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

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

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.

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.

Your athletics
“Extracurricular activities, like sports, can also be impaired, because marijuana can lower your motor coordination skills and your motivation,” says Dr. Ruben Baler, a health scientist at the National Institute on Drug Abuse, Washington DC.

Your driving
“There is no question that driving under the influence of alcohol raises the risk of an accident, and studies suggest that alcohol and marijuana in combination raises the risk even further,” says Dr. Misch, associate vice chancellor for health and wellness at the University of Colorado School of Medicine. “Marijuana users should not drive for at least three to four hours after getting high.” Some studies have found that using marijuana without alcohol also impairs our driving ability; marijuana, like alcohol, impairs our decision-making skills and reaction times.

What effect does marijuana have on the user’s life?
One size will never fit all. Some people are able to use a lot of pot and have a high quality of life, while others suffer academically or emotionally, or become dependent. “Problematic” use is defined loosely by the impact of marijuana use on an individual. Here’s what to look at:

Tolerance “Excessive cannabis use can lead to a higher tolerance to the effects of the drug (meaning you’ll need to smoke more to get the desired effect), and even symptoms of withdrawal when use is abruptly stopped,” says Dr. Ryan Vandrey, associate professor at the Behavioral Pharmacology Research Unit of Johns Hopkins University School of Medicine, Maryland.

Goals and quality of life “Frequent use of cannabis [can] interfere with attaining goals, tending to responsibilities, and interpersonal relationships, and [even with those negative consequences] it gets harder to quit or reduce use,” says Dr. Vandrey.

Reason for use Using marijuana to cope with anxiety, stress, and other issues carries the risk of dependence and learning problems. In addition, self-medicating can prevent users from developing healthy coping skills (such as exercising, journaling, reading, and talking to friends and family). “I would challenge students to consider why they are smoking [or using marijuana in other ways] in the first place,” says Dr. Jose Valdes, assistant professor of neuropsychiatry at Nova Southeastern University, Florida.

Why “problematic use” is not easy to define
Marijuana affects people differently The amount of money a user spends on marijuana, and even the amount of marijuana consumed, do not align neatly with the impact on users’ functioning, according to a study by researchers at the University of Southern California (presented at the American Public Health Association conference, 2015).

Safety and risk depend on how a drug is used “Safety of a drug is much more complicated than a yes or no question, and whether it is legal/illegal,” says Dr. Vandrey. “There are many medications and products that are legal but are damaging or lethal if used incorrectly or by a person who has an allergy.”

It’s hard to know what causes problematic outcomes  Some studies link marijuana use to other risky behaviors or poor outcomes. For example, in a study of college students, the following experiences were associated with using marijuana within the last 30 days: being taken advantage of sexually, not using condoms in sexual encounters, heavy drinking, poor exam performance, missing class, and getting hurt or injured. But correlation is not causation. Maybe marijuana caused bad test scores; maybe students used marijuana in an attempt to cope with bad test scores; or maybe the students who used marijuana also skipped class, resulting in bad test scores. Researchers are working to figure out cause and effect.

Source: Correlates and predictors of marijuana use among US undergraduates. In 143rd APHA Annual Meeting and Exposition (October 31–November 4, 2015).

Signs of problematic marijuana use
Signs of a marijuana use disorder include certain health problems and failure to meet goals and responsibilities at school or work.

• Wanting marijuana and/or being high much of the time
• Needing increased amounts of marijuana to maintain the desired effects
• Withdrawal symptoms (e.g., mood or sleep changes)
• Using marijuana in combination with alcohol and/or other drugs
• Using marijuana to the point that it negatively affects life and functioning (e.g., driving under the influence or social withdrawal)
• Using marijuana to cope with anxiety, stress, insomnia, or other issues
• Using high-potency forms of marijuana, such as hash oil extracts and concentrates (sometimes called “wax” or “shatter”)

Nearly three in ten marijuana users had a marijuana use disorder in 2012–13, according to a 2015 study in the Journal of the American Medical Association.

Help with drug dependence (National Association of Addiction Treatment Providers)

Marijuana use may increase alcohol risk
Marijuana users may be more likely to develop an alcohol use problem, recent research suggests. Marijuana users are five times more likely than non-users to abuse alcohol or become dependent on it, according to a 2016 study in Drug and Alcohol Dependence. In adults with an existing alcohol use disorder, using marijuana was associated with ongoing drinking problems; the adults who did not use marijuana appeared better able to abstain from alcohol, the same study suggests.

For help with problematic substance use, make an appointment with student health or counseling services on your campus.

Long-term, frequent marijuana use starting in adolescence or early adulthood may impair the brain chronically and irreversibly—or it may not. That uncertainty speaks to the difficulties inherent in researching the effects of substance use.

If marijuana can cause long-term harms, those effects likely vary according to when the individual started using, how much and how often they used, how recently they used, the potency of the marijuana used, and other factors.

Marijuana may affect IQ
In a 2012 study of New Zealanders, those who started using marijuana heavily in adolescence experienced an average decline of 8 IQ points by age 38 (non-users experienced an average 1 IQ point increase over the same time span). The IQ drop persisted even after the users quit marijuana. The participants who started using marijuana as adults did not experience the same IQ decline, suggesting that marijuana use may have neurotoxic effects during critical developmental stages (Proceedings of the National Academy of Sciences).

Marijuana may affect life outcomes
Chronic marijuana use is associated with life setbacks, research suggests. A 2003 study compared frequent marijuana users with their peers from similar socioeconomic backgrounds who reported much less marijuana use. The frequent users were less likely to have graduated from college and had lower incomes, according to Psychological Medicine (2003). The frequent, chronic users believed that marijuana was to blame for their ongoing struggles.

But we don’t know for sure
These research findings are difficult to interpret. It’s possible that other factors explain the effects. For example, maybe the people who used marijuana heavily also used alcohol or other potentially harmful substances, or routinely skipped class as teens, resulting in lower IQ scores later. Which comes first? Maybe less motivated people use more marijuana, rather than marijuana causing that loss of motivation.

In states that have legalized the medicinal and/or recreational use of marijuana, college administrators may feel caught between state and federal law. If a college allows marijuana use, it may risk losing federal funding. Some colleges are exploring exemptions that could allow medical use on campus.

On the upside, for students who are interested in grappling with these issues constructively, this is a good time to get involved. “The reality is that students need to be at the table with the administration and faculty to come up with policies around marijuana use,” says Dr. Seamon.

Real concerns remain. Getting caught using marijuana can narrow your opportunities in various ways:

• Academics Any student convicted of a drug offense while receiving federal student grants or loans can temporarily or permanently become ineligible for federal aid.
• Athletics Drug policies around testing and penalties for college athletes vary from school to school. Under National Collegiate Athletic Association rules, testing positive for marijuana at a bowl game or postseason championship can result in a half-season suspension. The NCAA is reported to be reviewing this policy and moving toward a rehabilitative (rather than penalizing) response to marijuana use.
• Employment Some employers conduct drug tests as part of their hiring process, most typically for lower-skill jobs. THC can be detected in your system using a urine test for up to 12 weeks after usage (depending on how much and how often you use). Some companies also drug test their employees.
• Driving Driving under the influence of marijuana is illegal. If you’re caught you could get fined, lose your license, or do jail time. In some states drivers can be penalized for having traces of marijuana in their blood, even if they are not impaired.

How does your state penalize drivers who use marijuana?