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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. 

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 (

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.

[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.

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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.

Harrington, C. H., Harris, K. S., Baker, A. K., Herbert, R., et al. (2007). Characteristics of a collegiate recovery community: Maintaining recovery in an abstinence-hostile environment. Journal of Substance Abuse Treatment, 33(1), 13–23.

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.

Johnston, L. D., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., et al. (2015). National survey results on drug use 1975–2015: College students and adults ages 19–55. Monitoring the Future/National Institute on Drug Abuse. Retrieved from

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Knight, J. R., Wechsler, H., Kuo, M., Seibring, M., et al. (2002). Alcohol abuse and dependence among US college students. Journal of Studies on Alcohol and Drugs, 63(3), 263.

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.

Laudet, A., Harris, K., Kimball, T., Winters, K. C. et al. (2016). In college and in recovery: Reasons for joining a collegiate recovery program. Journal of American College Health, 64(3), 238–246.

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When is marijuana use a problem? And why that’s hard to answer

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This content was developed with extensive input from the Professional Advisory Board of Student Health 101, which includes two physicians and 12 campus health educators and related specialists.

As the federal government considers legalizing recreational marijuana use, the drug is becoming more accessible in Canada. For anyone who’s choosing to use (or considering using) marijuana, it’s important to unravel what this might mean for them. “Like all drugs, using marijuana can be beneficial or harmful depending on how, when, where, in what dosage, in what form, and by whom it is being used,” says Dr. Gerald Thomas, Collaborating Scientist at the Centre for Addictions Research of British Columbia.

If recreational use becomes legal, responsibly using marijuana involves making decisions based on the best information available. What is that best info? Much of what we hear about marijuana comes via sources pushing their own agenda (pro- or anti-legalization). For various reasons, the effects of mind-altering substances, especially illegal ones, are difficult to determine. “The science of marijuana is still developing,” says Dr. Neil Boyd, Professor and Director of the School of Criminology at Simon Fraser University, British Columbia. “Prohibition has generally limited scientific efforts to expand our knowledge of the drug.”

If you choose to use, here’s how to reduce your risk [printable]

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?

Is moderate marijuana use safer than drinking?

“The key to using marijuana responsibly is to consume it in moderation, in ways that do no harm to oneself or others,” says Dr. Ethan Nadelmann, executive director of the Drug Policy Alliance, which advocates for evidence-based drug policy.

Marijuana effects are highly variable
The effects depend on its potency, the method of delivery, and how it is used (where, why, how often, etc).

Moderate use is not clearly defined
“For marijuana, I advise (for those who choose to use) smaller doses of lower potency preparations, less frequently. That may mean several hits from a joint once or twice a week, ” says Dr. Davis Smith, a practicing internist based in Connecticut and medical director of Student Health 101. (Yes, this is still vague; it’s difficult to determine potency or define a hit. The absence of clarity is a reason to be cautious.)

It makes sense to avoid edibles and resins
Dried marijuana (the flowering tops and leaves of plants) is generally less potent than hashish (dried and compressed resin extracts) and hash oil extracts. Edibles take longer to have an effect on the user, and the quantity consumed is trickier to control (compared to smoking), increasing the likelihood of overuse.

It’s difficult to compare marijuana and alcohol for safety
Any comparison with alcohol depends on the potency of the substances, how they are consumed, and other factors. “Infrequent, small consumption of THC [the component of cannabis responsible for most of its psychological and physiological effects] is, in most cases, unlikely to be more harmful than low-risk alcohol use (e.g., a couple of beers twice a week),” says Dr. Smith. “It is probably less harmful than heavy alcohol use, especially when you factor in the risks that can come with alcohol, like fighting, vandalism, vomiting, etc.” (Until we have a better understanding of marijuana’s effects, this type of comparison is tentative.)

Frequent, heavy THC consumption appears harmful
Researchers are working to better understand what that harm looks like. The risks of alcohol are better researched than the risks of marijuana. Emerging research in states that have legalized marijuana use, such as Colorado, is revealing increased emergency room visits and traffic accidents related to marijuana use.

Your brain on pot now: Your mood

When marijuana feels awe-ful
For many people, marijuana feels good. Some find marijuana helps them relax or feel more enthusiastic about life. They may express themselves more freely or feel more empathic, potentially deepening their social bonds. For some, marijuana heightens sensory experiences (e.g., food tastes better) and creative thinking.

When marijuana feels awful
“Pleasant experiences with marijuana are by no means universal,” says Dr. Ruben Baler, health scientist at the National Institute on Drug Abuse, Washington DC. “Instead of relaxation and euphoria, some people will experience anxiety, fear, distrust, or panic. These effects are more common when too much is taken, the marijuana has an unexpectedly high potency, or when a user is inexperienced.”

When is euphoria a red flag?
“Some users are primed to have an especially fabulous experience of substance use; they have very receptive reward centers in their brains,” says Dr. Smith. “Such individuals are at much greater risk of developing substance use disorders. Starting later reduces that risk. Those with strong family history of substance abuse may be especially good candidates for abstinence.”

Your brain on pot now: Your grades

There is clear evidence that marijuana impairs memory and learning during use and for several days afterward. “Students who go to class high are not getting their money’s worth,” says Dr. Misch.

As use increases, so does risk. “The more a person uses marijuana, the more there are well-documented decreases in attention, concentration, and memory,” says Dr. Jason Kilmer, assistant professor of psychiatry at the University of Washington.

What does heavy use mean for students? “Daily marijuana users may find themselves consistently intellectually impaired. For near-daily or daily users, even stopping for several days may not lessen the intellectual impairment,” says Dr. Misch.

Right side of the law

Federal laws around marijuana remain relatively strict. Students who use marijuana risk a range of negative consequences. Young people, especially those of color, are disproportionately targeted by law enforcement for marijuana-related crimes, an ACLU study showed (2013).

Your state may allow medical use, recreational use, both, or neither. Wherever you live, it is important to “understand the laws and work within the letter of the law,” says Dr. Seamon. For info on what your state allows, see Find out more.

[survey_plugin] Article sources

Ruben Baler, PhD, health scientist, National Institute on Drug Abuse, Washington, DC.

Jason R., Kilmer, PhD, assistant professor, psychiatry and behavioral sciences; assistant director, Health and Wellness for Alcohol and Other Drug Education, University of Washington.

Donald Misch, MD, associate vice chancellor for health and wellness, associate professor, University of Colorado School of Medicine.

Ethan Nadelmann, JD, PhD, executive director, Drug Policy Alliance.

Marsha Rosenbaum, PhD, director emerita, Drug Policy Alliance (San Francisco office); author, Safety First: A Reality-Based Approach to Teens, Drugs and Drug Education (Drug Policy Alliance, 2014).

Matthew J. Seamon, PharmD., chair and associate professor of pharmacy practice, Nova Southeastern University, College of Pharmacy, Florida.

P. Davis Smith, MD, internist, director of health services, Westminster School, Simsbury, Connecticut; medical director, Student Health 101.

Lori Holleran Steiker, PhD, ACSW, associate professor, University Distinguished Teaching Professor, University of Texas at Austin School of Social Work.

Jose Valdes, PharmD, BCPP, assistant professor, neurology and neuropsychiatry, Nova Southeastern University College of Pharmacy, Florida.

Ryan Vandrey, PhD, associate professor, Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Maryland.

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