Stigma Sucks: How to Address Substance Use in College

August 4, 2020 2:56 pm Published by 3 Comments

“I don’t respect people who drink or smoke. Like, you need a chemical to make you feel good? That’s not okay.”  My jaw drops, and I ‘stretch’ over my shoulder to see who it was that made this preposterous statement. I scan the university coffee shop, before finding my suspect. There he was, tired eyes, grabbing for his coffee, telling his friends how he ‘doesn’t respect’ people who use substances. And while I would like to act like this is a rare occurrence of hypocrisy, it is not. You would think that on college campuses, with the amount of education being provided, and liberal thinking flowing as freely as the alcohol, that the stigma around substances would be diminished. However, that is not the case, and the prevalence of stigma takes a large toll on the mental health of college students.


I am by no means saying everyone needs to use Adderall to get through a test or smoke a joint. But what I am saying is that it’s incredibly shitty to make fun of the student popping the Adderall when you’re on your third coffee of the night. It’s moronic to talk down to someone for smoking on the sidewalk as your friends carry you home from a frat party. Yes, there are significant issues with substances on college campuses. But the way to solve them isn’t to stigmatize the users but is instead to attack the problem head-on. The normalization of alcohol and caffeine and stigmatization of other drugs points to a larger issue on college campuses: the deteriorating mental health of college students. 


The first point of action is the students. While there are plenty of initiatives that a university can take, at the end of the day, the campus culture is formed by its inhabitants. So what can students do? We need to de-stigmatize substance use, and instead approach the topic with compassion and empathy. Let’s look at a hypothetical. You notice that a friend of yours has started to take Adderall to pull all-nighters, and then spends all weekend getting high. There are two ways to approach the situation. First, how these types of things are typically approached on college campuses: stigmatize the person and act on this judgment. Negative behavior causes negative behavior. So if you begin to carry a negative image of your friends, such as that they are reliant on drugs, or a ‘stoner’, they will want to escape this narrative. And while the logical response may be “These people are calling me a stoner, I should stop doing drugs” the easier, and likely response is “Wow, that hurt me. I’m going to get high to make the pain go away”, perpetuating the stigma.  


Taking a compassionate approach, while vulnerable and challenging, has far better results. If you approach your friend and make it clear that you are not placing judgment, but are acting because you care about them, and are worried, it’s going to be hard for them not to listen. And with passionate, caring individuals on their team, someone who uses substances can be empowered to take the steps to get help. In their research, analyzing the social support mechanisms used by 19 college students at a midwest university, Sun Young Park concluded that “The most salient social group our participants interacted with to share their concerns was their close friends, a dedicated and intimate group.”As teammates, classmates, and friends, we have a real opportunity to provide meaningful social support to our peers. We have the power of compassion. Once we begin to de-stigmatize substance use and approach the topic with compassion, we can look at the real issue: mental health.


While students may be able to apply pressure to a university to invest more in mental health, they can’t provide the counselors themselves. However, students can acknowledge the difficulties of college, and the tolls they take on our mental health. For many, it’s the first time that they need to be independent. When you combine that with social pressure, academics, new relationships (romantic and platonic,) it’s no wonder that students seek relief. But in the current social landscape, it’s hard to acknowledge any mental health struggles. It’s ‘weak’ to admit the pain. As students, we can change that. In our actions and words, we can normalize the conversation about mental health. And that doesn’t mean ‘Joey is drinking because he’s upset.’ That means getting our hands dirty. We need to have hard conversations with our friends, and ourselves. Once we become more vulnerable with each other and begin to be open with our struggles and emotions, we can work to address some of the problems. 


On the other side, universities can take more concrete actions to work to fight stigmas and improve mental health. We’ve seen many universities adopt a policy of amnesty regarding alcohol, but why stop there? Let’s say, for instance, some friends and I would like to experiment with cocaine. Johnny goes first. He does a line, I do a little less, and my other friend chooses simply to watch. In 5 minutes, Johnny is unresponsive. The cocaine was cut with Fentanyl. He’s overdosed. But am I going to call 911? I can get kicked out of school, or arrested, as I have also done the cocaine. And what about my other friend? He faces the same risk. The policies currently in place regarding substances do little to diminish their use but create a fear of repercussions, which may stop potential responders from acting. Additionally, with being ‘against the rules’, substance use is further stigmatized. Schools don’t need to be ‘pro-substance’, but they don’t need to be vehemently taking such strong actions against them.


So what actions can schools take to de-stigmatize substance use, without endorsing it? For one, instead of giving punishment to those involved with substance use, give help. If I’m kicked out of a university for smoking weed in my dorm, I’m not going to stop smoking weed. I’m more likely to stop going to college. If I was instead referred to a mental health professional or peer support advocate, we could work to get to the root of the problem: what is causing me to smoke weed? What can I do as an alternative to using substances? Or, maybe I’m not ready to stop smoking and need the information to use more safely. Not only will changing policies help to fight stigma, but they will also allow students to seek out the help they need. As stated by the Students for Sensible Drug Policy, we must push for “policy changes based on justice, liberty, compassion, and reason.”


However, a crucial part of reform away from punishment, towards progress is the accessibility of mental health professionals. Many schools like to preach that they have mental health professionals for students to use. This raises two questions: 1. Do you have enough mental health professionals? For instance, at Northwestern University, not only have I heard anecdotes of students reaching out to the university’s mental health system and being told they will have to wait for a long period of time, I have experienced it myself. It’s hard for a college student to seek mental health. But it’s crushing to seek mental health, and then be told that it’s not available at this time. Schools must invest more in their students, and hire more mental health professionals, so that help can be available for whomever, whenever it is needed. The rising availability and affordability of telehealth may also help alleviate some of these issues. Telehealth can make it easier for students and counselors to create appointments, as it eliminates travel times and doesn’t require an open office. Furthermore, Telehealth is readily available if counselors are invested in, and most insurances cover Telehealth. Support groups are also a realistic option for Telehealth, as stated by Sun Young Park: “Social support has been shown to address gaps in care; and with technology, it could be advanced by helping reduce the students’ burden in reaching out to others, enhance their relationships with support groups, and scale to wider support audiences.”


Secondly, if schools have enough mental health professionals, how do they ensure that they are used appropriately? For one, there may be a stigma around mental health on the campus, and it may be difficult for a student to take the step to seek mental health care because of a fear of appearing ‘weak’. Through campaigns (on campus and social media) normalizing the use of mental health professionals, encouragement of students to seek help, and emphasis on mental health as part of the university experience, colleges can work to make sure that students actually seek out the help they need. And with these measures, more students will be exposed to the concept of mental health support and will learn that they have access to mental health professionals, allowing them to seek them out. 


Stigma sucks. It turns opportunities for improvement and growth into vacuums of shame and judgment. However, students and universities can work together to eliminate stigma on college campuses, bettering the lives of all parties involved.  



Jacob Brown is a communications intern from Buffalo Grove, Illinois. He is a rising Junior at Northwestern University, studying economics and business institutions. In his free time, Jacob enjoys sports broadcasting and being involved in his fraternity.

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  • Michelle Augoustatos says:

    Thank you for writing this. As a mental health professional that strongly supports harm reduction, I applaud you for standing up and fighting the fight with us. We need everyone we can to understand the negative stigma around mental health and addiction. This was beautifully written and I appreciate your involvement.

  • peter moinichen says:

    SSDP heroically pushes for an end to the war on drugs. We are all in the dark about what is in the substances we choose to injest as long as prohibition rules the land. Check your drugs. Knowledge is life.

  • Thanks so much for writting this as this is a real probem on campuses. The stigma only makes it worse. The fear of the repucssions causes people to die. Knowing how to approach a friend you see in need to be rescued from addicting behaviors or depression could save thier life!

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