Office Hours: Risks of substance experimentation unknown on college campuses

Drug use on college campuses has been on the rise for decades. Nearly half of all collegiates binge drink or abuse drugs at least monthly. Illegal drug use in this group has doubled between 1993 and 2005, and a similar increasing trend continues to this day. The reasons for the increase aren’t as relevant here as addressing some of the concerns about it and having a plan to address the ongoing rise.

Experimentation is pretty common. The two primary concerns with this are that drug use is illegal, so you could put yourself at legal risk, and that there are biological consequences to such experimentation. Not everyone that tries a drug will become addicted or have a negative consequence, but many will. I have seen many people end up in the hospital for both mental and physical issues secondary to substance experimentation. I’m not only referring to “hard drugs,” but also to prescribed medications, such as Adderall or Xanax; especially when these are taken with other substances or in larger than prescribed amounts.

To tease out whether or not a person is actually experiencing a problem with their substance use, I and other professionals look for specific indicators. Some common behaviors include needing a substance to get their day started, sincerely trying yet failing to cut back, and feeling guilt when using a substance. We pay attention to the effect substance use has on an individual’s ability to successfully function. An unhealthy relationship with a substance can interfere with one’s relationships, academic success, and ability to sleep, as well as make him or her more anxious and irritable. If any of these indicators are presents, then there is a current problem of some severity that merits further attention and treatment planning.

Many college students take other people’s prescribed stimulant medications, especially during mid-terms and finals. Research results vary, but most agree that around 30 percent of students use illicitly obtained, non-prescribed stimulants.

I have been told by students that Adderall in particular is “really big at Tulane.” Adderall is the most common among many methamphetamine or stimulant medications. When used as prescribed, with proper monitoring and with an understanding of the side effects, this type of medication can be very effective and therapeutic. Most illicit users, however, are unaware of proper dosing, and of the physical, mental and legal risks.

If you are taking such medications when you should not be, or are taking more than a normal dose, then you have a radically increased chance of suffering side effects. Short-term adverse consequences include sleep difficulties, restlessness, irritability, depression and even a change in sex drive. I have seen many students abuse these medications — prescribed or illicit — then try to self medicate these consequent side effects with increased dosages or other substances. This then compounds the problems and can, in some circumstances, result in severe depression and/or psychosis. A newly understood, longer-term consequence is brain structure alteration, which can result in a decline in decision-making ability and mental flexibility.

Drug use among students is hardly limited to just prescription medications. The most commonly abused drugs on college campuses are alcohol and marijuana. These are both, generally speaking, regarded as socially acceptable, but come with many of the same physical, mental and legal risks and consequences of any other drugs. Of course, opiates — from pain pills to heroin — are also abused and come with even higher risks for physical addiction and adverse side effects.

When it comes to addressing a substance abuse problem, the first step really is acknowledging that there is a problem. Developing an issue with mental and/or physical addiction is far more common than you think. In order to address these problems we must be able to talk about them, without fear of judgment or social ousting. So if you happen to be someone’s confidant, it is crucial to be supportive, understanding and compassionate. Help them to find the attention they need. There are student resources and also resources in the medical community: group or individual therapy, or MD specialists who can help.

Arwen Podesta MD is a psychiatrist, addiction doctor, integrative and holistic doctor, and forensic psychiatrist. She holds a position as Clinical Faculty at Tulane Psychiatry, is also medical director at Odyssey House Rehab, and has a collaborative practice with counselors, a nutritionist and a massage therapist