College tends to be the time when young people begin to use or abuse substances. In 2016, the NIH conducted a study on college-aged adults in the United States, which included the following results on drug use/abuse in that age group:
- Marijuana Use Among this Age Group Remains a Concern
- Daily marijuana use is at the highest level since the early 1980s for this age group, with 4.9 percent of college students and 12.8 percent of non-college peers reporting daily use
- Heavy Alcohol Use Appears to be Higher in College Students than Non-College Peers
- Binge drinking (five or more drinks in a row): 32.4 percent of college students and 28.7 percent of non-college peers in the past 2 weeks.
- Intoxication (having been drunk): 40.8 percent of college students and 30.4 percent of non-college peers in the past month.
These figures alone are cause for concern. With the rising prevalence and devastating effects of the opioid crisis over the past few years, those who are involved in collegiate recovery have been increasing their efforts to match the demand for this vulnerable portion of our population.
This month I was instated as the president of the Association of Recovery in Higher Education (ARHE). ARHE is a national organization representing 113 universities and colleges, and the professionals and students who are part of them, providing programs for students in recovery from severe substance use disorder. Founded in 2012, ARHE has seen significant growth over the past 6 years as more and more universities are realizing the need to support persons in recovery and then developing specific support programming to meet that need.
Collegiate recovery programs (CRPs), communities, and efforts are beginning to receive more and more national attention, offering students in recovery organized and specialized support. The success stories of such programs are important resources in extending the continuum of care several years post-treatment. For example, collegiate recovery programs are listed on the Office of National Drug Control Policy (ONDCP) website as part of the wide range of services, program models, and supports available to those in recovery.
In a recent letter, the ONDCP compels college and university administrators to establish CRPs on their campuses as well recognizing CRPs as part of a powerful solution to combat the opioid crisis. From the letter:
Collegiate recovery is playing an invaluable role, all across the country, to help students reclaim their futures. This investment in students is paying off not just for individuals, but for their institutions, and for their families and loved ones who know their children are living and studying at an institution that puts a priority on their well-being.
The Administration is working with partners all across the country to find ways to address the devastating opioid crisis facing our country. In 2016, nearly 42,250 Americans lost their lives from a fatal overdose. We all have a part to play. We respectfully ask you to consider adding a small collegiate recovery program to the tools available on your campuses to support students. https://obamawhitehouse.archives.gov/ondcp/about
How Many Universities Offer Support Currently?
The graph from ARHE represents the past 6 years of growth starting from its inception in 2012. Although collegiate recovery programs have been in existence since the late 1980s (e.g., Brown, Rutgers, and Texas Tech Universities being the firsts), these numbers illustrate the rapid growth of the field. The graph also represents the number and types of people who have been drawn to the recovery movement on college campuses and who have professionally gathered together. These numbers represent not only universities (113) but also other organizations, entities, professionals, and students who have a heart and passion for this work. See ARHE at https://collegiaterecovery.org/
Although compelling, the above numbers represent only the tip of the iceberg when it comes to the collegiate recovery field and movement. For example, in their recent census of the field, Transforming Youth Recovery (TYR, 2017) found that 184 institutions (both 2 and 4 year) self-reported offering some type of recovery support for students on their campus. TYR also reported that an additional 55 colleges and universities previously responded to their survey as offering recovery supports bringing the estimated number to over 240 who are part of the movement. See Transforming Youth Recovery at (https://www.transformingyouthrecovery.org/).
The field owes much to both ARHE and TYR for not only the accurate reporting of these numbers but also for developing and supporting these collegiate recovery programs, communities, and developing efforts.
Types of Supports and Best Practices
The types of collegiate recovery support offered varies from campus to campus. Many universities have institutionalized recovery support services and are called Collegiate Recovery Programs (CRPs) meeting the standards and recommendations advocated for by ARHE making up their institution members. These standards and recommendations include the following:
- CRPs embrace abstinence-based recovery as the standard of the field.
- CRPs are housed with an Institution of Higher Education conferring academic degrees.
- CRPs are non-profit entities.
- CRPS have paid qualified, trained, ethical and dedicated professionals who support students in recovery.
- CRPs provide a variety of recovery support services to assist students in maintaining and protecting their recovery.
- CRPs have within them a collegiate recovery community with students in recovery from substance use disorder/addiction as the primary focus.
- CRPs do best with a dedicated physical space on campus for the student in recovery to gather and offer peer support to each other.
A list of these universities and colleges can be found here https://collegiaterecovery.org/crps-crcs/
Taking nothing away from collegiate recovery communities, or student-led and peer-run support communities, as well as other recovery support efforts, the above standards, and recommendations, represent the best practices of the field to date. Important to note is that many collegiate recovery programs also offer recovery housing for students.
Who are These Students in Recovery?
Students in recovery from their severe substance use disorder are historically a marginalized group on college campuses. Past writers within the field began to recognize students in recovery as a specialized population in need of support in the 1990s. For example, Bratter and Parker (1994; 1995) were some of the first researchers to recognize the leadership potential, as well as the positive influence students in recovery, can have on colleges campuses. Doyle (1996), argued the need for cohesive structures of support for recovering students. Dickard and colleagues (2011), noted in their work that relapse, defined in this case as a return to use, can be prevented by providing recovery supports to students. Maybe more importantly, such recovery support leads to educational achievement for these students. Misch (2009), was also an advocate for recovery supports on college campuses and highlighted how students in recovery serve as important role models for other students (Brown, Ashford, Thompson Heller, Whitney, & Kimball, 2018).
The largest study to date on collegiate recovery programs and their students was conducted by Laudet, Harris, Kimball, Winters, and Moberg (2014), entitled Characteristics of Students Participating in Collegiate Recovery Programs: A National Survey. Results from the study reveal that these students in recovery programs in the past met the criteria for severe substance use but no longer do. This survey of students also reveals the majority being male and white with a call to increase the diversity of students within CRPs. In addition, 70% also reported a past history of co-occurring mental health disorder. Follow-up studies indicated that students participate in their programs on average of 7 semesters (between 3-5 years, are typically a little older than the average emerging adult (26 years) and enrolled in their CRPs because of the desire to have a supportive peer network and receive social support (Laudet, et a., 2016).
Why Collegiate Recovery Programs?
The treatment and recovery field continues to most often treat those who suffer from severe substance use disorder in an acute manner. The need for extending the continuum of care for those who seek a recovery journey is essential. Collegiate Recovery Programs (CRPs) are an incredibly cost-effective way (usually offered at no cost to students and their families) to extend the continuum of care several years post-treatment. The research to date offers strong evidence that students in recovery who participate in collegiate recovery programs, with strong peer support with the community, have low instances of relapse, excel in their academics with high graduation and retention rates (Brown, Ashford, Thompson-Heller, Whitney, & Kimball, 2018).
In our current desperate need to find reasonable and cost-effective solutions to the opioid crisis, to treatment, and extending the continuum of care for those in recovery past their most vulnerable times (e.g., 0-5 years), collegiate recovery programs, communities, and recovery supports on college campuses are a beacon of hope and an invaluable resource to implement.
Association of Recovery in Higher Education. https://collegiaterecovery.org/
Bratter TE, Parker TH. Bright, angry, recovering students: Their value to colleges. The Journal of College Admission. 1994;142, 23-28.
Bratter TE, Parker TH, Pierson R. Gifted, self-destructive recovering students. The Journal of College Admission. 1995;146, 23-29.
Brown, A.M., Ashford, R.D., Thompson Heller, A., Whitney, J., & Kimball, T.G. (2018).
Collegiate recovery programs: Literature review from 1988-2017.
Doyle KS. The recovering college student: Factors influencing accommodation and service provision. Dissertation Abstracts International Section A: Humanities & Social Sciences. 1999; 60(6-A).
Dickard N, Downs T, Cavanaugh D. Recovery/Relapse Prevention in Educational Settings For Youth With Substance Use & Co-occurring mental health disorders: 2010 Consultative Sessions Report. US Department of Education, Office of Safe and Drug-Free Schools. 2011.
Laudet AB, Harris K, Kimball T, Winters KC, Moberg DP. Characteristics of Students Participating in Collegiate Recovery Programs: A National Survey. Journal of Substance Abuse Treatment. 2015;51:38-46. doi:10.1016/j.jsat.2014.11.004.
Laudet AB, Harris K, Kimball T, Winters KC, Moberg DP. In college and in recovery: Reasons for joining a Collegiate Recovery Program. Journal of American College Health. 2016;64(3):238-246. doi:10.1080/07448481.2015.1117464.
Misch DA. On-campus programs to support college students in recovery. Journal of American College Health. 2009;58(3):279–280.
Transforming Youth Recovery https://www.transformingyouthrecovery.org/