and academic supports, according to a 2011 study in Alcoholism Treatment Quarterly. College administrations are well positioned to facilitate these.

Part of the solution is as simple as physical infrastructure. “Universities can help facilitate students getting together and supporting themselves and each other; having dedicated space makes that easier,” says Ruyak. Early class registration means students don’t have to choose between accessing recovery supports and meeting their academic requirements, he says. “Students need to put their recovery first. If you don’t, it’s hard to be the best student you can be.”

What does campus recovery programming look like?Group of happy students

Collegiate recovery communities vary widely, both in the types of services available and in what they require of the students who access them. “There are many models of different types,” says Masters. “In Missouri, we allow each college to pick what works for them while maintaining fidelity to various tenets of recovery.”

Campus recovery programs typically include some (but not necessarily all) of the following elements:

  • Meetings on campus; meetings typically emphasize peer support. These can take various formats, such as the 12-step approach of Alcoholics Anonymous and Narcotics Anonymous, the coping strategies emphasized in SMART Recovery, or the Christian fellowship of Celebrate Recovery (see Find out more today).
  • Sober or drug-free housing, such as a residential building or dorm restricted to students who don’t use
  • Academic support, such as priority registration to help students organize their class schedule around their recovery programming
  • Individual or group counseling to address recovery-related issues, such as relapse prevention and coping strategies
  • Sober leisure activities and social events
  • Dedicated staff with expertise in recovery
  • Financial support, such as scholarship and grant opportunities
  • Classes dedicated to addiction recovery

Programs may specify a particular recovery approach or allow students to choose what works for them. For example, at Oregon State University, “We want students to choose their path of recovery. We don’t define what that looks like as long as it is positive for the community and they are not using,” says Ruyak. 

[/vc_column_text][vc_tta_accordion shape=”square” color=”black” c_icon=”chevron” active_section=”0″ collapsible_all=”true”][vc_tta_section title=”Who’s in campus recovery and how do they get there?” tab_id=”1496879913500-c3da5220-966a”][vc_column_text]The average age of students in college recovery programs is 26, according to the Journal of American College Health (2016)—a number that hints at the nontraditional routes of many students in recovery (as explained below). “In our program, they’re from age 19 into their 40s, ranging from people who are literally just getting sober to people with nine years of sobriety,” says Sarah Nerad, program manager of the collegiate recovery community at The Ohio State University.

The campus recovery population may include:

  • Students who got sober or stopped using in high school; some take a gap year before going to college
  • Students who took time out of college in order to access alcohol and/or drug treatment, and returned to college once their recovery was on track
  • Students who did not go to college after graduating from high school, but instead worked, had children, became sober, and returned to education in their 30s, 40s, or 50s
  • Students who got sober in college (e.g., accessing outpatient alcohol and/or drug treatment)

Many recovery communities are open to others, including:

  • Students who are not in recovery but are sober and/or don’t use drugs; e.g., because of their religious beliefs or a family history of addiction
  • Students in recovery who are sober and do not need major supports
  • Students who are taking a break from drinking or substance use as a lifestyle choice or who are considering getting sober
  • Students who are not sober but are allies to their sober peers
[/vc_column_text][/vc_tta_section][vc_tta_section title=”How do I join a campus recovery program?” tab_id=”1496879913578-ab05c6ef-42c4″][vc_column_text]If you’re already in college, ask about recovery services at your disability services office, counseling center, or student health center. If you’re not in school or are considering a transfer, check college websites and/or contact their student health centers. The membership requirements for recovery programs are variable. “There are many campus programs and policies that support substance-free living, and students in recovery benefit from these as does the general population of students,” says Dr. DeRicco. “If you have taken time out for substance use treatment and are looking to return to school, factors that improve your chance of success include the presence of a campus recovery program, psychoeducational programming (e.g., handling stress and triggers), and access to group meetings.”

Some elements of programming (e.g., sober housing and early class registration) may be restricted to students who meet specific membership requirements. Other elements (e.g., sober meeting space and social events) may be open to students who are not members of the recovery program but can benefit from those resources and/or support students in recovery.

To be admitted to recovery programming, staff may consider:

  • Your treatment history
  • Your duration of abstinence/sobriety before you start the program
  • Your enrollment status (e.g., a minimum number of credit hours)

The program may require:

  • Your regular participation in a specified program (e.g., 12-step meetings) or a program of your choice that supports recovery
  • A signed sobriety contract (sobriety may be defined in various ways)
  • Your agreement to drug testing
  • Costs or fees for some services
[/vc_column_text][/vc_tta_section][vc_tta_section title=”How can I start a recovery community on campus?” tab_id=”1496879916304-78a6321a-4784″][vc_column_text]Supportive peers are highly valuable to recovery. If you are new to recovery and want to start a group on campus, reach out to other students who have more experience. “When you have a year or two of recovery under your belt, a leadership role comes more naturally,” says Nerad.

  • Contact your college administrators: Start with health educators, the disability services office, the counseling center, and the dean of student life or residence life. “Students in recovery [may be] an anonymous population. Help your college know that this community exists.” says Masters.
  • Reach out to likely allies: Talk with faculty and students in departments and programs that prioritize community service and can help you strategize and organize (e.g., social work, psychology, sociology, and counseling). Be sure to involve your disability services staff on campus; they are well positioned to support students in recovery.
  • Organize a Meet & Greet: When you have gathered a core group of students and allies, help other students connect with their peers in recovery. Talk with your staff and faculty allies about what space will work for a meeting and how to offer free pizza. Promote the event around campus. Invite student government representatives to show their support.
  • Locate space for meetings and support groups: Liaise with administrators, health educators, and counseling staff about access to meeting space and other resources, such as free photocopying and coffee.
  • Form a student organization: Reach out to your student government to learn the process and protocol.
  • Look for community-based allies: Check out meetings run by AA, NA, or other organizations including local rehab centers. “From doing a bit of networking in that community you will be able to find other local resources to help you start programs on campus,” says a fourth-year student at Ashford University (online).

What if starting a campus-based group is not an option?

This may be an issue on small campuses where there are not enough students in recovery to maintain an ongoing group. “You can find a lot of the same benefits in traditional models of recovery.  There are 12-step meetings and counseling opportunities everywhere, and those can work as a starting point to build the fellowship that comes out of a campus org,” says a fourth-year undergraduate member of a campus recovery program at a midwestern university.[/vc_column_text][/vc_tta_section][vc_tta_section title=”How do I know if my drinking and/ or drug use is a problem?” tab_id=”1496879917336-204f169d-c89b”][vc_column_text]It’s not necessarily easy to know if your own alcohol and/or drug use has become problematic. If alcohol and/or drugs are negatively affecting your life, or you’re having trouble moderating your use, it’s important to seek help earlier rather than later. “People in their late 20s, 30s, and 40s say, ‘I wish I’d got sober in college’,” says Nerad. Under diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), addiction or dependency (termed substance use disorder), can be mild, moderate, severe, or in remission.

Six percent of the US student population meets the diagnostic criteria for alcohol dependency, according to the Journal of Studies on Alcohol and Drugs (2002). For some students, risk-taking is a developmental stage that they outgrow. Others may be self-medicating in response to an underlying emotional and/or physical health issue that isn’t being addressed in healthier ways.

When students seek help managing their alcohol or drug use, it’s usually in response to an alarming experience. “They woke up one day and realized their situation was not good; they got black-out drunk, they need help,” says Nerad. “They go to the student health center, counseling center, or health educator. Some students look up AA.” Many colleges have online screening tools for identifying risky substance use and assessing the need for further support, and brief interventions that can help students manage their use and avoid further negative consequences.

These questions can help you figure out if your drinking or drug use is problematic:

  • When you start drinking and/or using, are you able to stop before you start to experience negative consequences?
  • Are you able to set rules for your drinking or use and comply with them? For example: using only marijuana, not other drugs; drinking only on weekends.
  • Is your drinking or drug use having a negative impact on your life? For example: declining grades; friends losing patience with you; legal or disciplinary consequences; spending more money than you can afford on alcohol or drugs; life starting to feel unmanageable.

11 criteria that indicate problematic use (VeryWell.com)

Treatment for alcohol and/or drug misuse can take a variety of forms

“Depending on the level of care needed, a young person may or may not need to take a medical leave from campus,” says Dr. DeRicco. She outlines these treatment options:

  • Depending on the campus location, off-campus services in conjunction with on-campus supports may be sufficient.  When it is clinically appropriate, combining academics with treatment, and/or having academic goals imbedded in a treatment plan, can provide important motivation for success.
  • For many, medically assisted treatment is critical. Inpatient, outpatient, or residential treatment may be indicated and may require time out from academic life.
  • A few campuses (e.g., Augsburg College, Minnesota, and Texas Tech University) are associated with therapeutic treatment communities. Far more commonly, a collegiate recovery program or collegiate recovery community supports students before or after treatment.
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[survey_plugin] Article sources

Beth DeRicco, PhD, director, higher education outreach, Caron Treatment Centers, Pennsylvania.

Joan Masters, MEd, senior coordinator, Partners in Prevention, University of Missouri Wellness Resource Center; regional consultant, The BACCHUS Network, NASPA.

Sarah Nerad, MPA; program manager, Collegiate Recovery Community; director of recovery, Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery, Office of Student Life, Ohio State University.

Ann Quinn-Zobeck, PhD, former senior director of initiatives and training, The BACCHUS Network, NASPA.

John Ruyak, MPH, alcohol, drug, and recovery specialist, Oregon State University.

Davis Smith, MD, staff physician, University of Connecticut Student Health Center; medical director, Student Health 101.

American College Health Association. (2016, Spring). American College Health Association—National College Health Assessment (ACHA-NCHA) reference group data report. Retrieved from https://www.acha-ncha.org/docs/NCHA-II%20SPRING%202016%20US%20REFERENCE%20GROUP%20DATA%20REPORT.pdf

Association of Recovery in Higher Education. (2016). The collegiate recovery movement: A history. Retrieved from https://collegiaterecovery.org/the-collegiate-recovery-movement-a-history/

Borsari, B., & Carey, K. B. (2006). How the quality of peer relationships influences college alcohol use. Drug and Alcohol Review, 25(4), 361–370.

Bugbee, B. A., Caldeira, K. M., Soong, A. M., Vincent, K. B., et al. (2016, August.) Collegiate recovery programs: A win-win proposition for students and colleges.
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Clapp, J. D. (2014, February 28). [Review of the book Substance Abuse Recovery in College: Community Supported Abstinence, by H. H. Cleveland, K. S. Harris, & R. Wiebe (Eds)]. Journal of Social Work Practice in the Addictions, 14(1), 113–114.

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Harrington, C. H., Harris, K. S., & Wiebe, R.P. eds. (2010). Substance abuse recovery in college: Community supported abstinence. Advancing responsible adolescent development. New York: Springer, 2010.

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Laitman, L., Kachur-Karavites, B., & Stewart, L. P. (2014). Building, engaging, and sustaining a continuum of care from harm reduction to recovery support: The Rutgers Alcohol and Other Drug Assistance Program. Journal of Social Work Practice in the Addictions , 14(1), 64–83.

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Drinking? The science of the buzz and how you can control it

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The science of drinking: How to make it work better for you

If you choose to drink alcohol, you’re likely familiar with the relaxed, chatty buzz that may come early in the evening—and the slump that sometimes follows (the tiredness, the nausea, maybe the fear of what you posted online). If you’re drinking in school, you can learn how to get that buzz without the slump. For those who drink alcohol, this skill is key to a night—no, a lifetime—of positive experiences and few, if any, regrets.

What makes alcohol tricky to navigate? First, we need to understand how alcohol affects us—which in certain key respects is different from popular myth. With those basic concepts, we can choose to drink alcohol in ways that give us what we want from it.

Second, we all like to believe that we make our own choices, and to some extent, we do. But it’s complicated. A ton of research shows that our behavior, including what we drink, is highly dependent on what’s happening around us. In college, getting the alcohol buzz without the slump means grappling smartly with social dynamics, in addition to understanding the science of how alcohol affects us. This is especially relevant when you’re new to college, new to drinking, or both. (The minimum legal age for consuming alcohol in the US is 21.)

This guide is designed to help you figure out: What experience you want to get from alcohol and how to get this experience without negative consequences—that’s how much you can drink, what you can drink, and at what pace

Why some alcohol can feel fun—and more alcohol doesn’t

Getting a buzz on

If you choose to drink alcohol, it may help you relax, socialize, and have fun—up to a point. Depending on what you drink, how much you drink, and how quickly or slowly you drink it, the alcohol level in your blood will rise to a certain level—let’s call it “peak buzz.”

For most people of average tolerance, peak buzz happens when your Blood Alcohol Content (BAC)—the concentration of alcohol in your bloodstream—approaches 0.06 percent. For most people, two to three drinks within an hour will have this effect. Some research indicates that 0.06 percent BAC is on the high side; you may find peak buzz comes at any point after 0.04 BAC.

After the buzz, the slump

Beyond that point—0.06 percent BAC—the enjoyable effects of alcohol decline and wear off. You may feel sleepy, flat, disconnected. You may get moody or sick, or make unwise decisions. From here, there’s no going back to peak buzz. Drinking more alcohol can only take you deeper into the slump and toward regret territory.

The science of the slump—and why you can’t get the buzz back

Explained by Dr. Jason Kilmer, associate professor of psychiatry and behavioral science, University of Washington:

“The biphasic aspect actually occurs within the brain. The brain center that inhibits our actions is the first to be affected (depressed) by alcohol. So without the inhibiting center the other areas somewhat go wild, and we feel uninhibited, etc. Later, the brain functions that allow us to act bolder and less shy also get depressed, and then we slump.” —Dr. Pierre-Paul Tellier, director of student health services at McGill University, Quebec

These buzz effects and slump effects in the chart are examples of how people may experience alcohol; the sequence of effects on each side of the chart is in no particular order.

The key to getting what you want from alcohol

Three questions to match your alcohol intake with peak buzz

What do I drink?

The amount of alcohol you consume depends partly on what you’re drinking. Alcoholic beverages vary enormously in their alcohol content.“I’ve had students say, ‘I only had a few drinks.’ But they’re talking about shots, and they don’t realize that five shots in an hour is the equivalent of five beers in an hour.” —Joan Masters, substance abuse prevention provider, University of Missouri

12 fl ox of regular = 8-9 fl oz of malt liquor = 5 fl oz table wine = 2-3 fl oz of cordial, liqueur, or aperitif = 1.5 fl oz shot of 80-proof distilled spirits

What’s my usual serving size?

The amount of alcohol you consume also depends on the shape and size of your glass or cup. A standard serving size is unlikely to be whatever your new friend just ladled into that solo cup.

How to get the hang of serving sizes:

  • Take bartending classes: Many campuses and community organizations offer classes in bartending and safe serving practices—often for free.
  • Practice measuring and pouring, so you know what 5 oz. wine (for example) looks like in a red solo cup. Remember:
    • Red solo cups come in different sizes.
    • The lines on red solo cups are not reliable measures of serving size.

Try this size calculator (NIAAA)

3 different sized solo cups with 5 fl oz of liquid each

The same size beverage can look very different depending on the size and shape of the cup or glass.

How long will I be out for?

Think about pacing your drinking. Most people take about one hour to metabolize one standard drink. If you’ll be out for, say, four hours, and you plan to have three alcoholic drinks, you may decide to have one alcoholic drink per hour for the first three hours.

Pregaming—drinking before you go out—means you hit peak buzz earlier. If you keep drinking, your mood declines earlier too.

How to estimate your Blood Alcohol Content

BAC calculators and charts help you estimate the number of standard drinks you can consume before your BAC reaches peak buzz (0.06 percent).

Example:
Woman (155 lb, 5’7″): 3 standard drinks in 3 hours
Man (155 lb, 5’7″): 3 Â― standard drinks in 3 hours

Check out this BAC chart (Yale University)

Or this one (Cleveland Clinic)

BAC charts and calculators are useful but limited tools:

  • They estimate how much alcohol someone of your body type and sex can typically drink before experiencing certain effects (positive and negative).

  • They do not account for various other factors that may influence your alcohol tolerance (e.g., age, health, fatigue, medications, food consumed, and whether or not the environment is familiar).

  • You may need to adjust the BAC percentage to account for the amount of time you’re drinking.

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Article sources

Jason Kilmer, PhD, associate professor of psychiatry and behavioral science, University of Washington; assistant director of health and wellness for alcohol and other drug education, Division of Student Life, University of Washington.

Joan Masters, MEd, senior coordinator, Partners in Prevention, University of Missouri Wellness Resource Center; area consultant, The BACCHUS Network.

Ann Quinn-Zobeck, PhD, former senior director of BACCHUS initiatives and training, NASPA - Student Affairs Professionals in Higher Education (peer education initiatives addressing collegiate health issues at US colleges).

Pierre-Paul Tellier, MD, director of student health services, McGill University, Quebec.

Ryan Travia, MEd, associate dean of students for wellness, Babson College, Massachusetts; founding director, Office of Alcohol & Other Drug Services (AODS), Harvard University.

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