Home Articles and Resources A Complete Guide to Substance Abuse in College

A Complete Guide to Substance Abuse in College

Julie Goldberg

Featuring expert review from Julie Goldberg, MA, LAC

Leandra Spilka

Q&A with current college student Leandra Spilka

Substance abuse is by no means an issue just among college students—it affects people of all ages and education levels. The college years in particular are a unique time in a person’s life—they can be both exhilarating and overwhelming, which can contribute to the conditions for substance abuse by some students.

This guide addresses substance abuse in college, with the goal of helping students, faculty, and staff understand how to recognize signs and what to do.

What Is Substance Abuse vs. Substance Use?

When discussing drugs and alcohol, substance use and substance abuse are often used interchangeably—yet they have very different meanings.

Substance use is the consumption of any alcohol or drug. Meeting a friend for an after-work beer is substance use, but it does not indicate an issue or pattern of harm.

Substance abuse occurs when someone continues to use alcohol or drugs despite patterns of harm and misuse. Failing your mid-term due because you were partying and then sleeping through the final after a night of drinking is a sign of substance abuse.

In general, if substance use is negatively impacting relationships, academics, sleep, or health, it may be time to cut back. There aren’t specific numbers or hard and fast “rules” that define a substance use disorder. But if you or someone you know continue to use substances despite negative outcomes, you should start paying attention. More detailed warning signs are provided later on this page.

What Leads to Substance Abuse in College Students?

The traditional four-year college experience is the perfect storm for substance misuse and abuse. While 18-year-olds can vote and legally buy a gun in the United States, the late adolescent brain (age 18–24) isn’t fully developed until age 26. College students are expected to live independently and act like adults, yet their prefrontal cortexes aren’t fully online. They are wired to live for the moment, ignore long-term consequences, and participate in thrill-seeking behavior. This impacts their ability to consider the long-term impacts of substance use. Assuming substances won’t have any long-term negative effects is completely aligned with proper brain development at that time. The adolescent brain functions in the here-and-now, ignoring signs that substance use may be having a negative impact on their life.

Substances allow people to relax, and perhaps even be more outgoing and do things that they normally wouldn’t do. Alcohol, weed, Xanax, Ritalin, etc., are all drugs. Just like Tylenol helps a headache, substances help people achieve a desired effect. In college, substances may act as a bonding elixir, creating a sense of connection over a shared experience of lack of inhibition.

There’s also a lot of pressure on college students. Not only do they have to maintain good grades, but many students participate in extracurricular activities, hold jobs, want to score the best summer internship, and try to maintain a thriving social life on top of it all. There’s pressure to succeed, yet many college-age students don’t have the tools to thrive. Any pressure needs a release—and alcohol and drugs offer exactly that.

Signs You May Be Using Too Much

There’s no magic system to determine if you or a friend or family member has been drinking, smoking, or taking too much. However, there are questions you can ask and different areas of your life to examine to see if substance use is having a negative impact on your life. People often have blind spots about their own behavior, and substance use is no exception.

Substance use is so normalized on college campuses that many people ignore the obvious signs of abuse. There’s no specific list of warning signs unique to the college experience—substance abuse is substance abuse, no matter the location.

Look over this list and ask yourself if your substance use—or that of a student you know—may be impacting daily life in a negative way. Just because you answer yes to one of these questions doesn’t mean the person necessarily has a substance use disorder. It may simply mean they need to cut back or re-examine patterns or behaviors. If you feel you or someone you know has a substance use disorder, read this information to learn what to do next.

Substance Abuse Warning Signs Checklist

  • Cravings to use the substance
    You think about using while in class, eating with friends, or doing schoolwork.
  • Wanting to cut down or stop but being unable to
    You tell yourself you’re only going to have two beers out with friends this weekend and instead have eight beers and a couple of shots.
  • Taking the substance in larger amounts or for longer than you meant to
    You meet a friend for a beer at happy hour and continue to drink all night.
  • Neglecting other parts of your life because of the substance use
    You fall behind in schoolwork and avoid extracurricular activities.
  • Continuing to use even when it causes problems in your relationships
    Your partner doesn’t like the way you behave when you’re drunk, so you continue to drink and hide it from loved ones.
  • Continuing to use even when you have a physical or psychological problem that could be made worse by the substance
    You have asthma and smoking irritates your lungs, yet you continue to use cannabis.
  • Using substances even when it puts you in danger
    You walk home late at night alone along a busy street while intoxicated.
  • Spending a lot of time using the substance
    Social activities on the weekend are focused on drinking.
  • Spending a lot of time recovering from the use of the substance
    You stay in bed late into the morning multiple times a week because you’re hungover.
  • Spending a lot of time getting the substance
    You plan with friends when and how to get alcohol before going out on a Friday night. You drive an hour to another town to pick it up.
  • Needing more and more of the substance to get the effect you want
    You don’t feel anything after smoking one bowl—you need to smoke two or three bowls to feel “high.”
  • Development of withdrawal symptoms, which can be relieved by taking more of the substance
    You need the substance to feel “normal.”

Types of Substances Used by College Students

Understanding the types of substances commonly used by college students can help friends, parents, educators, and administrators provide support.


Fast Facts About Alcohol

  • Approximately 60% of college students reported drinking the prior month, with nearly two-thirds engaging in binge drinking. Binge drinking is defined as having four drinks (for women) or five drinks (for men) over the span of two hours.
  • 20% of college students qualify as having Alcohol Use Disorder (AUD), according to criteria.
  • Nearly 600,000 students are injured due to inebriation each year, including broken bones, sprained muscles, bruising, and fractures.
  • 11% of the alcohol consumed each year is ingested by individuals aged 12–20.
  • More than 4,300 minors die each year due to underage drinking issues.

Overdrinking has detrimental effects on the body in both the short term and the long term. Students who engage in binge drinking regularly may have trouble concentrating or remembering things, struggle getting to sleep, and suffer from nausea, dehydration, and the dreaded hangover. Those who continue drinking heavily for years are at risk for decreased brain function, liver disease, diabetes, weakened immune systems, hormonal imbalances, and heart disease.

Students should familiarize themselves with their college’s alcohol policy. Failing to adhere to these policies can result in suspension or even expulsion. Butler University provides an example of what to look for. Learners also need to understand the laws in their state governing DUIs. Getting a DUI in college—or at any point in life—can derail academic, professional, and personal progress and leave you with jail time, fines, and/or license suspension.

The National Institute on Alcohol Abuse and Alcoholism reports that one standard U.S. drink in America is equivalent to:

One Standard Drink



12 fluid ounces



5 fluid ounces

Liquor (80-Proof)


1.5 fluid ounces

Alcohol: How Much Is Too Much?

Several factors go into determining the appropriate amount of alcohol, including weight and sex. According to the Centers for Disease Control, moderate drinking habits include one drink per day for women and two drinks per day for men.

When ascertaining how much is too much, most people consider blood alcohol content (BAC). States set BAC limits for driving and use these numbers to calculate whether a driver is over the legal limit. Alcohol.org provides a BAC calculator that allows you to estimate your BAC by entering information about your body and the amount and type of alcohol consumed.


Fast Facts About Marijuana

  • College students use marijuana more than any other illicit drug.
  • 38% of college students said they used marijuana at least once in the previous 12 months, while 21% said they had used it in the previous 30 days.
  • 4% of college students said they used marijuana on a daily or near-daily basis in 2017.
  • Individuals must be at least 21 years old to legally purchase recreational marijuana. However, individuals over the age of 18 can get a medicinal marijuana card in states where weed is legal.
  • Marijuana has either been legalized or made available for medicinal purposes in all but 11 states as of 2020. It is decriminalized but not legal in Nebraska, Mississippi, and North Carolina.
  • Nearly 800 distinct strains of marijuana exist.

Marijuana (cannabis) serves as an overarching term for both marijuana and hemp, but each serves a different purpose. Hemp is used to make CBD products and does not result in a person getting “high.” Marijuana, conversely, contains a higher amount of Tetrahydrocannabinol (THC) and produces more psychoactive effects.

Marijuana comes in three different species, including sativa, indica, and ruderalis. Each of these types has different effects on the mind and body. Individuals often use the sativa strand for a happy, uplifting high, while indica creates a calming, sleepy feeling. While the high may last only a short while, THC can show up in an individual’s hair for up to 90 days.

Marijuana affects individuals differently, and the long-term effects are still being researched. Some studies show a lower IQ in individuals who smoke heavily, while others have suggested marijuana can cause breathing issues, increased heart rate, and pregnancy risks.

Marijuana is now fully legal in Alaska, California, Colorado, Illinois, Maine, Massachusetts, Michigan, Nevada, Oregon, Vermont, and Washington. It is also legal in Washington, D.C.

Legal Drugs

The drugs listed below are legal when used as prescribed by the person whose name is on the prescription. However, these drugs can be addictive and are often used illegally by college students.

Addictive Legal Drugs

Ritalin, Adderall (Stimulants)

These drugs are used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy.

Possible long-term effects include heart disease, high blood pressure, irregular heartbeat, seizures, addiction.

Xanax, Valium (Sedatives)

These drugs are used to treat anxiety disorders, panic disorders, seizure disorders, and chronic sleep issues.

Possible long-term effects include memory loss, confusion, depression, anxiety, nightmares, seizures, sleep issues, addiction.

Oxycontin, Vicodin, Percocet (Opioids)

These drugs are used to treat moderate to severe pain, inflammation, or fever.

Possible long-term effects include irregular heartbeat, kidney failure, liver damage, cardiovascular issues, reproductive complications, dependence, addiction.

Illegal Drugs

Recent years have seen a rise in the use of both stimulants and hallucinogens. All of the drugs listed below can be addictive, while others—such as heroin and cocaine—are highly addictive. Some of the most common illegal drugs used on campus include the following.

Addictive Illegal Drugs

Cocaine (Stimulant)
Also known as Coke or Blow

Cocaine can help users feel more alert, attentive, and energized by sending extra dopamine to the brain.

Possible long-term effects include seizures, heart disease, nosebleeds, headaches, mood issues.

LSD (Hallucinogen)
Also known as Acid or California Sunshine

LSDs create hallucinations that distort time and space. These can either feel euphoric or terrifying, depending on whether you have a good or bad “trip.”

Possible long-term effects include depression, anxiety, panic attacks, recurring hallucinations, heart failure.

Ecstasy (Synthetic, similar to a stimulant)
Also known as MDMA or Molly

Ecstasy creates a short-term euphoria that causes the user to feel an intensified sense of love and affection.

Possible long-term effects include trouble feeling real pleasure, issues around memory and other brain functions, sleep trouble, depression and/or anxiety, psychosis, kidney failure.

Heroin (Opioid)
Also known as Dope or Smack

Heroin creates a “rush” in the brain and body, and users feel a sense of pleasure. It can also lead to drowsiness, vomiting, and cloudy mental functions.

Possible long-term effects include changes in brain physiology and physical structure, greater potential for blood infections, overdose, death.

Psilocybin (Hallucinogen)
Also known as Magic Mushrooms or Shrooms

Mushrooms can cause hallucinations, but the experience is typically more calming than LSD, with a feeling of relaxation and peace.

Possible long-term effects include depression, panic attacks, impaired memory, mental disturbances, heart failure, lung failure.

What You Can Do If…

You think you have a problem, but you aren’t sure:

  • Review the warning signs listed above and see how many apply to you.
  • Check out the resources listed below.
  • Talk with trusted friends and family. See if they’ve noticed any concerning behavior or are worried about you in any way.
  • Call a helpline. You don’t have to give out any personal information and the person on the other end of the line won’t pass judgment or force you into any course of action.

You know you have a problem:

  • Tell family and friends (only if this won’t jeopardize your safety). Let your loved ones know you are struggling and build up a network of support. Have a go-to person you can call in times of cravings or triggers.
  • Surround yourself with friends who don’t use or have a healthy relationship with substance use. Try going to an AA support group or a recovery group on campus.
  • Get comfortable telling people you’re struggling with substance abuse. Practicing saying “I don’t drink” or “I’m sober.” The more you talk about it, the less taboo it’ll become.
  • Seek out mental health care. Think of this as going to the gym for your brain. Talking to a trained substance use counselor will give you additional support and keep you on track if your desire is to remain sober.
  • Seek out medical attention. Maintaining good physical health is key when struggling with sobriety. Talk with a trained medical provider about any physical issues you may be experiencing. Sometimes there’s an easy solution that may have been clouded by substance use. For example, if you’ve been using cannabis to help with headaches, you might discover a new glasses prescription that will eliminate your headaches.
  • Check out additional resources below.

Be Proactive

If you notice that you or a friend may be using substances more than you’d like, change your activities before they become a habit!

Explore what a healthy amount of substances means to you. Technically speaking, binge drinking is defined as five or more alcoholic drinks for males and four or more alcoholic drinks for females in a single night. Moderate drinking is defined as up to one drink per day for women and up to two drinks per day for men. To maintain a healthy, balanced lifestyle, try to maintain moderate drinking habits.

Most campuses have Mental Amnesty and Good Samaritan laws to help those in a medical emergency. In general, this means if you or a friend experience a medical emergency due to substance use and need medical attention, no charges will be filed, regardless of substances consumed or age. These laws vary from state to state, so check with your local police department and discuss Good Samaritan laws with friends. It’s important that your friends know that if substance use gets out of hand, you can get help without worrying about getting in trouble.

Try to fill your social life with a variety of activities, not just those that focus on substance use. College campuses have some of the most robust cultural scenes in the country, many of which do not involve substances. Check out the local improv group, see a play, or go to see live music.

Helping a Friend or Loved One

Having a friend or family member suffering from substance abuse is challenging for everyone involved. You want your friend to take care of themselves, so it’s important to model that behavior yourself. Seek out mental health care for additional support and don’t think you need to “do it all.” Connecting a loved one with an expert, rather than trying to fill the role of an expert, is always the best course of action.

Ways to support:

  • Invite them to sober activities (working out, going to see a play, hiking, playing a board game).
  • Understand that sobriety is a journey and takes time. Have an empathetic and open mind if someone lets you know they are struggling. This builds trust and confidence.
  • Attend an Al-Anon group.

Q&A With Leandra Spilka, Psychology Student at SUNY Cortland

Leandra Spilka

Leandra Spilka is a senior at SUNY Cortland majoring in psychology. She offers her perspective about substance abuse on campus—both as a student and as a family member of someone who has had substance abuse issues.

What challenges do you and other college students face when it comes to substance abuse?

Personally, as a senior at SUNY Cortland I feel as though many students face multiple challenges when it comes to potential substance abuse. For most freshman coming in there is a certain stigma when it comes to how you are supposed to act or the fear of missing out, FOMO. Some students may face the challenges of wanting to fit in with their friends or feel that by drinking and using other substances they would have more fun. I also feel when a majority of students come into college as a new student, they do not understand the amount of freedom they have, or how to balance the amount of schoolwork they have with pleasure. At SUNY Cortland, in my personal experience, no one has ever pressured me to do any drugs or pressured me to do something I did not want to.

Is it easy for students on your campus to get alcohol? What about marijuana and other drugs (legal or illegal)?

It is relatively easy to get alcohol off campus using fake identification or asking upperclassmen. Marijuana and other substances are the same as well, but I feel you need to know exactly where you are getting it from or a highly trusted source. If a student is looking for other substances it is easy to ask around to be directed to the right person.

Do you feel there is a “party culture” at your school? Why or why not?

I feel there is a certain party culture at SUNY Cortland, it differs within the places you go or the bars you attend. The party culture is that you are supposed to be having an awesome time, dancing with your friends as well as being obliterated drunk. I have attended parties soberly and still have had a great time; I feel strongly that whatever energy you put out is what you will receive back, and that is something I have noticed works well towards party culture and life as a whole. Many people at parties will get extremely under the influence, and people sometimes will get out of hand. I have seen students in an ambulance with alcohol poisoning, and it has personally scared me to not get to that level. I have also noticed that many people will get angrily drunk and try to cause problems. I feel a person needs to decide how they want to act, what they are comfortable with, as well as not succumbing to pressure and knowing personal limits.

Have you ever felt pressure to drink or use other substances? How did you handle it?

I personally have never felt any pressure to use any substances—my older brother has struggled with substance use issues for all of my college experience, and I have learned from his own personal college experience. When I see a friend or someone using substances I am able to have an open mindset to what they are going through and a judgment-free zone.

What would you do if you thought a friend possibly had a substance abuse problem?

If I felt a friend had substance abuse issues, I would make sure they know their feelings are valid, and I am there for them to talk about anything. It is extremely upsetting to see this happen to someone, based off my own personal experience, so I can understand how they are feeling. I would urge them to go to the counseling center or talk to a trusted adult about what their next steps would be if they were willing to get some help.

Does your campus have resources for students who need help? How can students find out about such resources?

SUNY Cortland has some resources for students dealing with substance abuse and addiction. They offer some educational resources like “AlcoholEdu,” which is an educational resource when one violates alcohol policies, as well as alcohol free events and environments. They also require a course as a freshman called CORE 101 that speaks about substance abuse and helps give students a bit of an education on the topic.

The counseling center is also available to help with addiction-related issues and there are some educational resources through the counseling centers. During the time of COVID-19, the counseling center refers students struggling with substance use issues to Kennesaw State University Center for Young Adult Addiction and Recovery. The counseling center does not have any specialized services towards students dealing with past substance abuse issues or failed treatments, as well as drug testing.

Resources About Substance Abuse

The Internet is full of places you can go to learn about substance abuse. Make use of the resources that follow to educate yourself about substance abuse and learn how to get help.

24/7 Helplines




The Recovery Village


Student Tools



Meet the Expert

Julie Goldberg

Julie Goldberg

Editor’s note: Julie Goldberg reviewed this article for accuracy. She also wrote some sections and contributed to this guide’s direction.

Julie Goldberg, MA, LAC, is a therapist in private practice specializing in adolescent therapy. She aims to empower teens to feel comfortable and confident to navigate the challenging adolescent years. Julie also works as a Prevention Specialist and district trainer for substance use prevention at Denver Public Schools. As an addiction counselor, she provides tools to help teens make safe and healthy choices while building up a client’s resilience before addiction occurs. You can learn more about her on her company website, Third Nature Therapy.