CATALYST, Winter 2006 Vol. 7 No. 2
A Publication of the U.S. Department of Education's Higher Education Center for
Alcohol and Other Drug Abuse and Violence Prevention
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College Students and Other Drugs
Going to college full time in a two- or four-year college is a risk
factor when it comes to drinking alcoholic beverages. Surveys routinely
find that full-time undergraduate college students use alcohol, engage
in high-risk drinking, and drink heavily at higher rates than
peers who are not enrolled full time, including part-time college
students and persons not enrolled in college. But when it comes to other
drug use, students more closely resemble their noncollege peers.
According to the National Survey on Drug Use and Health, for persons
aged 18 to 22 years, the rate of current illicit drug use, defined as
use within the past 30 days, was nearly the same among full-time
undergraduate college students (21.4 percent) as for other persons aged
18 to 22 (22.5 percent).
It's a different story for tobacco. In 2003, college students were less
likely to report current cigarette use than were their peers. Students
reported using cigarettes in the past month at a rate of 31.4 percent,
compared with 45.3 percent of their peers who were not enrolled full time.
Marijuana is by far the most common of the illicit drugs used by college
students, with 20.3 percent reporting use within the past 30 days,
according to the Core Institute's 2003
Alcohol and Drug Survey of 38,857 undergraduate students from 89 two-
and four-year colleges around the nation. At 4.6 percent, amphetamines
are a distant second when it comes to illicit drug use by college students.
Ecstasy, or MDMA, a so-called club drug, raised concerns when there was
a sharp increase in its use by college students after 1997. Annual use
rates rose fourfold in just three years, from 2.4 percent in 1997 to 9.2
percent in 2001, before it began to decrease, reaching 4.4 percent in
2003. The trends among college students have run fairly parallel to
those for the noncollege segment of these young adults and high school
seniors through 2003. Since 2000, the noncollege segment has exhibited
the highest rate of ecstasy use-reaching 14 percent in 2001, when use
among college students and 12th-graders was at 9 percent. But ecstasy
use has sharply declined, with the 2003 annual use rates for college
students at 4.4 percent and their noncollege peers at 6.7 percent.
Recently, the nonmedical use of prescription drugs has increased among
students and nonstudents alike (see article on page 6). While such use
is increasing, it still lags far behind marijuana use.
Good News Over the Long Haul
Since 1980, Monitoring the Future
(MTF), an annual survey of drug use by students that is supported by the
National Institute on Drug Abuse, has asked college students about their
alcohol, tobacco, and other drug use. Student drug use has dropped considerably
over the past 24 years. The proportion of college students using any illicit
drug in the 12 months prior to the survey dropped fairly steadily between 1980
and 1991-from 56 percent to 29 percent. In other words, illicit drug use
fell by nearly half during this 11-year period. After 1991, annual (and
also 30-day) prevalence held fairly steady for a couple of years before
beginning to rise, reaching 38 percent in 1998-still well below the peak
of 56 percent in 1980. There has been little change since, with the 2003
rate at 36.5 percent.
The noncollege group moved similarly from 1980 to 1998. But in 2000, the
noncollege group had a 4 percentage-point increase in its annual use of
illicit drugs that was due largely to their increased use of marijuana,
amphetamines, and tranquilizers in that year. For example, according to
MTF, amphetamine use among college students and their noncollege age
peers leveled for a year before beginning to increase in both groups
after 1992 and 1993, respectively, through 2001, with a leveling through
2003. The 2004 Core Survey found the annual prevalence of amphetamine
use among college students to be 8.3 percent. Nevertheless, over the years,
those not in college consistently have reported a higher rate of
amphetamine use than college students. The noncollege segment's 2003
level of almost 41 percent remains above that of the college student
sector.
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Commentary: Environmental Management and the Prevention of Other Drug
Abuse
by William DeJong
The essence of environmental management is to structure the campus and
community environment in ways that will decrease both the demand for and
the supply of alcohol and other drugs. Recent years have seen increasing
numbers of campus administrators join with community leaders to develop
and implement environmental approaches to reduce alcohol problems among
students. Based on that foundation, campus officials should now apply
the same commitment and energy to reducing other drug abuse.
Campus administrators who have applied the environmental management
approach have focused primarily on reducing alcohol-related problems. Key
strategies include limiting alcohol availability, restricting alcohol
marketing and promotion, and developing and enforcing new policies that
restrict the times, places, and circumstances under which alcohol can be
purchased and consumed. At the same time, administrators have sought to
reduce the attractiveness of illegal and dangerous alcohol use by
offering and promoting a variety of social, recreational, extracurricular,
and public service options and by creating a campus environment that supports
health-promoting norms.
While alcohol is the leading substance use problem on college campuses,
the abuse of other drugs-including marijuana, cocaine, ephedra, Ecstasy,
methamphetamine, OxyContin, Ritalin, and steroids-is also of great
concern and deserves focused attention from administrators who are
responsible for creating safe and healthy campuses.
Campus officials have an obligation to keep students informed about the
dangers of illicit drug use, especially as new research becomes
available, and they should also work to refer addicted students to drug
treatment and recovery programs. By themselves, however, these
individually focused interventions will not make a significant dent in
the scope of the problem.
To make real progress against illicit drugs, campus administrators need
to develop and implement the types of environmental approaches they have
already embraced to combat alcohol-related problems. Many of the tactics
being used nationwide to change the alcohol environment will also serve
to reduce the attractiveness and availability of illicit drugs; however,
there are additional tactics specific to illicit drug use that should be
considered as well.
The environmental management approach involves five strategies, with
each one focused on a problematic aspect of typical college
environments. Each strategy involves multiple program and policy options
for administrators to explore as part of a comprehensive strategic plan
for preventing illicit drug use.
1. Offer and promote social, recreational, extracurricular, and public
service options that do not include alcohol and other drugs.
Students at residential colleges may have comparatively few
responsibilities and a great deal of unstructured free time, and there
are too few social and recreational options. To help ensure that
substance use does not become the easiest and most readily available
option, campus administrators are investing additional resources to:
create and promote substance-free events and activities; provide greater
financial support to student clubs and organizations that are
substance-free; open or expand a student center, gym, or other
substance-free setting; and develop student service learning or
volunteer activities.
With problems related to Ecstasy and other club drugs in mind,
administrators can design alternative events that simulate the club and
rave atmospheres that appeal to some students, with high-energy music,
dancing, and extended hours. Such events must be widely advertised as
substance-free. As with any event, adequate supervision and security
measures must be in place to ensure that alcohol and other drugs are not
used.
2. Create a social, academic, and residential environment that supports
health-promoting norms.
Beginning with student recruitment materials and continuing with routine
communications from the president and other administrators, campus
officials must clearly state their expectations that students will not
engage in illegal alcohol and other drug use or misuse prescription
drugs. Communications from faculty and staff must reinforce, not
undermine, those declarations.
There are additional options for conveying the institution's
expectations that its students will be focused on their academic
objectives and not engage in illegal alcohol and other drug use:
modifying the academic schedule to increase the number of early morning
and Friday classes; increasing academic standards so that students will
need to spend additional time studying outside of class; increasing faculty-
student contact; and improving faculty mentoring of students.
Students generally overestimate the percentage of their peers who use
marijuana or other drugs, which in turn can lead to perceived normative
pressure to engage in substance use. One promising strategy is to
conduct a social norms campaign that communicates accurate information
about how few students actually use other drugs, thus reducing that
normative pressure.
Regarding the residential environment, many colleges and universities
now offer substance-free residence halls where all substance use (even
alcohol and tobacco use by people of legal age) is expressly prohibited.
Another option is to employ older, salaried resident assistants who can
both declare and enforce the institution's housing rules with greater
authority than can junior or senior undergraduates.
3. Limit the availability of other drugs both on and off campus.
An existing campus and community coalition, which includes active
participation by law enforcement agencies, can work to identify where
students are getting and using illicit drugs and then take action by
arresting and prosecuting dealers, working to close clubs that allow
drug use on the premises, and taking actions against local landlords
whose premises are used to sell drugs. In addition, local ordinances can
be amended to prohibit sales of drug paraphernalia.
Campus health officials can tighten controls on prescribed drugs by
reviewing prior medical records before writing prescriptions for new students
and restricting prescriptions to a month's supply or less. Students using
campus-based computers also can be blocked from accessing online pharmacies.
4. Restrict marketing and promotion of clubs and raves.
Campus officials can act to prohibit on-campus advertising of rave clubs
and related events where club drug use may be encouraged or tolerated.
Student party announcements that refer or allude to illicit drug use can
similarly be prohibited.
5. Develop and enforce campus policies and local, state, and federal laws.
Administrators should revise campus alcohol and other drug policies as
necessary to cite specific
drugs of abuse and then seek to communicate those policies clearly and
frequently to the campus community, including possible consequences for
violations.
When it comes to enforcing these laws, the campus should never be viewed
as an enclave that protects students from the consequences of their
illegal behavior. Hence, administrators should authorize campus police,
residence hall staff, and other appropriate staff to work in partnership
with local law enforcement to uphold campus policies and local, state,
and federal laws related to the distribution or possession of illicit
substances.
Other tactics to be considered include: (1) developing and enforcing new
policies to curb off-campus parties, including tougher ordinances to
restrict open house assemblies and noise; (2) developing a system for
local law enforcement agencies to report off-campus offenses to campus
officials; and (3) collaborating with local drug courts or other
community-based diversion programs.
Environmental management is based on a simple but powerful idea: the
most cost-effective way to reduce substance use problems among college
students is to change the campus and community environment in which
students make decisions about alcohol and other drug use. This
prevention approach has paid off in reducing alcohol-related problems on
campus. It will work to reduce other drug abuse as well.
William DeJong is a professor of social and behavioral sciences at the
Boston University School of Public Health and a senior advisor to the
Higher Education Center for Alcohol and Other Drug Abuse and Violence
Prevention.
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Message from the Center Director
The literature as well as the field's front-line experience tell us that
alcohol remains the drug of choice among college students, and so it is
also the drug of focus for much of the prevention field. Yet the
impressive advances we have made in preventing high-risk alcohol use can
sometimes distract us from the need to address the concerns peculiar to
the "other drugs" that students are using and abusing, to the impairment
of their health and their education.
In this issue of Catalyst, we look to some of the good work and progress
the field has made in addressing abuse of other drugs. The field as well
as the general public are aware that marijuana remains a visible
presence on campus, and that while Ecstasy and other club drugs may
fluctuate in popularity, they have not been conquered. Lately the
emerging concern of "pharming," or students sharing and abusing
prescription drugs recreationally, has commanded campus leaders'
attention, as has the resurgence of the strikingly dangerous
methamphetamines. Variable as the challenges of these drugs may be, a
comprehensive prevention approach based in environmental management can
be the foundation for real progress against the spectrum of illicit
drugs on campus.
As reported by Monitoring the Future
and summarized elsewhere in
this issue, we've seen some important gains in drug abuse prevention
over the past decades. The battle is not won, though, and in some cases
we have lost ground. While alcohol by far remains the drug of choice
among college students, we must not lose sight of the toll that other
drug abuse takes. There is important work to be done in responding to
other drug use-both illicit and legal-by college students.
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Q&A with R. Vic Morgan
R. Vic Morgan, Ph.D., has been the president of Sul Ross State
University in Alpine, Texas, since 1990. In 1975, he joined the
university as an associate professor of mathematics. He was appointed
president in September 1990. Morgan has been active in professional
organizations in mathematics, student affairs, and educational
administration. He has served on the Commission of Colleges for the
Southern Association of Colleges and Schools. He is also a member of the
Presidents Leadership Group, a project of the Center for College Health
and Safety funded by The Robert Wood Johnson Foundation.
Q: With so much focus on college students' alcohol use, why do you
feel university presidents also should be concerned about students'
marijuana use?
A: If 33 percent of college students report using marijuana currently
or within the last year, then it is a major problem. I don't understand
why many people distinguish marijuana from alcohol. Marijuana stays in
the system, carrying over from the activity of the night before well
into the next two or three days, which has an impact on learning and
motivation. And, of course, it's illegal.
At Sul Ross we have a zero-tolerance policy for the use of illegal
drugs, so any student who is caught with any illicit drug-including
marijuana-faces suspension for two long semesters. We have some
flexibility, depending on individual circumstances. For example, if a
student happens to be in the room where marijuana is found, but we
cannot tie it to him or her personally, we may impose probation to
include counseling. Marijuana is the most widely used illegal drug. We
are making some headway in other areas such as alcohol and tobacco use;
we now need to focus our attention on marijuana use as well.
Q: Many students contend that there are few negative consequences
related to marijuana use-certainly not the magnitude of those associated
with alcohol use. How do you respond to them?
A: I tell them that they don't have all the facts and data. Marijuana
is a depressant and hallucinogen and different people have different
reactions. It decreases motivation and affects short-term memory and
judgment. Paranoia, defensiveness, anxiety, and depression can also
occur. While research doesn't definitively say that the use of marijuana
leads to the abuse of other illegal drugs, we do know that there is a
correlation. People who use marijuana are eight times more likely to use
cocaine and 15 times more likely to use heroin than those who do not use
marijuana. Until recently it was not believed that marijuana could be
addictive. Not everybody who uses marijuana becomes addicted-just like
not everybody who uses alcohol becomes addicted. It's the same
principle. In addition, students lose the ability to absorb and retain
information. If they use marijuana the night before a class, they have
more difficulty concentrating and focusing on their studies the next
day. Until recently, I didn't realize that alcohol has much the same
effect. I thought that once you got past the hangover, the learning
restrictions that it places on the brain are gone, but that's not true.
Its impact also carries over for several days, and with marijuana, the
effect often increases with time.
Q: Is it because marijuana use interferes with the primary mission of
students in going to college-which is to get an education-that you
believe it should be of concern to presidents?
A: Exactly. It is principally a learning issue, but there are health
issues that are as severe-or more severe, perhaps-as with alcohol and
tobacco use. For example, I have learned that a marijuana joint contains
many of the same chemicals as a tobacco cigarette, but at a level
equivalent to four cigarettes. In addition, smoking marijuana decreases
the ability to fight such things as chest colds. Bronchitis, emphysema,
and bronchial asthma can arise from the prolonged use of marijuana. And
marijuana can lower inhibitions, which may lead to unprotected sex, with
the risk of sexually transmitted diseases.
In addition, some of the marijuana currently on the marketplace is the
result of biological processes to increase the THC
[tetrahydrocannabinol] concentrations-or potency-in marijuana. That
means there is a more concentrated dose of the chemicals leading to the
problems related to marijuana use. That's assuming that the marijuana is
good. There are additional adverse consequences of street marijuana in
that it may not be pure and may contain
a number of unknown additives.
Q: Are there lessons that university presidents can learn from alcohol
and tobacco prevention when it comes to marijuana use?
A: Most strategies we have used to influence alcohol and tobacco use
can be used with marijuana. I believe in the social norming process of
helping students and young people understand that not everybody is doing
it. The same documents and instruments used for social norms campaigns
for alcohol use can be used for marijuana to communicate to students
that a smaller percentage of their peers use marijuana than students
believe. Like a lot of other issues in higher education, students have a
lot of misperceptions. If we can counter some of those, then perhaps we
can encourage students to change their behaviors.
Q: You mentioned that you have a zero-tolerance policy on your
campus. Do you have some specific prevention measures aimed at
preventing or reducing marijuana use that you can talk about?
A: They are not different from the prevention measures we use for
alcohol and tobacco. It is now okay to ban tobacco. For the most part we
also ban alcohol from campus facilities. We have a collection of
programs where we train peer mentors to work with students to convey the
social norms message that "not everybody is doing it" and that they can
have a good time without alcohol and other drugs. We incorporate those
presentations into the orientation program for new students and parents.
We have programs and presentations in the residence halls. While many
are sponsored by grants, such as one from the Texas Alcoholic Beverage
Commission to address alcohol issues, we always incorporate the issues
of marijuana and other illegal drugs in those presentations. We purchase
brochures and literature on alcohol and other drugs and distribute those
materials to the campus community.
Q: Marijuana poses some very special problems when it comes to talking
about other drugs because there is a lot of resistance among students to
hearing about the negative effects of marijuana. Is that true on your
campus?
A: I'm certain it is. Students from one campus to another aren't very
different when it comes to social issues. As a society we seem to be
creating a group of people-students and adults-who are almost immune to
hazard warnings related to drugs, alcohol, and tobacco. For example, ads
for drugs on television spend about 15 seconds on a litany of all the
possible negative consequences that the drug may cause. Such warnings
tend to dull our ability to recognize what the true hazards are. We are
constantly bombarded with hazard warnings, so we just tune them out. It
is a part of our culture to explain away hazards. For example, if you
truly believe that unprotected sex can lead to AIDS, then why on earth
would you ever do it? If you truly believe that alcohol creates problems
for you, then why do you drink? Of course, young people think that they
are indestructible and it's not going to happen to them, but it does.
Q: The Higher Education Center promotes an environmental management
approach to prevention. Are there environmental management strategies
other than social norming, which seeks to change the normative
environment, that could be applied to marijuana prevention?
A: Virtually anything that works with alcohol should also work with
marijuana. The big difference is that you don't find marijuana on the
shelves in the convenience stores, so students aren't as likely to be
open in its purchase and use. We have to continue providing activities
that are attractive to students. If we, through social norming, are
trying to convince students that not everybody is using marijuana or
alcohol, then we need to put students in environments where not
everybody is doing it. In addition to social norming, we are also using
other parts of the Higher Education Center's environmental strategies,
in that we have stringent policies (i.e., drug testing and no tolerance)
and we enforce the policies and laws. These activities can be included
in the prevention of marijuana use just as they are with alcohol.
Q: What advice would you give to other presidents on how to use their
leadership role on campus to address marijuana use?
A: Presidents certainly can be vocal about marijuana. We can be aware
of the effect it has on our students. As a president, I work with the
people on campus who control the students' study assignments and class
and exam schedules-the faculty and deans-because it is very important
that we be a five-day-a-week class campus. We expect students to be in
class on Friday, and we expect Friday to be a test day just as any other
day would be.
Presidents have to speak out whenever the opportunity arises. We have to
be concerned that our students will not be successful in their purpose
in coming to college. College success is a degree. We must get involved
in state- and national-level issues that address marijuana. And we have
to do a better job of articulating the problems associated with
marijuana use than we have done in the past.
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Marijuana and Learning
According to a report from the National Institute on Drug Abuse
(www.nida.nih.gov/ResearchReports/Marijuana/
), research has
shown that marijuana's adverse effect on memory and learning can last
for days or weeks after the acute effects of the drug wear off. For
example, a study of 129 college students found that among heavy users of
marijuana-those who smoked the drug at least 27 of the preceding 30
days-critical skills related to attention, memory, and learning were
significantly impaired, even after they had not used the drug for at
least 24 hours. The heavy marijuana users in the study had more trouble
sustaining and shifting their attention and in registering, organizing,
and using information than did the study participants who had used
marijuana no more than three of the previous 30 days. As a result,
someone who smokes marijuana once daily may be functioning at a reduced
intellectual level all of the time. More recently, the same researchers
showed that a group of long-term heavy marijuana users' ability to
recall words from a list was impaired one week following cessation of
marijuana use, but returned to normal by four weeks. An implication of
this finding is that even after long-term heavy marijuana use, if an
individual quits marijuana use, some cognitive abilities may be recovered.
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Legal but Not Necessarily Safe
by Kellie Anderson
Students pulling all-nighters studying for exams or working under
deadlines for papers used to rely on copious quantities of coffee or
caffeine tablets such as No-Doz to stay awake-if not fully alert. These
days, some students are engaging in more dangerous practices to burn the
midnight oil. Prescription stimulants such as Ritalin and Adderall have
replaced caffeine for many students looking to study and focus for long
periods of time.
While alcohol and marijuana remain the drugs of choice among college and
university students, prescription drugs are quickly gaining ground as
drugs of choice on campuses. Painkillers, depressants, and stimulants
are widely available to students, some of who use them to relieve
stress, stay awake to study or party, or to lose weight. They are a
small but increasing minority at colleges big and small, urban and rural.
College students' use of prescription drugs is part of a growing
practice in the United States. About 6.3 million Americans use
prescription drugs nonmedically, a number lagging far behind only
marijuana, according to government estimates. Emergency room visits
related to prescription painkillers rose by 153 percent between 1995 and
2002, according to the federal Drug Abuse Warning Network
.
Among young adults, 18 to 25 years old, the rise in misuse is outpacing
that of the population as a whole, according to fall 2004 data from the
National Survey on Drug Use and Health. Young adults' nonmedical use of
prescription painkillers rose by 15 percent in 2003 from the previous
year, compared with no increase among the general population.
"In just one year, it went up 15 percent for young people," said Leah
Young, a spokesperson with the U.S. Department of Health and Human
Services' Substance Abuse and Mental Health Services Administration. "I
find that disturbing."
People view prescription medications differently from illicit drugs,
such as marijuana or cocaine. Because such medications are prescribed by
physicians and are created in well-regulated laboratories, many students
believe that taking prescription medications is safe, even when obtained
from sources other than physicians. But prescription drugs have many
side effects that can be adequately managed only when taken under a
doctor's careful supervision in a controlled manner. These side effects
are often magnified when medications are taken in combination with other
prescription and over-the-counter drugs, alcohol, or illicit drugs.
Students are most likely to nonmedically use three classes of
prescription drugs: opioids or painkillers, like OxyContin or Vicodin;
central nervous system (CNS) depressants, such as Valium or Xanax; and
stimulants, including Ritalin, Dexedrine, and Adderall.
Painkillers
Physicians can prescribe opioids as painkillers primarily for people who
are suffering from acute, chronic, or severe pain, such as those who
have had surgery or have pain-causing conditions. Physicians closely
monitor patients for whom they prescribe painkillers due to their risks
for side effects, especially when mixed with other drugs, and their
potential for addiction.
The nonmedical use of painkillers is on the rise, and narcotic pain
relievers are now the most abused class of drugs among Americans aged 12
and over. Because they affect the pleasure-mediating areas of the brain,
causing feelings of euphoria, students may use opioids, including
OxyContin and Vicodin, to achieve a "high" while partying. Students
sometimes mix these drugs with alcohol to enhance their effects. Many
painkillers have a time-release coating so that the drug enters the
system gradually. But students may crush the pills to compromise this
mechanism and swallow, snort, or inject the powder to experience the
drug's effect immediately.
Students taking these drugs over a long period of time will build up a
tolerance to their effects, leading to more frequent use and higher
doses to achieve the same effect. Long-term, medically unsupervised use
of painkillers can lead to physical dependence and withdrawal symptoms
when users suddenly stop taking the drug. Moreover, students who inject
powder forms of opioids are at risk of contracting hepatitis or HIV and
have a higher likelihood of overdosing than those who take the drug in
other ways.
Taking a large dose of opioids, or taking them with other drugs, can
lead to respiratory depression and death. Painkillers are especially
dangerous when mixed with alcohol, antihistamines, barbiturates,
benzodiazepines, and anesthetics.
Central Nervous System Depressants
Physicians prescribe CNS depressants like Valium or Xanax to treat
anxiety and sleep disorders. Students may nonmedically use these drugs
to "come down," mellow out while partying, or help them sleep. When used
without a prescription or taken other than prescribed, CNS depressants
have the potential for abuse. As with opioids, regular use of CNS
depressants leads to tolerance and physical addiction. Suddenly stopping
use may lead to severe withdrawal, which can have life-threatening
consequences.
CNS depressants can slow down respiratory and circulatory systems and
may lead to death. And they are potentially lethal when taken in
conjunction with other prescription pain medications, over-the-counter
cold and allergy medicines, or alcohol.
Stimulants
Diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) among
children skyrocketed in the 1990s. Many of those children are now in
college and take stimulants to treat their ADHD. Ritalin, Dexedrine, and
Adderall are prescription stimulants that increase alertness, attention,
and energy by regulating brain chemistry in those with ADHD. For others,
these drugs increase blood pressure and heart rate, increase blood
glucose, suppress appetite, constrict blood vessels, and may cause
feelings of euphoria-effects similar to those of illicit amphetamines,
often called speed.
Students take Ritalin and Adderall to stay awake for studying marathons,
to party all night, or to lose weight. According to a recent study
(Addiction, January 2005), up to 25 percent of students at some
colleges report nonmedical use of stimulants. Students who take
stimulants to study during "crunch time" may believe that doing so is
safe because they are taking the drugs for short periods of time rather
than on a regular basis. As with painkillers, students may swallow the
pills whole, chew them, crush and snort them, or pulverize and inject
them to get a quicker high. Students who use stimulants while partying
sometimes combine the drugs with alcohol.
While stimulants are not considered to be physically addictive, they can
result in psychological dependency, prompting the use of higher doses,
which can lead to paranoia and hostility, dangerously high body
temperature, and irregular heartbeat. Overdoses may cause lethal heart
failure or seizures. Students who use stimulants intravenously are at
increased risk for HIV, hepatitis, and overdose.
When mixed with other drugs, especially decongestants, these stimulants
pose increased risk. Their effects are also enhanced when taken with
antidepressants, reinforcing the need for a doctor's close supervision
when taking these drugs.
Access and Prevention
It's easy for students to get prescription drugs. They get prescriptions
from physicians. They buy or steal prescription drugs from someone who
has a prescription, such as a parent, friend, or acquaintance. They buy
them from online pharmacies (see sidebar "Online and Easy!").
Anecdotal data suggest that students are most likely to buy prescription
drugs to use recreationally from fellow students who have legitimate
prescriptions, a practice called "pharming." Students who sell their
prescription drugs to others say that they decrease their dosage or
actually ask their physicians to increase the prescription.
"Students who take 10 mg of Ritalin twice a day get a prescription for
60 pills a month," said Riley Venable, Ph.D., associate professor of
counselor education at Texas Southern University in Houston. "They may
decide to keep 30 for their own use and sell the remaining 30."
Some students obtain prescriptions from campus health services. For
example, students will learn the symptoms of ADHD and act them out to a
campus physician in hopes of getting a prescription for Adderall.
Administrators can prevent nonmedical and recreational prescription use
on campus by limiting access. Venable said that because health officials
at Texas Southern University are aware of the potential for prescription
drug abuse among students, they are selective in prescribing
painkillers, CNS depressants, and stimulants. Before they will dispense
any stimulants, university-based physicians require a medical history
from the student's doctor who originally prescribed the drugs.
University physicians are suspicious of students who suddenly manifest
symptoms of ADHD or who ask for specific drugs by name. In addition,
they do not increase the dosage of these medications at the student's
request and limit replacements for "lost" pills. They may opt to
prescribe controlled-release tablets that don't provide a quick "high"
if taken whole. They can also refuse to prescribe a large number of
doses for any of these drugs.
Venable cautioned that prevention activities for prescription drugs need
to differ from typical prevention efforts for illicit drugs.
"We can't stigmatize these drugs. Some students do have valid medical
reasons for being on these prescription medications," he said. "But we
can take steps to minimize the risks for abuse."
Kellie Anderson, M.P.H., is special projects officer at the Higher
Education Center for Alcohol and Other Drug Abuse and Violence Prevention.
Online and Easy!
Anyone with an e-mail address is likely to be bombarded with offers from
Internet pharmacies for prescription medications at low cost and without
a prescription. Apparently all that is needed is a credit card and a
computer to access a cornucopia of prescription drugs online.
According to a 2004 white paper from the National Center on Addiction
and Substance Abuse (CASA), painkillers, depressants, and stimulants are
readily accessible online. Out of the 157 online pharmacy sites CASA
tested in early 2004, 90 percent did not require a prescription to
dispense prescription drugs, including controlled substances.
Internet pharmacies are largely unregulated because the state and
federal authorities with regulatory powers over pharmacies have not been
able to keep up with them. For example, state authority to license and
register pharmacists does not apply to Internet pharmacies, and federal
legislation is not evolving quickly enough to address the problem. In
addition, online pharmacy sites come and go so quickly that they are
very difficult to track and regulate.
Some pharmacy sites require a prescription to be mailed or faxed, but
will charge a customer's credit card and ship medication without having
the prescription in hand. Some sites rely on customers to assess their
symptoms to determine their diagnosis and subsequent pharmacological
treatment, while still others provide online consultations with their
"doctors" before dispensing prescriptions. These sites allow students to
access the drugs for recreational use and also allow others to obtain
large quantities to sell on campus.
Colleges and universities can minimize the on-campus marketing of these
rogue pharmacies. Riley Venable, Ph.D., of Texas Southern University,
said his campus has installed spam-blocking programs that prevent
advertisements from these pharmacies from reaching students' campus
e-mail addresses. Limiting access to these sites in this way can
restrict the availability of these drugs on campus.
According to the CASA report, in response to safety concerns about
Internet pharmacy practices, federal agencies, including the U.S. Drug
Enforcement Agency, the U.S. Food and Drug Administration, the U.S.
Bureau of Customs and Border Protection, and the Federal Trade
Commission, have increased efforts to tackle the problem of rogue online
pharmacies. But to date, federal law and regulatory practice have not
yet caught up with Internet technology, and no new legislation has been
enacted.
------------------------------------------------------------------------
One Step Forward, One Step Back Reframing the Issue of Collegiate Drinking
by Robert J. Chapman
To suggest that collegiate drinking is a high-risk behavior of epidemic
proportions is not exactly news. For more than a decade, social
scientists have been nothing if not persistent in alerting us to the
problem and its apparent resistance to change. Yet, if we drill deeper,
we learn of significant changes in the campus drinking culture during
this period. With the design of intervention strategies for problematic
or indicated collegiate drinkers and prevention tactics for the
remaining students, professional educators are affecting collegiate
drinking. Having moderated their drinking, these students graduate, join
the professional workforce, and cease to be included in the research of
social scientists investigating collegiate drinking. When these changed
drinkers graduate, who replaces them? The very students that social
scientists tell us are among the highest-risk of all collegiate
drinkers: arriving freshmen.
Some of the factors that make first-year students among the highest-risk
drinkers are well-established patterns of high school drinking, the
increased independence and sense of personal freedom realized during the
last years of high school, and misperceptions about collegiate drinking.
In short, graduating students affected by environmental management
strategies, social norms campaigns, and what the literature refers to as
the maturing-out phenomenon are replaced by entering students who
frequently are experienced drinkers who expect to imbibe more often
because "that is what college students do." Knowing that higher
education is a cyclical environment that turns over its population every
four to five years, logic suggests that addressing the stubbornly
resilient rates of high-risk collegiate drinking by targeting first-year
students makes sense.
Historically, intervening with entering students has been the
responsibility of freshman orientation programs and, more recently,
opening weekend celebrations. Unfortunately, established high school
drinking behaviors coupled with misperceptions about collegiate drinking
that are exacerbated by a dearth of the life skills necessary to
negotiate the day-today demands of college life result in first-year
students being among the highest-risk drinkers on campus.
To make an appreciable difference in the risks freshmen run, these
students need to be exposed to prevention programming and intervention
strategies, similar to those that have shown results in higher
education, while still in high school. Such interventions are needed
years before high school students arrive on campus, and certainly no
later than when they begin their college quest in earnest.
If institutions of higher education begin to market to high school
juniors following their completion of the PSAT (Preliminary Scholastic
Aptitude Test) then these same colleges and universities need to
collaborate with high school educators to implement strategies to lessen
high-risk drinking by their future students. Such an approach would
necessitate a formal transition to college curriculum for high school
students and their parents as well as establish a collaborative
collegiate-high school coalition to address mutual concerns. Such a
curriculum could address the following issues:
* High school students, like their older collegiate counterparts,
misperceive the realities of what most of their peers are doing.
Likewise, the transitioning high school student needs to
understand that not all students in college drink, and those who
do are moderate drinkers. In short, high school students are as
likely to misperceive the norms regarding their peers as is any group.
* High school students often experience a great deal of stress
during their first year on campus. Coupled with the increased
freedom of college, the campus environment exacerbates existing
patterns of alcohol and other drug use.
* High school students need life-skills training that will increase
the likelihood of being more assertive to assume the
responsibility for the consequences of their own behavior, while
at the same time being more proactive when encountering a peer's
high-risk behavior. Many students recognize risky behavior when
they see it, but are silent, if not encouraging, when encountering it.
* High school students' parents tend to be preoccupied with academic
issues as the preeminent factors in predicting collegiate success.
Parents need to be encouraged to remain active in their child's
social life and provided with resources to help them act on,
instead of react to, high-risk and dangerous behavior exhibited in
high school.
* High school student personnel professionals need to be supported
in their quest to engage students regarding a comprehensive
preparation for collegiate life. Training in effective
intervention techniques that have been shown to work well with
high-risk and resistant students can increase the likelihood of
affecting student transitions.
* It is when future collegians are in secondary school that we need
to assertively address the problems of high-risk and dangerous
collegiate drinking.
To learn more, visit the Web site of the Network: Addressing Collegiate
Alcohol and Other Drug Issues at www.thenetwork.ws
and click on Online Resources
http://www.thenetwork.ws/resources.htm" to read A Parent's Guide to
Alcohol, Drinking & Choosing a College
.In addition, visit
www.higheredcenter.org and click on Parents."
Robert J. Chapman, Ph.D., is the Pennsylvania regional coordinator for
the Network.
------------------------------------------------------------------------
Activist Coalitions Get Offensive Show Suspended
Welcome New Network Members
* Andover College, Portland, Maine
* Felician College, Rutherford, N.J.
* Gadsden State Community College, Gadsden, Ala.
* Lynn University, Boca Raton, Fla.
* MacMurray College, Jacksonville, Ill.
* Massachusetts College of Art, Boston, Mass.
* Southeast Arkansas College, Pine Bluff, Ark.
* Unity College in Maine, Unity, Maine
* University of Saint Francis, Fort Wayne, Ind.
As of July 31, 2005, Network membership stood at 1,541 postsecondary
institutions.
A radio program airing on Friday mornings in eight Florida cities drew
fire from the Florida Higher Education Alliance for Substance Abuse
Prevention and Hillsborough County's Tampa Alcohol Coalition for its
high-risk drinking message and demeaning portrayal of women. On "Drunk
Bitch Friday" (DBF) starting at 6 a.m., a woman begins drinking
alcoholic beverages. During the course of the four-hour program, the
woman drinks to intoxication, with encouragement from the hosts Lex
Staley and Terry
Jaymes.
For over two years, DBF has been a weekly feature of the Lex and Terry
Show, which is syndicated out of the Cox Radio station Rock 105 (104.5
FM), WFYV in Jacksonville. As the woman drinks, Lex and Terry interview
her, describe how she looks and acts, and refer to her as "drunk bitch."
Sometimes people call in to criticize the woman or make sexually
suggestive remarks to her. As the women on the show become increasingly
drunk, some get sick and vomit. Some pass out. Lex and Terry provide a
trashcan for them to vomit in and a sofa to pass out on.
Hillsborough County's Tampa Alcohol Coalition has been monitoring DBF
since September 2004. Members sent letters complaining about the content
of the DBF feature to the local radio station manager of WHPT 102.5 FM
and met with him. They also invited him to coalition meetings and gave
him the opportunity to get feedback about DBF from the group. But when
the station continued to broadcast DBF, Tampa Alcohol Coalition members
sent letters complaining about the show to businesses advertising on
DBF. Several dropped their ads. In addition, Tallahassee and Gainesville
activists organized a letter-writing campaign targeting their local
radio stations and advertisers.
While 24 stations around the country air Lex and Terry's DBF segment,
the bulk of them are in Florida, including Tampa, Tallahassee,
Pensacola, West Palm Beach, Jacksonville, Panama City, Ft. Myers, and,
until April 8, 2005, Gainesville. That's when WRUF in Gainesville
suspended the show. Broadcasts of "Drunk Bitch Friday" were suspended
after University of Florida (UF) President Bernie Machen became
concerned about the show's content. WRUF is a commercially licensed
radio station, but UF's Board of Trustees controls the Cox Radio
contract that includes clearance to air Lex and Terry broadcasts.
President Machen is actively working toward reducing underage drinking
and alcohol abuse at UF, a long-standing member of the Network.
President Machen and the Board of Trustees asked for a legal opinion on
whether the content of the DBF show violates Federal Communications
Commission (FCC) guidelines. They also had concerns about its high-risk
drinking message. WRUF general manager Larry Dankner said the decision
to stop airing the show was mutual among the trustees, President Bernie
Machen, and WRUF.
On the day that WRUF suspended the DBF show, the Florida Higher
Education Alliance for Substance Abuse Prevention (FHEASAP), which
includes a number of Network members, asked its members to make
telephone calls or e-mail complaints to the DBF program. Information and
talking points about DBF were sent to the FHEASAP group e-mail list;
members were asked to listen to DBF and view the Web site before sending
in their complaints. Florida community coalitions were asked (through a
state coalition electronic list) to send letters or call the Rock 105
radio station to complain about DBF on April 8 as well. Several
communities sent complaints to local radio stations that broadcast the
show and to the stations' advertisers. Information about DBF was
forwarded to other organizations, including women's groups such as the
National Organization of Women (NOW). NOW members from around the state
got involved. They called or wrote to Rock 105 and complained to the
FCC, which is charged with regulating interstate and international
communications by radio, television, wire, satellite, and cable.
In the aftermath of WRUF's suspension, the Lex and Terry show has gone
on the defensive both on air and on their Web site. The show's
management posted a letter on the Web site explaining that "Drunk Bitch
Friday" might offend some people, but asserting that it has been a very
popular feature. The letter also claims that many women apply for the
chance to be on the show. Once selected, the women sign a contract
agreeing to the risks of drinking to intoxication. Participants are
provided a limousine ride to and from the radio station, to prevent
impaired driving. The letter posted on the DBF Web site says, "DBF is a
funny, entertaining and compelling feature."
But, after receiving numerous complaints and the WRUF suspension, the
DBF show and Web site were modified. As of Friday, April 15, 2005, the
show no longer uses the refrain "Chug, Chug, Chug, drunk bitch, drunk
bitch, drunk bitch" after each set of ads. Lex and Terry don't call the
show "Drunk Bitch Friday"-they now refer to it as DBF. An offensive
photo of two drunken women, one sprawled on the sidewalk with her legs
spread open exposing her underwear, has been removed from the DBF Web site.
The media exposure on the Gainesville suspension of "Drunk Bitch Friday"
helped raise awareness about college drinking and alcohol abuse. By
networking with organizations across the state, the effort organized by
Florida campus community coalitions has made a significant impact.
For more information regarding the Florida Higher Education Alliance
for Substance Abuse Prevention, contact Robert M. Ruday, dean of
students, University of Tampa, and cocoordinator for the
Alabama/Florida/Georgia region of the Network at bruday@ut.edu
.
------------------------------------------------------------------------
Brief: Performance Enhancer?
The use of stimulants to stay awake and study has long been a part of
college life, especially around exam time. But now, a dispatch from the
New York Times News Service (Aug. 1, 2005) says that the reliance on
prescription stimulants to enhance performance has risen, becoming
almost as commonplace as No-Doz, Red Bull, and maybe even caffeine. As
many as 20 percent of college students have used Ritalin or Adderall to
study, write papers, and take exams, according to recent surveys focused
on individual campuses.
One of the factors driving the use of such drugs is that students have
become convinced that it will help them achieve academic success,
according to Robert A. Winfield, M.D., director of University Health
Service at the University of Michigan, Ann Arbor, who sees a growing
number of students who falsely claim to be Attention Deficit
Hyperactivity Disorder (ADHD) sufferers so they can get a prescription.
But Laurence Greenhill, Ph.D., a clinical psychiatrist at the
university, told the Times that the idea that Adderall is a performance
enhancer is a myth. "It won't increase your intelligence; it just
increases your diligence,-he said. "Essentially, the drugs delay the
onset of sleep so you can stay up all night and cram."
Much like performance-enhancing drugs in professional sports, the spread
of prescription stimulants among college students is raising issues of
competitiveness and fairness. But, according to the Times, interviews
and e-mail exchanges with two dozen students at Columbia University
suggest that "the prevailing ethos is that Adderall is a legitimate and
even hip way to get through the rigors of a hectic academic and social
life."
------------------------------------------------------------------------
Resources
For more information on the following topics, visit the Campuses and
Other Drugs page on the Higher Education Center's Web site
www.higheredcenter.org/drugs/:
Center Publications Related to Other Drugs <../drugs/hec-pubs.html>
Other Drugs by Topic <../drugs/other-drugs.html>
Date Rape and Club Drugs <../drugs/club-drugs.html>
Ecstasy <../drugs/ecstasy.html>
Ephedrine <../drugs/ephedrine.html>
GHB <../drugs/ghb.html>
Ketamine <../drugs/ketamine.html>
Marijuana <../drugs/marijuana.html>
Methamphetamine <../drugs/meth.html>
OxyContin <../drugs/oxycontin.html>
Ritalin <../drugs/ritalin.html>
Rohypnol <../drugs/rohypnol.html>
Steroids <../drugs/steroids.html>
Internet Resources for Drug Prevention <../drugs/int-resources.html>
Other Related Articles <../drugs/articles.html>
------------------------------------------------------------------------
Higher Education Center for Alcohol and Other Drug Abuse and Violence
Prevention
Funded by the U.S. Department of Education
Catalyst is a publication of the U.S. Department of Education's
Higher Education Center for Alcohol and Other Drug Abuse and Violence
Prevention.
Editor: Barbara E. Ryan
Production Manager: Anne McAuliffe
Graphic Designer: Shirley Marotta
Center Director: Virginia Mackay-Smith
Other Staff: Olayinka Akinola, Jerry Anderson, Kellie Anderson, Tom
Colthurst, Laurie Davidson, William DeJong, Elisha DeLuca, Beth DeRicco,
Gloria DiFulvio, Gretchen Gavett, Kathie Gorham, Monica Grinberg,
Jessica Hinkson, Rob Hylton, Linda Langford, Anne O'Neill, Michelle
Richard, Helen Stubbs, Chris White
Our Mission
The mission of the U.S. Department of Education's Higher Education
Center for Alcohol and Other Drug Abuse and Violence Prevention is to
assist institutions of higher education in developing, implementing, and
evaluating alcohol and other drug abuse and violence prevention policies
and programs that will foster students' academic and social development
and promote campus and community safety.
How We Can Help
* Training and professional development activities
* Resources, referrals, and consultations
* Publication and dissemination of prevention materials
* Support for the Network: Addressing Collegiate Alcohol and Other
Drug Issues
* Assessment, evaluation, and analysis activities
This publication was funded by the Office of Safe and Drug-Free Schools
at the U.S. Department of Education under contract number ED-04-CO-0137
with Education Development Center, Inc. The contracting officer's
representative was Richard Lucey, Jr. The content of this publication
does not necessarily reflect the views or policies of the U.S.
Department of Education, nor does mention of trade names, commercial
products, or organizations imply endorsement by the U.S. government.
This publication also contains hyperlinks and URLs for information
created and maintained by private organizations. This information is
provided for the reader's convenience. The U.S. Department of Education
is not responsible for controlling or guaranteeing the accuracy,
relevance, timeliness, or completeness of this outside information.
Further, the inclusion of information or a hyperlink or URL does not
reflect the importance of the organization, nor is it intended to
endorse any views expressed, or products or services offered.