A Different Kind of Intervention
LONG BEFORE HE BECAME PRESIDENT OF <b>Frostburg State University</b> (Md.), Jonathan C. Gibralter was teaching elsewhere. The high level of student alcohol abuse compelled him and his wife-who ran the alcohol and drug prevention program there-to personally urge the president to take action. "If you don't do something about this," Gibralter's wife said, "somebody's going to die."
"About two weeks later, in an off-campus apartment, two kids were under the influence, and one pulled out a knife and cut the other kid, and he died," Gibralter says. A stronger stance from the president and more institutional programming about alcohol and other drugs might have prevented the tragedy, he adds.
That incident remained in Gibralter's mind as he progressed in his career. When he attained the presidency at Frostburg-where students had a reputation as hard partiers-he began his tenure with a firm pronouncement, saying, "I'm not putting up with this. I'm not accepting that it's part of our culture." In the student newspaper, he announced a "zero tolerance" policy for the use and abuse of alcohol and other drugs on campus. "Some of the students didn't like it. A lot of students thanked me," he recalls.
Gibralter's public stand places him in a growing but still small minority of university presidents who openly acknowledge that substance-abuse issues are present on campus. Progressive colleges and universities are shifting their primary efforts from individual users to the entire campus community and emphasizing to students that a fulfilling collegiate experience can be had without substance abuse.
The National Institute on Drug Abuse's report <em>Monitoring the Future: National Survey Results on Drug Use, 1975-2006</em> reports that despite considerable attempts to raise awareness over the last several years, the use of alcohol by college students has remained fairly steady. As Gibralter points out, the negative consequences continue to be numerous: 1,700 alcohol-related deaths and nearly 600,000 injuries annually, almost 70,000 assaults in which alcohol plays a role, and such academic setbacks as missed classes, failing grades, and flunking out for an estimated 25 percent of students.
Equally troubling, according to data collected by the alcohol-prevention firm Outside the Classroom, while binge drinking levels have stayed essentially the same, female drinking has increased dramatically, reaching rates equal to those of men.
The other noteworthy trend, according to both data and campus observers, is that while the use of illicit drugs has begun to fall, prescription drugs are being misused in larger numbers. Opioids such as OxyContin and Vicodin, depressants such as Valium and Xanax, and stimulants such as Ritalin and Adderall are easily obtained online or from parents or friends and can become problematic swiftly.
"Young people get them prescribed-they have their tonsils out, they have a surgery, they break an arm-and then they get addicted to them very quickly," says Sharon Guck, coordinator of the Alcohol and Substance Abuse Program at <b>Western Connecticut State University</b>. "Others try them illegally right from the beginning."
The powerful stimulant properties of newer prescription medications have made them very attractive to stressed-out, overscheduled students, who believe that because they have been prescribed by a physician, they must be safe-never mind that the prescriptions often aren't even theirs to begin with. "They don't have a real sense of being involved in anything that we would typically call drug abuse or substance abuse," says Kitty Harris-Wilkes, director of <b>Texas Tech University</b>'s Center for the Study of Addiction and Recovery. "There is an underlying attitude by a lot of students that, well, they're prescription drugs-what's wrong?"
NIDA-funded research conducted by Amelia M. Arria of the <b>University of Maryland</b>'s Center for Substance Abuse Research suggests that students' use of nonmedical prescription drugs often is linked with other drug use. "One study shows that there was a strong association between marijuana dependence and prescription stimulant use," Arria says. "We think what's happening is that a person starts to use marijuana, starts not going to class, becomes marijuana dependent, and then picks up prescription stimulants as a compensatory mechanism."
Harris-Wilkes notes that most freshmen have already decided before they begin college whether they're going to drink or use drugs on campus. For college presidents and student life personnel, that's reflected in at least one positive trend noted by Brandon Busteed, the founder and CEO of Outside the Classroom and a former trustee of <b>Duke University</b>: More teetotalers are coming to college than ever before, providing a great opportunity to foster abstinence across the student population. "There is some indication that providing services, support, visibility, and recreational opportunities for that kind of student population that's less reliant on the alcohol culture is an opportunity to take advantage of," he says. "That's the one positive."
No one has devised a large-scale, effective way to deal with campus alcohol and drug abuse. But across the country, individual colleges and universities are paying attention to new data and employing evidence-based practices with beneficial effects. The increasing use of online intervention tools such as AlcoholEdu and eCHUG from <b>San Diego State University</b> researchers, which compile students' alcohol and drug use, has led to an unprecedented level of information for administrators to use to devise effective programs and policies.
At <b>William Paterson University</b> (N.J.) first-year students can't register for their second term if they haven't yet completed a substance abuse survey. The requirement establishes "that this is an issue for us and for them," President Arnold Speert says. "We make it a peer issue more than just the institution talking down to them." The survey also establishes a benchmark for students as they continue through their college years.
Studies show that alcohol and drug usage occurs in much smaller quantities than students believe, and schools are beginning to leverage that information. At <b>Illinois Wesleyan University</b>, administrators realized that their traditional anti-alcohol messages-mock-ups of mangled cars on the quad and information distribution-were falling on deaf ears. So they created a series of provocative posters illustrating how students on their campus actually drink.
"There are unspoken rules or codes that students follow," says Robert Rogers, a mental health counselor at Illinois Wesleyan. "If there are accepted norms about drinking on college campuses, the theory says, students will drink to that level." Yet, when students are informed about what the norm actually is, they adjust their drinking accordingly, he adds.
It's important for schools to have regular activities for students who aren't looking to drugs or alcohol as the primary basis for their recreation, say experts. "Universities that are really taking advantage of that abstainer thing are ones that have really great up-at-night, late-night alcohol-free activities in place," Busteed notes, citing <b>West Virginia University</b> and <b>The Pennsylvania State University</b>. "There's a big difference between just doing it on a couple of weekends and having an always available, always-on venue on campus. It has to be regularized or students don't get in tune with it."
The disparity between perception and reality shows up in other areas as well. A researcher at <b>Boston University</b>'s School of Public Health asked students about their support of alcohol enforcement measures and about how likely their peers were to support them. "It was stunning to see the difference in the actual support versus the perceived support," Busteed says. "For example, cracking down on fake IDs: They thought that only 20 percent of students were in support of that, and the actual percentage was 60 percent."
In an age of happy hours that extend well beyond 60 minutes, community partnerships have become another vital tool.
"The bars seem to be urging students to drink daily," says Tom Hall, director of education and training programs for alcohol and other drug prevention at the <b>University of Central Florida</b>. "I can remember when there was a Thursday and Friday night and Saturday drink special, but now, literally every day of the week there is a drink special. Some of them are pretty egregious, certainly in this area."
Community efforts take many forms, including joining with community groups to lean on bar owners to limit alcohol-related promotions, engaging with the bars themselves, and linking with municipal governments and law enforcement to coordinate communication and prevention initiatives. At the same time, experts are urging higher ed institutions to ensure that campus facilities and programs are adequately funded.
"I'm a big advocate of allocating resources such that the health center becomes an easily accessible and quality place to receive early intervention services," Arria says. "From what we've seen in our study, college is an opportunity to make sure that students have the quality mental health services that they need. Things can go undetected at a very early stage, but if you detect them and do something about them while students are in college, you could really deflect trajectories later on."
The <b>University of Southern California</b> has extrapolated from prevention models that indicate, counterintuitively to the individualistic American idea, that behavior choices may rely less on one's own choosing and more on one's environment. And so education efforts such as AlcoholEdu, says Paula Swinford, director of health promotion and prevention services at USC, must be matched by efforts that place alcohol- and drug-related choices in context.
As examples, she includes having Friday morning classes ("so that the environment doesn't say that the weekend starts on Thursday"), not selling beer in the Los Angeles Memorial Coliseum during football games, and working with resident advisors so that there's an evenhandedness to what is considered a punishable offense.
Swinford adds that individuals can certainly buck the trend. "But in general we are pretty much creatures of our context, and we make choices based on what's available to us."
Presidents addressing the issue of substance abuse at their institutions say that peers seeking a solution on their own campuses should start looking in the mirror.
For the most part, campus leaders don't really like to talk about substance abuse, because if they talk about it, they feel they're acknowledging it's a problem, says Gibralter of Frostburg State. "There's not a lot of leadership in our country right now around this issue. It is infrequent that you see a president take a stand on a campus regarding alcohol and other drugs."
Yet by engaging the issue directly, presidents are opening up informative conversations and helping to legitimize healthy behaviors. "Individuals who want to abstain can declare that with some pride and not be concerned that they're not getting the best of a college experience," says Speert of William Paterson University. "It's those kinds of things that we're encouraging."
<em>Tom Durso is a freelance writer based in Glenside, Pa. Formerly he was director of communications at his alma mater, Saint Joseph's University in Philadelphia.</em>