Like the college drinking culture, drug use on college campuses exists in that gray area between outright disapproval and tacit acknowledgement of it as a rite of passage.
Since incoming freshmen first left home to attend school away from the watchful eyes of parents and guardians, college dormitories, Greek residences and off-campus apartments have developed reputations — sometimes deservedly so — as places of hedonistic revelry. As the nonprofit organization Students for a Sensible Drug Policy points out , “Every weekend across the U.S., 21 million college students make choices about how they are going to party. Will it be a sober night, or will they choose to consume alcohol or another drug of unknown origin, potency, or composition regardless of rules or prohibitions against doing so? Based on government data about drug use, we can conservatively estimate that, each month, 12 million students choose to consume alcohol, 4 million choose to use marijuana, and another 4 million will choose another drug.”
In other words, more than half of all college students choose to partake in mind- or mood-altering substances … and those decisions are sometimes accompanied by long-lasting and occasionally disastrous consequences. Educators and administrators often find themselves in a conundrum: How do they address the problems of drug use on college campuses without taking draconian measures that go against decades of tradition and infringe on individual choice?
To begin to explore solutions, however, the problem needs to be thoroughly explored. Let’s dive in.
Drug Use on College Campuses: What Do the Numbers Tell Us?
A number of surveys, studies and reports are conducted regularly to assess the toll that drug use on college campuses takes on a student population. What do they tell us?
According to the 2018 College Prescription Drug Study (“a multi-institutional survey of undergraduate, graduate and professional students”), conducted by Ohio State University :
- “9.1% of students reported misusing pain medications, 9.4% reported misusing sedatives and 15.9% reported misusing stimulants.”
- “16% of students said it is somewhat easy or very easy to obtain pain medication for nonmedical use; 20% of students said sedatives are somewhat easy or very easy to obtain; 28% of students said stimulants are somewhat easy or very easy to obtain.”
- “The most common reasons students reported misusing pain medications were to get high (43%) and to relieve pain (40%); sedatives were to get to sleep (53%) and to relieve anxiety (49%); and stimulants were to study or improve grades (79%).”
The fall 2020 executive summary of the American College Health Association’s National College Health Assessment surveyed more than 13,000 college students. Of the almost 2,000 respondents who indicated drug use in the previous three months :
- 5% reported using marijuana in some form for non-medical purposes;
- 4% reported cocaine use;
- 8% reported nonmedical use of prescription stimulants such as Ritalin and Adderall;
- 6% reported using sedatives such as Valium, Ativan or Xanax;
- 5% reported using hallucinogens such as LSD, mushrooms, Ecstasy or MDMA;
- .6% reported using inhalants;
- Another .6% reported using prescription opioids for nonmedical purposes; and
- Methamphetamine use (.1%) and heroin use (0%) were negligible.
The 2019 Monitoring the Future Survey , funded by the National Institute on Drug Abuse (NIDA) and conducted by researchers at the University of Michigan-Ann Arbor, revealed:
- “Marijuana use among young adults (ages 19-28) increased to all-time highs in 2019, which was true for annual use, 30-day use, and daily use; the five-year increases from 2014 to 2019 for all three levels of marijuana use were significant.” In addiction: “Nearly one-in-ten (9.4%) was a daily or near-daily marijuana user in the past 30 days.”
- “Annual and 30-day prevalence of vaping marijuana showed significant increases in 2019 for 19-28 year olds (to 22% and 13%, respectively, in 2019).”
- “There were significant five-year increases in annual prevalence of LSD (to 3.5% in 2019) and of cocaine (to 6.5% in 2019).”
The NCAA National Study on Substance Use Habits of College-Student Athletes, most recently released in 2018 , found that:
- Self-reported marijuana use by student athletes is lower than non-athletic peers, but 25 percent of the more than 13,000 respondents said they did so for both social reasons (77%) and pain management (19%).
- “Reported cocaine use among student-athletes is similar to that of nonathletes (4% use in the last year).”
- Two percent of student athletes report misusing a narcotic pain medication, and 6% report misusing “ADHD stimulants.”
- Interestingly, lacrosse players represent the highest percentage of male student athletes who report using marijuana (50%) and cocaine (22%) in the past year.
The 2019 National Survey on Drug Use and Health (NSDUH) , conducted by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) revealed a number of data points about first-time drug use among college-age students 18-25:
- “The number of past year initiates of marijuana use increased from 733,000 in 2002 to 1.2 million in 2019.”
- “The number of young adults in 2019 who initiated cocaine use in the past year averaged to about 1,300 young adults each day” — about 476,000.
- “Among young adults in 2019, an average of 50 young adults initiated heroin use each day” — roughly 19,000.
- “Among young adults aged 18 to 25 in 2019, 63,000 people initiated methamphetamine use in the past year,” or about 170 new users daily.
- “In 2019, 681,000 young adults initiated hallucinogen use in the past year, or an average of about 1,900 new hallucinogen users aged 18 to 25 each day.”
- “The number of young adults in 2019 who initiated prescription stimulant misuse in the past year averaged to about 1,000 young adults each day,” or about 364,000 total.
- “The number of young adults in 2019 who initiated prescription pain reliever misuse in the past year averaged to about 1,100 young adults each day,” or about 404,000.
But for the purposes of truly gauging the problem of drug use on college campuses, one statistic from the NSDUH stands out as troubling: the perceived risk of substance use by young adults ages 18-25 has fallen — slightly in some cases, but down nevertheless — across a range of substances: “Perceived great risk of harm from smoking marijuana weekly declined from 19.1 percent in 2015 to 15.0 percent in 2019. Perceptions of great risk of harm from substance use among young adults declined slightly from 2015 to 2019 for … weekly cocaine use (from 84.3 to 82.6 percent), and weekly heroin use (from 94.0 to 93.3 percent).”
Drug Use on College Campuses: A ‘Drugopedia’
Alcohol is a no-brainer as the top substance when it comes to drug use on college campuses, followed closely by marijuana. (In fact, those two drugs are of enough concern that they deserve their own sections, which can be found here and here.)
However, there’s a host of chemicals that have found a niche use among college students, including:
- WHAT IT IS: According to Healthline , “a brand name for the combination of dextroamphetamine and amphetamine. It’s a prescription drug used primarily to treat ADHD or narcolepsy (daytime sleepiness). The medication alters certain naturally-occurring chemicals in your brain by enhancing the effects of neurotransmitters such as dopamine and norepinephrine.”
- WHAT IT DOES: According to WebMD , “The drug works as a stimulant, increasing attention, focus, alertness, and energy.” Because of that, the website Live Science points out , “There is a rising trend of college students abusing Adderall and similar drugs, like Ritalin, to perform better on tests and papers. A study by the Substance Abuse and Mental Health Services Administration (SAMHSA) found that full-time college students were twice as likely as non-students to have used Adderall non-medically.”
- WHAT DOES THE DATA SAY? According to the Binghamton University Undergraduate Journal of Research and Creative Activity , “A survey of 596 northeastern college students revealed misusing Adderall significantly correlated with higher levels of mental distress such as anxiety and depression.” In addition, the Journal of Clinical Psychiatry reported in 2016  that from a period of 2006 to 2011, the nonmedical use of Adderall by adults had gone up by 67.1% and emergency department visits involving the medication had gone up by 155.9%.
- WHAT IT IS: According to the National Library of Medicine’s MedlinePlus , Ritalin — also known as methylphenidate — “is used as part of a treatment program to control symptoms of attention deficit hyperactivity disorder,” or ADHD, and narcolepsy. Like Adderall, it’s “in a class of medications called central nervous system (CNS) stimulants. It works by changing the amounts of certain natural substances in the brain.”
- WHAT IT DOES: According to Healthline , “Both Adderall and Ritalin are central nervous system (CNS) stimulants. They work by increasing the availability of the neurotransmitters norepinephrine and dopamine in your CNS connections. This speeds up your brain activity. Ritalin works sooner and reaches peak performance more quickly than Adderall does.”
- WHAT DOES THE DATA SAY? At the University of Buffalo’s Research Institute on Addictions, researchers explored the side effects of Ritalin taken by those who don’t have a diagnosis of ADHD. Their findings  “showed changes in brain chemistry associated with risk-taking behavior, sleep disruption and other undesirable effects.” In one study funded by the NIDA in 2009 , lead author Dr. Yong Kim stated that “methylphenidate, which is thought to be a fairly innocuous compound, can have structural and biochemical effects in some regions of the brain that can be even greater than those of cocaine.”
- WHAT IS IT? According to the NIDA , these drugs, also known as methylenedioxy-methamphetamine (MDMA), are synthetic drugs “that alter mood and perception (awareness of surrounding objects and conditions). It is chemically similar to both stimulants and hallucinogens, producing feelings of increased energy, pleasure, emotional warmth, and distorted sensory and time perception.”
- WHAT’S THE DIFFERENCE? Columbia University’s online health resource “Go Ask Alice” puts it succinctly : “It’s difficult to say because MDMA is an illegal, unregulated substance. Further complicating it, the slang terms are also unregulated. At its most basic level, molly is generally sold in pure powder form, while ecstasy is usually sold in pill form … Molly is often considered the purer form of MDMA. Why? Many users believe that molly contains more MDMA and less filler compared to ecstasy pills, which users generally expect will have been cut with ingredients other than MDMA.”
- WHAT DOES IT DO? According to the NIDA , MDMA impacts three chemicals in the brain:
- “Dopamine — produces increased energy/activity and acts in the reward system to reinforce behaviors;
- “Norepinephrine — increases heart rate and blood pressure, which are particularly risky for people with heart and blood vessel problems;
- “Serotonin — affects mood, appetite, sleep, and other functions. It also triggers hormones that affect sexual arousal and trust. The release of large amounts of serotonin likely causes the emotional closeness, elevated mood, and empathy felt by those who use MDMA.”
- WHAT DOES THE DATA SAY? According to a study published in the online psychiatric journal Focus in 2019 , “The annual prevalence of MDMA use among college students more than doubled from 2004 to 2016, and the rate of emergency room visits resulting from MDMA use in this age group continues to increase.” In 2020, researcher Ross van der Wetering at the Victoria University of Wellington in New Zealand concluded that  “the findings of the current research suggest that repeated MDMA exposure results in many of the same neuroadaptations that result from repeated exposure to other drugs of abuse.”
- WHAT IS IT? According to Medical News Today , “Ketamine is a medication that is used to induce loss of consciousness, or anesthesia. It can produce relaxation and relieve pain in humans and animals. It is a class III scheduled drug and is approved for use in hospitals and other medical settings as an anesthetic. However, it is also a commonly abused ‘recreational’ drug, due to its hallucinogenic, tranquilizing and dissociative effects.”
- WHAT DOES IT DO? Over at Healthline , they report that “Ketamine blocks glutamate, a neurotransmitter in your brain. In turn, this blocks signals between your conscious mind to other parts of your brain. That results in the dissociative feeling of being separate from yourself and your environment.” However: Ketamine’s interaction with glutamate have shown promising treatment possibilities for depression in recent years.
- WHAT DOES THE DATA SAY? A 2018 study published in the journal Frontiers of Psychiatry  found “a distinctively reduced oxytocin level in (ketamine dependent) patients and the level did not normalize after early abstinence.” (Oxytocin is a naturally occurring hormone produced in the brain that has been documented to have relationship-enhancing effects.) A 2020 study published in the journal Psychopharmacology  found that “KD (ketamine dependent) patients had significantly lower orexin-A … and increased ACTH levels.” Orexin-A is one of two protein receptors in the brain that play a role in  “regulating feeding and drinking behavior, metabolism, the sleep–wake cycle, and the endocrine system.” ACTH is adrenocorticotropic hormone, which controls the production of cortisol in the pituitary gland . In addition to helping break down sugar, protein and fat in food, cortisol helps the body fight infection, regulates blood pressure and helps the brain deal with stress.
GHB (Gamma-Hydroxybutyric Acid)
- WHAT IS IT? The Drug Enforcement Agency (DEA) reports that  GHB, “prescribed as Xyrem, it is also known as the ‘date rape drug.’ It comes in a liquid or as a white powder that is dissolved in water, juice, or alcohol. In liquid form, GHB is clear and colorless and slightly salty in taste.”
- HOW DOES IT WORK? According to the NIDA , “GHB (Xyrem) is a central nervous system (CNS) depressant that was approved by the Food and Drug Administration (FDA) in 2002 for use in the treatment of narcolepsy (a sleep disorder) … GHB acts on at least two sites in the brain: the GABAB receptor and a specific GHB binding site. At high doses, GHB’s sedative effects may result in sleep, coma, or death.”
- WHAT DOES THE DATA SAY? A 2019 study of 23 GHB users, published in the journal Human Brain Mapping , found that “These results suggest that regular GHB-use is associated with decreased” resting state functional creativity (rsFC), a measure of brain plasticity, which is “the ability of neural networks in the brain to change through growth and reorganization.”
- WHAT IS IT? The National Drug Intelligence Center reports  that “LSD (lysergic acid diethylamide) is a synthetic (man-made) drug that has been abused for its hallucinogenic properties since the 1960s. If consumed in a sufficiently large dose, LSD produces delusions and visual hallucinations that distort the user’s sense of time and identity.”
- HOW DOES IT WORK? Although first synthesized in 1938 and popularized as a recreational drug in the 1960s, the way LSD affects the brain has only recently been understood. According to a 2017 study published by the National Institute of Mental Health , “LSD interacts with proteins on the surface of brain cells called serotonin receptors. Serotonin is a chemical messenger that helps brain cells communicate.” Through action on one particular receptor, it reacts more to one of the two major signaling pathways activated by serotonin than the other. in addition, “the team also found that the serotonin receptor closes a ‘lid’ over the LSD molecule, preventing it from quickly detaching. This likely explains the drug’s long-lasting effects.”
- WHAT DOES THE DATA SAY? As a hallucinogen, according to Brown University , “LSD is not considered an addictive drug. Although addiction to hallucinogens is rare, poly-drug addicts (people who are addicted to several drugs) frequently abuse hallucinogens. However, LSD does produce tolerance, so some users who take the drug repeatedly must take higher doses to achieve the same effects. This is very dangerous given the unpredictability of the drug and dose.” In recent years, there have actually been studies that demonstrate “A few single administrations of LSD or related substances within a therapeutic setting may be beneficial for patients with anxiety associated with severe illness, depression, or addiction,”  and only a single study from almost three decades ago, reported in a 1993 article in the journal Addiction , that catalogs some of the ills: “Evidence supports the association of LSD use with panic reactions, prolonged schizoaffective psychoses and post–hallucinogen perceptual disorder, the latter being present continually for as long as 5 years.”
- WHAT ARE THEY? According to the website Live Science , “Psilocybin is the main psychoactive ingredient in hallucinogenic mushrooms, also called ‘magic mushrooms’ or ‘shrooms.’ There are over 100 species of mushrooms that contain psilocybin. Although people have been consuming magic mushrooms for thousands of years, the compound wasn’t isolated until 1957 and it was produced synthetically a year later. Since 1970, psilocybin and psilocin (a closely related compound) have been listed by the U.S. Drug Enforcement Association (DEA) as Schedule I substances — the federal government’s most restrictive category.”
- WHAT DOES IT DO? Medical News Today reports  that “Psilocybin is a hallucinogen that works by activating serotonin receptors, most often in the prefrontal cortex. This part of the brain affects mood, cognition, and perception.” Like LSD, “hallucinogens work in other regions of the brain that regulate arousal and panic responses. Psilocybin does not always cause active visual or auditory hallucinations. Instead, it distorts how some people that use the drug perceive objects and people already in their environment. The quantity of the drug, past experiences, and expectations of how the experience will take shape can all impact the effects of psilocybin.”
- WHAT DOES THE DATA SAY? In recent years, researchers have experimented with the use of psilocybin as a treatment for depression with remarkable results. In November 2020, in the journal JAMA Psychiatry , “researchers report that two doses of the psychedelic substance psilocybin, given with supportive psychotherapy, produced rapid and large reductions in depressive symptoms, with most participants showing improvement and half of study participants achieving remission through the four-week follow-up.” HOWEVER: A 2020 study of self-reported negative outcomes , designed as a tool to aid researchers in tailoring correct dosing for such trials, reported that “findings reinforce the need to manage anxiety during psilocybin administration, indicating that distortions at the level of thought were the main cause for bad trips. Additionally, these bad trips were also associated with high doses of psilocybin as well as with emergencies. Longer-term health problems were associated with multiple doses and concurrent use with other substances.”
- WHAT IS IT? A substance derived from leaves of the coca plant, found in South America. According to the NIDA , “Users primarily administer cocaine orally, intranasally, intravenously, or by inhalation … cocaine use ranges from occasional to repeated or compulsive use, with a variety of patterns between these extremes. Any route of administration can potentially lead to absorption of toxic amounts of cocaine, causing heart attacks, strokes, or seizures—all of which can result in sudden death.”
- HOW DOES IT WORK? The NIDA  details how cocaine affects the brain’s mesolimbic dopamine system — its reward pathway that “originates in a region of the midbrain called the ventral tegmental area and extends to the nucleus accumbens, one of the brain’s key reward areas. Besides reward, this circuit also regulates emotions and motivation.” Through normal biological processes, dopamine “acts as a chemical messenger, carrying a signal from neuron to neuron. Another specialized protein called a transporter removes dopamine from the synapse to be recycled for further use … cocaine acts by binding to the dopamine transporter, blocking the removal of dopamine from the synapse. Dopamine then accumulates in the synapse to produce an amplified signal to the receiving neurons. This is what causes the euphoria commonly experienced immediately after taking the drug.”
- WHAT DOES THE DATA SAY? A study published in 2020 by Cambridge University  found that “History of cocaine use appears relatively common in university students; and has a number of untoward associations in terms of mental health, use of other substances, and risky sexual practices.” And while it’s a decade old, a study published in 2011 in the journal Addictive Behaviors  found that “by their fourth year of college, 36% of all students had been offered cocaine at least once in their lifetime. Having the opportunity to try cocaine was significantly higher for males than females during and after the second year of college. Despite having less opportunity to use cocaine, females were more likely than males to develop symptoms of cocaine dependence.”
- WHAT ARE THEY? Brand names of a drug known as a benzodiazepine, or benzos, which “are depressants that produce sedation and hypnosis, relieve anxiety and muscle spasms, and reduce seizures,” according to the DEA . “Abuse is frequently associated with adolescents and young adults who take the drug orally or crush it up and snort it to get high.”
- HOW DO THEY WORK? The website Medical News Today  says that “Benzodiazepines work by enhancing the effect of a neurotransmitter known as gamma-aminobutyric acid, or GABA. Neurotransmitters are chemicals that communicate messages between brain cells. These messages can have either a stimulating or a calming effect. GABA is a neurotransmitter that sends calming messages to the body. When a person feels anxious, overstimulation occurs in the brain. When people take benzodiazepines, the brain will send messages to counter this overstimulation. This activity can reduce the symptoms of anxiety.”
- WHAT DOES THE DATA SAY? A July 2019 study published in the journal Drug and Alcohol Dependence  states that “In 2017, benzodiazepines and other tranquilizers were the third most commonly misused illicit or prescription drug in the U.S. (approximately 2.2% of the population)” and that “misuse is associated with myriad poor outcomes, including mortality, HIV/HCV risk behaviors, poor self-reported quality of life, criminality, and continued substance use during treatment.” And in December 2020, the Food and Drug Administration (FDA) mandated an added warning to benzos because , the agency notes, “physical dependence can occur when benzodiazepines are taken steadily for several days to weeks, even as prescribed. Stopping them abruptly or reducing the dosage too quickly can result in withdrawal reactions, including seizures, which can be life-threatening.”
- WHAT IS IT? Cannisters used to dispense whipped cream, which are readily available, “whippets” are charged with nitrous oxide — “a colorless and odorless substance that’s also known as ‘laughing gas,’” according to Healthline . “When inhaled, the gas slows down the body’s reaction time. This results in a calm, euphoric feeling. Nitrous oxide can be used to treat pain. It also functions as a mild sedative. Because of this, it’s sometimes used before dental procedures to promote relaxation and reduce anxiety.”
- HOW DOES IT WORK? The website of Bethesda Family Dentistry lays it out : “First, it has an anti-anxiety effect, which is caused by GABAA receptors that inhibit, or block, neurotransmitters. Second, it has an analgesic, or painkiller, effect caused by a chemical process that results in the brain releasing norepinephrine that inhibits pain signaling throughout the body. Finally, nitrous oxide has a euphoric effect due to increased stimulation of the reward pathway in the brain that releases dopamine. These three effects on the body can be achieved throughout the various levels of sedation.”
- WHAT DOES THE DATA SAY? In a study reported at the 2020 European Academy of Neurology Virtual Congress , researchers determined that “the recreational use of laughing gas, which is used as an anaesthetic agent in dental practices and during labour, is on the increase, resulting in growing numbers of patients with neurological problems reporting to specialist outpatient clinics and emergency rooms.” In 2015, the BBC reported  that “there have, however, been 17 fatalities related to the use of laughing gas in the UK between 2006 and 2012, according to research. The Advisory Council on the Misuse of Drugs (ACMD) says that there was one death in 2011 and five in 2010. The US records about 15 deaths a year.”
- WHAT ARE THEY? According to the NIDA , “Inhalants are volatile substances that produce chemical vapors that can be inhaled to induce a psychoactive, or mind-altering, effect. Although other abused substances can be inhaled, the term ‘inhalants’ is used to describe a variety of substances whose main common characteristic is that they are rarely, if ever, taken by any route other than inhalation.” While nitrous oxide is considered an inhalant, and is one of the most popular drugs on college campuses, “inhalants” can refer to any number of other solvents, aerosols, gases or nitrites that contain chemical compounds that can affect the brain. While anything from spray paint to oven cleaner to paint thinner to gasoline can be inhaled for a quick high, for the purposes of this “drugopedia” discussing drug use on college campuses, we’ll focus on one in particular that’s easily obtainable and a commonly used product in dormitories and classrooms: computer cleaner.
- WHAT IS IT? On the surface, they seem to be nothing more than cans of compressed air that come in awful handy for cleaning crumbs, dirt, hair and dead skin out of computer keyboards. However, as a 2020 article in the journal Cureus points out , “examples of ingredients found in these inhalants include aromatic hydrocarbons, nitrous oxide, and volatile alkyl nitrites” such as tetrafluoroethane or difluoroethane. As the Alliance for Consumer Education (ACE) points out , “When these products are used properly, they are safe and can improve our lives. When intentionally misused, they can be deadly — even upon first-time use.”
- WHAT DOES IT DO? According to the ACE , “because inhaled chemicals are absorbed through the lungs into the bloodstream and distributed to the brain and other organs, the effects of inhaling can be severe. Within minutes, the user experiences feelings of intoxication and may become dizzy, have headaches, abdominal pain, limb spasms, lack of coordination, loss of control, hallucinations, and impaired judgment. Worse, he or she may even die from a condition known as Sudden Sniffing Death Syndrome, which can even occur with first time users. Long-term inhalant users generally suffer from muscle weakness, inattentiveness, lack of coordination, irritability, depression liver or kidney damage and central nervous system (including brain) damage.”
- WHAT DOES THE DATA SAY? Simply put, sucking down big lungsful of computer cleaner isn’t a good idea. The website Live Science  reported a case of “a 40-year-old man in Michigan who intentionally inhaled three cans of compressed air to get high was rushed to a hospital, where doctors treated him for frostbite and significant swelling in his airway.” That Cureus paper reported on a 35-year-old man who, after huffing multiple cans daily, presented to the emergency room: “In addition to the intermittent chest burning, he also reports three weeks of sharp episodic pain in the left flank worse with movement, generalized muscle weakness, myalgias, and complaint of intermittent headaches described as ‘warm’ and significant nausea while huffing.” And while it’s more than two decades old, a landmark 2000 study published in the Journal of Substance Abuse  found that “early use of either inhalants or marijuana substantially increased risk of frequent drinking, binge drinking, smoking, illicit drug use, and substance-related consequences during the college years. However, the early use of inhalants conferred the greatest risk and was associated with twice the rate of binge and frequent drinking and significantly greater rates of tobacco and drug use than early marijuana use alone.”
- WHAT ARE THEY? According to the FDA , “Prescription opioids are powerful pain-reducing medications that include oxycodone, hydrocodone, and morphine, among others, and have both benefits as well as potentially serious risks.” Typically, they’re prescription pills that include a certain percentage of narcotic derived in the laboratory from opium along with a non-narcotic pain reliever such as acetaminophen.
- BRAND NAMES: Some of the most popular include hydrocodone derivatives such as Lorcet, Lortab, Norco and Vicodin; oxycodone derivatives like Percocet, Oxycet, OxyContin and Roxicet; oxymorphone derivatives like Opana; morphine derivatives like MS Contin; and numerous others. The American Society of Addiction Medicine provides a comprehensive list here. 
- WHAT DO THEY DO? According to the NIDA , “Opioids bind to and activate opioid receptors on cells located in many areas of the brain, spinal cord, and other organs in the body, especially those involved in feelings of pain and pleasure. When opioids attach to these receptors, they block pain signals sent from the brain to the body and release large amounts of dopamine throughout the body. This release can strongly reinforce the act of taking the drug, making the user want to repeat the experience.”
- WHAT DOES THE DATA SAY? The United States continues to grapple with an opioid crisis, much of it driven by prescription narcotics. According to the CDC , there were 70,630 overdose deaths in 2019 — and synthetic opioids were involved in 72.9% of them. Studies have repeatedly demonstrated that “the college environment is associated with sharing prescription medications,” according to a 2018 article in the Journal of Clinical Psychiatry . And in a 2017 article in the Journal of the American Academy of Child and Adolescent Psychiatry , Dr. Patrice Malone noted that “One in every four colleges or universities has an annual prevalence of 10 percent or higher for prescription opioid use,” and that “the use of opiates by college students has risen dramatically over the past two decades, resulting in increased accidental overdose among other things; thus making the quest for identifying strategies to address this public health crisis essential.”
- WHAT ARE THEY? As the NIDA points out , “Over-the-counter (OTC) medicines are those that can be sold directly to people without a prescription. OTC medicines treat a variety of illnesses and their symptoms, including pain, coughs and colds, diarrhea, constipation, acne, and others.” However, and this is what qualifies them for consideration in any discussion of drug use on college campuses: “Some OTC medicines have active ingredients with the potential for misuse at higher-than-recommended dosages.” They’re easy to obtain, they’re cheap and they can get users high.
- WHICH ARE THE MOST ABUSED? While any number of OTC medications can be used as a cheap alternative to the highs offered by prescription and illicit drugs, two of the most commonly abused are dextromethorphan and loperamide. The former, according to Medline Plus , “is used to temporarily relieve cough caused by the common cold, the flu, or other conditions.” It’s “in a class of medications called antitussives. It works by decreasing activity in the part of the brain that causes coughing.” “Loperamide is in a class of medications called antidiarrheal agents. It works by decreasing the flow of fluids and electrolytes into the bowel and by slowing down the movement of the bowel to decrease the number of bowel movements.” 
- HOW ARE THEY ABUSED? According to a 2017 paper in the journal Psychopharmacology Bulletin , “Dextromethorphan … also known as ‘DXM’ and ‘the poor man’s PCP,’ is a synthetically produced drug that is available in more than 140 over-the-counter cough and cold preparations … when consumed at inappropriately high doses (over 1500 mg/day), DXM can induce a state of psychosis characterized by Phencyclidine (PCP)-like psychological symptoms, including delusions, hallucinations, and paranoia.” And according to WebMD , “at high doses, loperamide can mimic the high of an opioid. People with a history of opioid abuse may be at a higher risk of abusing the drug. Some may even use loperamide in an attempt to wean themselves off of other drugs or manage withdrawal symptoms, according to the FDA.”
- WHAT DOES THE DATA SAY? According to a 2019 study published in the American Journal of Emergency Medicine , while adolescent abuse of DXM has decreased in recent years, “it has been found that rates have plateaued or are increasing among young adults.” Different formulations of cough medication containing it has been “an issue confronted by emergency department (ED) physicians when encountering patients concerned with a possible overdose,” and “adverse events generally present as central nervous system and autonomic symptoms including ataxia, somnolence, mydriasis, tachycardia, hallucinations, respiratory depression, and hypertension.” As for loperamide, a 2021 study in the British journal Clinical Medicine  notes that the drug “has the potential for substance misuse and is an emerging public health issue amid the growing opiate crisis,” and that the biggest danger to those who take large doses in an attempt to get high is cardiotoxicity: “High doses of loperamide can act on the central nervous system and cause prolonged QTc, which can precipitate life-threatening arrhythmias and sudden death.”
But wait! There’s more!
There’s always more, but for the purposes of this particular “drugopedia” detailing the data and specific substances of drug use on college campuses, these are the ones that show up in most surveys and polls. As previously mentioned, methamphetamine use and heroin use are negligible among college students, but they’re both substances that can’t be discounted, and you can find out more about them in our other writings on both drugs that detail the signs an individual may have a problem with meth or have a problem with heroin.
And it’s paramount to note that a drug problem doesn’t equate to addiction … but by the same token, all addictions start out as a drug problem. No one “plans” on becoming addicted to a particular substance, and as one particular landmark paper published in 2018 pointed out, many individuals who experiment in college, even to the point of developing a problem, don’t necessarily wind up as addicts or alcoholics … but by the same token, college becomes a laboratory for those experiments: “With the exception of marijuana use, most individuals who ever used a drug during college began after college entry.”
That eight-year longitudinal study was published in the American Journal of Drug and Alcohol Abuse , and the findings were illuminating when it comes to the issue of drug use on college campuses: “While information on actual availability of drugs on college campuses is scarce, prior research has documented high levels of perceived availability of drugs and prescription medications for nonmedical use among college students and college-aged young adults. In addition, previous analyses of the current sample have found that opportunity to use drugs declines after college graduation, while use given opportunity remains relatively stable throughout the college and post-college years. Taken together, these findings suggest that trends in drug use prevalence are strongly associated with changes in opportunity and availability, providing a possible environmental explanation for the relatively higher prevalence estimates of substance use during the college years as compared with the later years of the study.”
In other words: When it comes to drugs on college campuses, it’s important to acknowledge that they’re there … that the likelihood they’ll be sampled, used or experimented with is high … and that for many individuals, those experiences will translate into continued use when those substances are readily available.
And for some, that turns into a habit, which can become an addiction, which necessitates recovery resources like effective treatment that are as plentiful and easy to find as the substances that cause them.