College is a time of academic discovery and exploration. For many of the 16.8 million students enrolled at America’s two- and four-year degree programs each year, the university experience promotes academic growth, fosters new friendships, and expands understanding of a world outside the home environment. Approximately 75% of students attend four-year residential colleges and universities full time, which means the majority of these young adults are living away from home for the first time. In popular culture, the American college experience almost always includes drug or alcohol misuse as a rite of passage. However, despite the widespread use of alcohol and drugs in movies and television shows set on college campuses, these media reinforce a false narrative, especially when it comes to drug use. While almost 75% of college students report consuming alcohol at least once while in high school, drug use among college students tends to start while in college. For savvy prevention professionals, the campus environment offers a unique opportunity to prevent the initiation of drug use among college students, the consequences of which can be long-lasting and devastating.

Students often cite four main reasons that college campuses provide a rich environment for drug experimentation: (1) ease of drug availability, (2) lack of parental influence, (3) normalization of drug use among peers, and (4) low perceived risk of harm from drug use. However, for college students who engage in drug use, the personal and academic costs can be high, even more for drug use than for alcohol use, leading to gaps in enrolment, prolonged time to graduation, and even failure to graduate. Numerous studies have found an inverse relationship between consuming drugs intended to treat attention deficit and hyperactivity disorders (ADHD) (e.g., Adderall and Ritalin) as study aids and academic success. In other words, nonmedical use of prescription stimulants does not improve academic performance. For a small minority of students, college drug experimentation leads to lifelong struggles with addiction.

Although the prevention field has spent the last 25 years understanding the complex nature of alcohol misuse on college campuses and creating campus-wide interventions, drug use remains, for many college health and wellness professionals, an individual issue, despite emerging evidence that the college environment contributes to the initiation of drug use for the majority of college drug users.7 College is the ideal setting for innovative, campus-wide programming aimed at preventing and reducing drug use among college students, but these efforts remain few and far between. This guide is intended to bridge that gap, by providing a road map for university prevention professionals to collaborate with a wide range of stakeholders, from students to administrators, to address campus-wide drug misuse issues. We use the Strategic Prevention Framework (SPF) here as the “how to” for systematically measuring the scope of drug misuse issues, building relationships with key stakeholders, and planning and implementing a drug misuse prevention effort. Developed by the Substance Abuse and Mental Health Services Administration in 2004, the SPF is evidence based, widely used, and easily adaptable for multiple health issues.