The deadly opioid epidemic sweeping the country has largely spared college campuses, but drug abuse experts warn administrators they should be paying closer attention.
“This is a time when young adults have more access to substances than ever before and have more economic leverage and legal protections,” said Dr. Joseph Lee, medical director for the Hazelden Betty Ford Foundation Youth Continuum in Minnesota.
“I wonder if [college] administrators take it as seriously as they need to when it’s not on the map,” he told NBC News.
Opioid abuse has skyrocketed in the United States, killing more than 30,000 Americans between 2002 and 2015, according to the National Institute on Drug Abuse. At highest risk are young adults between the ages of 18 and 25.
The overdose rate among teens has doubled between 1999 and 2015, according to the Centers for Disease Control and Prevention. In 2015 alone, there were 772 deaths among those aged 15 to 19.
For the most part, college campuses have been spared.
“Kids start using when they are teenagers and peak in young adulthood,” said Lee. “But if you look at college students, you see that people who tend to use substances are much more likely to drop out.”
“When you put it together, you find a rather nuanced message that doesn’t downplay the seriousness, but shows why colleges are not seeing it,” he said.
The highest risk group usually never makes it to college, or they “bottom out” freshman year, according to Lee.
There is still “rampant use and misuse” of substances in college, mostly drugs like Valium, Adderall and cocaine, as well as alcohol, he said. “And very few get help.”
Some students are just experimenting — “not everyone develops a serious problem,” he said, although these drugs have been implicated in cases of DUI and date rape.
Opioids include prescription painkillers like codeine, Vicodin and Oxycontin, as well as heroin and the synthetic drug fentanyl. They bind to pleasure receptors in the brain and can be highly addictive.
These drugs slow down respiration and an overdose (especially when mixed with alcohol) can halt breathing altogether.
In 2016, the American College Health Association issued new guidelines for prescribing opioids, particularly in rural settings where students can not have access to specialized pain clinics.
'We do very little prescribing'
“There is little evidence that opioid prescription pain medication is useful outside the treatment of cancer-related pain,” says the ACHA report.
Armed with new data, some forward-looking colleges are taking a novel approach to provide support systems for students who are in recovery.
Dr. David McBride, director of the health center at the University of Maryland, said the school “sees very little” opioid use.
“And we do very little prescribing,” he told NBC News. “Occasionally we prescribe in small quantities for pain.”
Maryland, like many other states, is now required to report those prescriptions so doctors can thwart multiple prescriptions.
Working with local police, Maryland also has naloxone on the ready in case of any potential overdoses.
Naloxone (trade name Narcan) can reverse an opioid overdose. According to the National Institute on Drug Abuse, it can be used safely with non-medical personnel to save lives.
But, what the university is seeing are a “growing number” of students in recovery from “substances in general,” McBride said. “They got sober before coming to college or got sober while they were in school and want to engage in a community of support.”
Maryland provides a substance-free dormitory and also hosts support groups like Alcoholics Anonymous and Smart Recovery. As soon as next year, the university hopes to have a substance recovery house off-campus.
This approach has “taken wings” across the country, according to McBride, providing fellowship and safety to those who want to stay clean.
Recovery dorms can be found at, among others, Augsburg College in Minnesota, Ohio State University, Baylor University in Texas, George Washington University in Washington, D.C. and Rutgers, the state university of New Jersey.
Still, says McBride, most college efforts are still focused on alcohol — “the biggest public health” problem.
“Any time you put a group of individuals together in a geographically small space who are newly free and whose brains are still developing, it’s a potential recipe for unwise choices,” said McBride.
Hazelden Betty Ford’s Lee is also concerned about the “Animal House” culture, referring to the 1978 film of the same name. And he argues colleges should be spending more money on recovery facilities than fraternities.
When college students do become addicts, they have a hard time finding a place where they can stay sober.
“You look at how much Greek programs are supported, it’s a travesty,” Lee said. “They will support a party house, but very few put forth resources for people with mental health and addiction problems. It’s very sad.
“Students get mixed messages from college administrators, who are not on fire to do something about opioids.”