Opioid and Other Drug Use Among College Students: Predictors and Effective Intervention Approaches

A recent systematic literature review of 47 studies of prescription opioid misuse among college students found that among general populations of students, misuse ranged from 2% to 19.7%. The majority of studies reported prevalence rates below 10%.1 The prevalence of misuse varied among specific populations with highest rates among students reporting psychological distress, depression, suicidal thoughts/behaviors. Rates were also higher among white male students who reported the use of alcohol and other illicit drugs. Overdose deaths among college students were found to be highest in the U.S. compared to the other countries included in the study.

Studies have found that the most reliable predictors of alcohol use are the perceived prevalence of use by peers (descriptive norms) and perceived peer approval of use (injunctive norms). Social media has become an efficient means of communicating both descriptive and injunctive norms within adolescent and young adult populations. Posts of risk-related behavior is often associated with use patterns and negative outcomes at the individual level.2  While research on social media behavior and its influence on risk taking behaviors is challenging, the use of social media in prevention and intervention approaches is promising and merits further research.2  

A systematic review of mobile applications for reducing alcohol and drug use found that although mobile applications were associated with reductions in problematic substance abuse, less than one-third were significantly better than comparison conditions post treatment.3 The effectiveness of different approaches to intervention may also vary depending on the drug of abuse. A systematic review of reviews of interventions for adolescent (12-20 years old) substance use found that while brief motivational interventions were effective in reducing alcohol use and substance-use related problems, it was not effective in reducing cannabis use. Interventions using a combination of cognitive behavior therapy and motivational interviewing were effective in reducing alcohol and other drug use.

Longer courses (2-3 months) of pharmacological interventions such as buprenorphine, were more effective in reducing opioid use and achieving abstinence compared to shorter courses (14-28 days). The authors of this review emphasize the need for more research to determine the most effective combinations of behavioral and pharmacological interventions for opioid, alcohol, and cannabis disorders in adolescents.4

Resources

  • Campus Drug Prevention: This site contains links to federal and non-federal resources on college age drinking, including links to the most recent research publications. The articles below may be of interest.
    • 2018 College Prescription Drug Study: a multi-institutional survey of undergraduate, graduate and professional students administered by Ohio State University.
    • Prevention with a Purpose:  A Strategic Planning Guide for Preventing Drug Misuse Among College Students. A guide provides a roadmap for college and university-based prevention professionals to collaborate with a wide range of stakeholders, from students to administrators, to address campus wide drug misuse issues.
  • Substance Abuse and Mental Health Services Administration (SAMHSA)
    • Screening, Brief Intervention, and Referral to Treatment (SBIRT)
    • State Performance & Best Practices for the Prevention and Reduction of Underage Drinking (2020)
    • Substance Misuse Prevention for Young Adults (2019)
  • National Drug Enforcement Administration (2021) National Drug Threat Assessment  A comprehensive assessment of the threat posed to the United States by the trafficking and abuse of illicit drugs, the diversion and abuse of licit drugs, and the laundering of proceeds generated through illicit drug sales.

 

Articles of Interest

Lee, C. M., Cadigan, J. M., Kilmer, J. R., Cronce, J. M., Suffoletto, B., Walter, T., Fleming, C. B., & Lewis, M. A. (2021). Brief Alcohol Screening and Intervention for Community College Students (BASICCS): Feasibility and preliminary efficacy of web conferencing BASICCS and supporting automated text messages. Psychology of Addictive Behaviors, 35(7), 840–851. https://doi.org/10.1037/adb0000745

P. Priscilla Lui, Byron L. Zamboanga, Melissa M. Ertl, Lindsey M. Rodriguez, Jessica L. Martin & Rubi Gonzales (2020) Drinking motives, cultural orientations, and alcohol use among Hispanic college students at the U.S.–Mexico border, Journal of Ethnicity in Substance Abuse, DOI: 10.1080/15332640.2020.1845901

Sanchez A, Gainza  Perez M & Field CA (2021) The role of resilience in alcohol use, drinking motives, and alcohol-related consequences among Hispanic college students, The American Journal of Drug and Alcohol Abuse, DOI: 10.1080/00952990.2021.1996584

Staiger PK, O’Donnell R, Liknaitzky P, Bush R, Milward J (2020) Mobile Apps to Reduce Tobacco, Alchool and Illicit Drug Use:  Systematic Review of the First Decade.  Journal of Medical Internet Research, 22(11): pg. 17156.  PMID: 33231555.

Steele DW, Becker SJ, Danko KJ, Balk EM, Saldahha IJ, Adam GP, Bagley SM, Friedman C, Spirito A, Scott K, Ntzani EE, Saeed I, Smith B, Popp J, Trikalinos TA (2020).  Interventions for Substance Use Disorders in Adolescents:  A Systematic Review [Internet].  AHRQ Comparative Effectiveness Reviews. Report No.:20-EHCO14. Bookshelf ID: https://www.ncbi.nlm.nih.gov/books/NBK557291/

 


1 Weyandt LL, Gudmunsdottir G, Holding EZ, Marraccini ME, Keith M, May SE, Shepard BS, Sweeney C. (2020) Journal of American College Health; https://doi.org/10.1080/07448481.2020.1786095

2 Groth GG, Longo LM, Martin JL (2017).  Social Media and College Student Risk Behaviors:  A Mini-Review; Addictive Behaviors 65; pg. 87-91. DOI: https://doi.org/10.1016/j.addbeh.2016.10.003

3 Staiger PK, O’Donnell R, Liknaitzky P, Bush R, Milward J (2020) Mobile Apps to Reduce Tobacco, Alchool and Illicit Drug Use:  Systematic Review of the First Decade.  Journal of Medical Internet Research, 22(11): pg. 17156.  PMID: 33231555.

4 Steele DW, Becker SJ, Danko KJ, Balk EM, Saldahha IJ, Adam GP, Bagley SM, Friedman C, Spirito A, Scott K, Ntzani EE, Saeed I, Smith B, Popp J, Trikalinos TA (2020).  Interventions for Substance Use Disorders in Adolescents:  A Systematic Review [Internet].  AHRQ Comparative Effectiveness Reviews. Report No.:20-EHCO14. Bookshelf ID: https://www.ncbi.nlm.nih.gov/books/NBK557291/https://www.ncbi.nlm.nih.gov/books/NBK557291/

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