Strengthen Collegiate Recovery Programs

Introductory Paragraph

Recovery High Schools are secondary schools created specifically for students who are in recovery from a substance use disorder or co-occurring disorders. The purpose of recovery high schools is to offer students who are in recovery a safe place to earn their diploma while also focusing on their recovery. Just like other secondary schools, recovery high schools are staffed with teachers, counselors, support staff, administrators, and mental health professionals. The main difference between recovery high schools is that they provide students in recovery with the opportunity to separate themselves from situations and peers who might have impacted their prior use. Recovery high schools also provide opportunities for group therapy, meetings with addiction counselors, and an environment where they are encouraged to be open about their struggles.

Collegiate Recovery is a young, emerging, and quickly growing field. Yet, it is also more than a field - collegiate recovery is a profession, and it is a community. Collegiate recovery involves thousands of students across the country, their supporting staff mentors and allies, researchers learning more about recovery every day, and their collective experiences. Although the first collegiate recovery program started in the 1970s, the field as a whole is one that is young and blossoming. Collegiate recovery is anchored to the personal development of students in recovery and their communities, the prevention of substance use disorders and their related impacts, and the healing of the wounds that may have led to or resulted from maladaptive behaviors. All of this leads to ensuring that students impacted by addiction can access the full benefits of higher education without having to put their recovery at risk.

Key Information

Recovery High Schools

The first recovery high school was opened in the 1970s. However, recovery high schools did not gain a lot of traction or notoriety until roughly 2008. Today, there are approximately 45 recovery high schools across the nation, with this number increasing each year. Given the smaller nature and more involved education that recovery high schools offer, they tend to be more costly than traditional public high schools. Funding often comes from private donors, partnerships with other nonprofit organizations/agencies, and insurance. In some cases, state funding is available. Effectiveness statistics for recovery high schools are positive. Students who attend a recovery high school are much less likely to return to use compared to their peers who are either out of school or return back to a traditional high school.

Collegiate Recovery

The first collegiate recovery program emerged in 1977 at Brown University when a professor who was in recovery saw the need to help students find recovery as well. His title soon switched to “Dean of Chemical Dependency”, and he spent over 25 years serving students by helping them find counseling, meetings, offering non-clinical support, and academic advising. The next school to recognize the need for recovery support services was Rutgers, which in 1983, hired the school’s first ever Alcohol and Drug Counselor. This ultimately led to the opening of the first recovery house on a college campus in the world in 1988. In 1986 the Center for Collegiate Recovery Communities (CCRC) opened at Texas Tech. Their primary focus was conducting research, offering students' academic support, and providing a space for meetings. Texas Tech remains one of the strongest programs in the country. Later, in 1997, Augsburg University launched their StepUp program, which remains one of the largest collegiate recovery programs in the country. In the 2010's, Transforming Youth Recovery offered a grant program, and many new programs began to emerge. Today, there are over 250 communities and programs across the country. This reflects increasing traction in the collegiate recovery movement, but the unmet needs remain far greater:

• Less than 1% of community colleges and trade schools offer true recovery support for students.
• Less than 5% of four-year institutions offer collegiate recovery programs.
• Less than 1% of the 5% of universities with collegiate recovery, offer transitional living, recovery housing education programs, young adult IOPs, or treatment and education programs.

There is significant diversity in recovery support initiatives because of the unique culture, structure, and needs of each university. However, there are three major types of levels of collegiate recovery initiatives. These include collegiate recovery programs (CRP), collegiate recovery communities (CRC), recovery residency programs, and recovery support referral. Almost all collegiate recovery supports focus on peer support and sober social activities. Approximately one third of them include counseling or clinical support. The primary difference between a CRP and a CRC is that CRCs are often student-led and not always recognized or supported by the institution. These four types of recovery initiatives are described below.

CRP's are institutionally supported programs that provide safe, supportive learning environments for students in recovery from substance misuse or dependency, and often behavioral addictions and mental illness. Approximately 40% of university recovery support initiatives are CRPs. The primary components of CRPs include:

• Mutual aid support groups
• Physical space for students to gather
• Institutional acceptance and support of the CRP
• Staff, counselors, and/or student leaders
• Peers, recovery coaches, and/or counselors
• Social events and programming

CRC efforts are energized by students to create recovery-supportive learning environments at an institution of higher education. Approximately 60% of university recovery support initiatives identified as being a CRC. The key components of collegiate recovery communities are:

• Mutual aid support groups
• Students and/or other committed individuals who gather socially
• Peer recovery support

Collegiate Recovery Residency Programs offer recovery housing options for students in recovery enrolled at an institution of higher education. Recovery housing options differ from campus to campus. Some options include a building dedicated strictly to students in recovery and often have commitment requirements while others involve a sober living floor in a dorm building or a Living Learning Community framework. Approximately 10% of collegiate recovery initiatives also have a collegiate recovery residency program. Examples of these programs include:

• Rutgers
• Augsburg University
• Virginia Commonwealth University
• University of Houston

Recovery Support Referral. Colleges and universities that offer some level of substance misuse prevention services and referral-based recovery support resources for enrolled students. Approximately 30% of collegiate recovery initiatives include recovery support referrals. Although this level of support can differ widely from campus to campus, the key components of recovery support referrals are:

• Dedicated Alcohol and Other Drug (AOD) professional on staff
• Referrals to local treatment centers
• Continuum of care built into student conduct protocols

Best Practices and Common Practices

Each institution is unique, so best practices should be adapted to fit the needs of students. Generally speaking, the field of collegiate recovery recommends the following:

• Dedicated space on campus
• Dedicated staff
• Institutional financial support

Additionally, the following are common practices in many different types of programs and communities:

• Sober social activities
• Advocacy efforts for student needs
• Awareness events
• Mutual aid meetings (of any kind)
• Conference attendance
• Peer mentoring
• Registered student organizations
• Academic advisement and/or early registration
• Educational and training opportunities
• Service opportunities
• Recovery ally training
• Counseling
• Career readiness

Relevant Research

Recovery High Schools

• Data from Monitoring the Future indicates that teen drug and alcohol use continues to decline, but that the statistics are still alarming.

• A study titled "Recovery High Schools: A Descriptive Study of School Programs and Students" documents the higher effectiveness of recovery schools in preventing return to use than traditional schools.

Collegiate Recovery

• This article summarizes a research survey of almost 500 college students at 29 CRPs. One third of the students reported they would not be in college were it not for a CRP, and 20% would not be at their current institution.

• This article documents research findings that indicate that students in recovery-ready universities who are engaged in recovery initiatives have had better outcomes than the average of their student body regarding GPA, retention, and graduation rates. Additionally, students who feel accepted enough to be open about their recovery often take leadership positions in student government and student wellness organizations, and that they have increased employment opportunities. Further, collegiate recovery initiatives effective model peer-led recovery support for communities that are served by the campus, and these collegiate recovery promotes continued residence by students in recovery to stay in those communities as active citizens.

• This article reviews the literature supporting the need for the expansion of CRPs, presents information on the diversity of CRP services, and outline key areas where research is needed.

Impactful Federal, State, and Local Policies

Comprehensive Addiction and Recovery Act of 2016 (CARA 2.0)

This is the first major federal addiction legislation in 40 years and the most comprehensive effort undertaken to address the opioid epidemic. It encompasses all six pillars necessary for such a coordinated response – prevention, treatment, recovery, law enforcement, criminal justice reform, and overdose reversal. While it authorizes over $181 million each year in new funding to fight the opioid epidemic, monies must be appropriated every year through the regular appropriations process in order for it to be distributed in accordance with the law.

State Policies on Recovery High Schools

• New Jersey -- Senate Bill No. 2058 (216th Legislature, 2014) authorizes establishment of three pilot recovery alternative high schools that provide high school education and a substance dependency plan of recovery to test the effectiveness of this model.

• Rhode Island -- The Recovery High Schools Act (2013 General Laws, Title 16 - Education, Chapter 16-95) authorizes the creation of a pilot recovery high school for the purposes of demonstrating the effectiveness of this model in Rhode Island.

State Policies on Collegiate Recovery

• New Jersey -- In 2015, a bill was passed that required campuses to implement a sober living option within four years if at least 25 percent of the student body lives on campus.

Available Tools and Resources

• American College Health Assocation (ACHA): National College Health Assessment 2022 We often cite the statistic that 2.2% of all college students identify in recovery. Find that datapoint on page 36 of this document alongside a breadth and depth of additional student health data. If your campus participates in this survey, please use your data instead.

• Collegiate Recovery Community Replication Model - Mississippi State University Collegiate recovery programs are incredibly diverse (and increasingly so). These resources, and the next one, provide some context for how large southern campuses have established their programs. “The Collegiate Recovery Community offers comprehensive support services for recovering students by embracing a wellness approach. Choosing to focus on recovery enhancement as the best way to prevent recurrence of use allows the CRC to provide the programs and initiatives needed to enhance a student's recovery program. The following information is intended to assist partners in this recovery work.

• Inside Higher Ed (IHE): Students Are Learning to Stop Opioid Overdoses “As concerns grow over the presence of fentanyl and other opiates on campus, more colleges and universities are making the overdose-reversal drug naloxone widely available.” This article shares a number of perspectives from folks doing this work on campus

• The Association of Recovery in Higher Education (ARHE) represents CRPs and CRCs, the students involved, and the faculty and staff who support them. ARHE provides the education, resources, and community connection needed to help change the trajectory of the lives of college students in recovery.

• The Association of Recovery Schools (ARS) is the only association exclusively representing recovery high schools. ARS supports and inspires recovery high schools to achieve optimum performance. It empowers every student in recovery, providing hope and access to services. ARS offers technical assistance, accreditation, and support to members.

• The National Center on Safe and Supportive Learning Environments. This is a useful transcript of a Q&A session following a webinar titled "Supporting Recovery and Building Resilience on Campus: The Role of Collegiate Recovery Programs

• SAFE Project Campuses Initiative. SAFE Campuses is one of the six lines of operation at SAFE Project. The SAFE Campuses initiative aims to normalize recovery on every campus in the country. SAFE Campuses offers a variety of programs. It advocates for recovery support services, provides educational opportunities for collegiate staff and administrators, and collects data to strengthen the field of collegiate recovery. SAFE Campuses also promotes leadership opportunities for students in recovery. SAFE Campuses collects meaningful metrics that contribute to the knowledge base through the Collegiate Recovery Census Project. To learn more about collegiate recovery as a field or to contribute information about your university, please visit the SAFE Project Census page.

• SAFE Project. Making the Case: Fostering buy-in for recovery support. A slideshow from 2022 Summer Series that summarizes approaches to collegiate recovery advocacy among professionals and potential partners. This serves a similar role as the week 3 worksheet in the 2023 Summer Series.

• SAFE Project. Tools Over Fear”: Lessons Learned from Campuses Navigating the Fentanyl & Overdose Crisis. In this slideshow delivered at the 2023 NASPA Annual Meeting, the SAFE Campuses team summarized themes and outcomes from providing technical assistance to students and staff seeking to implement harm reduction measures across the country.

• SAFE Project. Recovery Allyship Training Slides. This slide deck has been developed at SAFE Project since 2019 with a strong focus on stigma reduction and understanding recovery inclusion. This training can be implemented on any campus, and our team is willing to collaborate on “Training of Trainers” and co-branding these resources.

• SAFE Project. Support Not Stigma.This slideshow was presented by the SAFE Campuses team at the 2023 NASPA Annual Meeting. The session covered the history of recovery ally trainings around the country, provided a content preview, shared the impact of these sessions, and gave implementation resources/strategy.

• SAFE Project. Webinar: Supporting Harm Reduction: MJ Jorgensen and Brandi Drtina. In this webinar, as part of the SAFE Project Collegiate Recovery Leadership Academy Webinar Series, community harm reduction experts share their experiences and perspectives on the value and use of harm reduction as an approach and set of tools

• SAFE Project. Where are the students: Students, Outreach & Recruitment. A slideshow from summer of 2022 that summarizes the tensions, barriers, and approaches related to student engagement with collegiate recovery initiatives.

• SAMHSA's Directory of Single State Agencies for Substance Abuse Services. SAMHSA is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities. Every state has a designated Single State Agency (SSA) that oversees federal grant applications for programs that aim to prevent, treat, and rehabilitate those with substance use disorders. The state-by-state directory of agencies provides essential contact information.

• Substance Use Disorder, Collegiate Recovery, & Student Accommodations - SAFE Project + AHEAD This slideshow, presented as part of the 2021 Association on Higher Education and Disability’s Fall Webinar Series, overviewed the relationship between disability law, substance use disorder, recovery, and student accommodations.

• The Texas Tech Guide. As one of the pioneers in the collegiate recovery field, Texas Tech is a model for what many CRCs and CRPs can look like. Texas Tech created a Collegiate Recovery Communities Curriculum for campuses who are interested in replicating their model.

• UC Davis Health: Can fentanyl be absorbed through your skin?. “UC Davis Health toxicology expert dispels myths around fentanyl exposure”

• University Health Services (UHS) at UC Berkeley Health Promotion Department: The Party Safe Toolkit. Summary: “PartySafe@Cal is dedicated to creating an alcohol and other drugs (AOD) culture at UC Berkeley that supports the well-being of all who live, study, work and play in the campus area. We strive to engage, educate and motivate stakeholders (that’s you!) to: Put well-being, safety, harm reduction, and equity at the center of alcohol and other drug choices, Recognize and respect that many chose not to use alcohol and other drugs, Ask all users and social/retail providers to do so in mindful and low-risk ways and situations, Support noticing problematic behaviors and situations and addressing them in timely, effective, and compassionate ways. We hope this Toolkit assists you play your unique role in our community.”

• Young People in Recovery (YPR) envisions a world where all young people have the resources they need to thrive in recovery from addiction to drugs and alcohol. YPR’s mission is to provide the life skills and peer support to help people recover from substance use disorder and reach their full potential.

Promising Practices

• North Carolina In 2015, The NC Department of Health and Human Service’s Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH) initially began using $750,000 in annual Substance Abuse Prevention and Treatment Block Grant funds to offer support to six campuses: University of North Carolina at Charlotte, Chapel Hill, Wilmington, and Greensboro, North Carolina A&T University and East Carolina University. Each campus initially received $125,000 annually to aid education, prevention and recovery efforts. As the pilot programs became more self-sustainable, funds were reallocated to add Appalachian State University, North Carolina State University and North Carolina Central University to the program.

• West Virginia: In 2019, the Alliance for Economic Development of Southern West Virginia was awarded roughly $321,000 by the West Virginia Department of Health and Human Services to establish a Southern West Virginia Collegiate Peer Recovery Network, offering peer recovery support services on seven higher education campuses (Bridge Valley Community and Technology College, Bluefield State College, Concord University, Marshall University, Southern West Virginia Community and Technical College, the West Virginia School of Osteopathic Medicine, and West Virginia State University).

• Virginia. In 2019, the Virginia Department of Behavioral Health and Developmental Services (DBHDS) awarded $675,000 of federal State Opioid Response (SOR) grant funding to Virginia Commonwealth University (VCU) to help expand substance use recovery programs at eight universities across the state.

Every campus is unique with differing needs, resources, and student desires. It is important to keep this in mind when developing recovery programming because there is no “one size fits all” when it comes to supporting students in recovery. While there is no template that fits the needs of every campus, below is a diverse list of campuses who have each approached collegiate recovery from a different lens and have found success in distinguishing ways.

• Auraria Recovery Community is a coalition serving students at three different institutions in the Denver area (University of Colorado Denver, Metropolitan State University of Denver, and Community College of Denver).

• Baylor and Saint Joseph's University are examples of faith-based, private institutions serving students in recovery.

• North Carolina A&T State University is the largest HBCU.

• Northampton Community College is a community college serving students in recovery.

• The Ohio State University and University of Michigan are examples of very large public institutions serving students in recovery.