Difference between revisions of "Strengthen Collegiate Recovery Programs"

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= Introductory Paragraph =
= 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 an 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, and researchers learning more about recovery every day. Although the first collegiate recovery program started in the 1970s, the field as a whole is still 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 substance use can access the full benefits of higher education without having to put their recovery at risk.
 
'''Collegiate Recovery''' is a field, profession, and 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 =
= Key Information =


'''Recovery High Schools'''
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&nbsp;“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 Alcohol and Drug Counselor. This 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 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: <ref>https://www.yoursafesolutions.us/backups/Collegiate-Recovery-Census-2017.pdf</ref> 
 
* Less than 1% of community colleges and trade schools offer true recovery support for students.  
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. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629137/</ref>
 
'''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&nbsp;“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.<ref>https://www.transformingyouthrecovery.org/research/2017-census-and-definitions-for-recovery-support-in-higher-education/</ref>
* Less than 5% of four-year institutions offer collegiate recovery programs.  
* 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.
* 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 among recovery support programs and 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), 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. There is significant diversity in recovery support initiatives because of the unique culture, structure, and needs of each university. However, there are four general types, or levels, of collegiate recovery initiatives. These include collegiate recovery programs (CRP), collegiate recovery communities (CRC), recovery residency programs, and recovery support referral. 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:
'''''CRP's''''' are institutionally supported programs that provide safe, supportive learning environments for students in recovery, either from substance use or behavioral health disorders. Approximately 40% of university recovery support initiatives are CRPs. The primary components of CRPs include:


*Mutual aid support groups  
*Mutual aid support groups  
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*Institutional acceptance and support of the CRP  
*Institutional acceptance and support of the CRP  
*Staff, counselors, and/or student leaders  
*Staff, counselors, and/or student leaders  
*Peers, recovery coaches, and/or counselors for recovery support
*Peers, recovery coaches, and/or counselors  
*Social events and programming   
*Social events and programming   


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


*Mutual aid support groups  
*Mutual aid support groups  
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*Peer recovery support  
*Peer recovery support  


'''''Recovery support referral: '''''Colleges and universities that offer some level of substance misuse prevention services and referral-based recovery support resources for enrolled students. Although this level of support can differ widely from campus to campus, the key components of recovery support referrals are:
'''''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:
*Dedicated Alcohol and Other Drug (AOD) professional on staff
*Referrals to local treatment centers
*Continuum of care built into student conduct protocols
 
*As of 2017, 28.3% of collegiate recovery initiatives included recovery support referrals.
 
Collegiate recovery residency programs: Collegiate recovery programs that offer recovery housing options for students in recovery enrolled at an institution of higher education. Examples of these programs include:


*Rutgers  
*Rutgers  
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*University of Houston  
*University of Houston  


Take note that 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.
'''''Recovery Support Referral.''''' Colleges and universities commonly 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:
*As of 2017, 11% of collegiate recovery initiatives also have a collegiate recovery residency program.
 
*Dedicated Alcohol and Other Drug (AOD) professional on staff
*Referrals to local treatment centers
*Continuum of care built into student conduct protocols
 
'''Best Practices'''


''Best 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:
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 space on campus  
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*Institutional financial support  
*Institutional financial support  


''Common Practices:''<br/> In addition to the above, the following are common in many different types of programs and communities:
Additionally, the following are common practices in many different types of programs and communities:


*Sober social activities  
*Sober social activities  
*Advocacy efforts for student needs  
*Advocacy efforts for student needs  
*Awareness events  
*Awareness events  
*Mutual aid meetings (of any kind)
*Mutual aid meetings  
*Conference attendance  
*Conference attendance  
*Peer mentoring  
*Peer mentoring  
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*Recovery ally training  
*Recovery ally training  
*Counseling  
*Counseling  
*Career readiness  
*Career readiness


*As of 2017<ref>https://www.transformingyouthrecovery.org/research/2017-census-and-definitions-for-recovery-support-in-higher-education/</ref>, 87.4% of collegiate recovery supports focus on peer support, 74.0% focus on social activities and sober fun, and 34.7% focus on counseling or clinical support.
= Relevant Research =


= Relevant Research =
* 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. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852860/</ref>


For those who have experienced addiction and pursue the promise of higher education, universities that are recovery-ready have found that <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952555/#R37</ref>these students have greater outcomes than the average of their student body<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952555/#R37</ref> regarding GPA, retention, and graduation rates. Further, research has indicated that students who feel accepted enough to be open about their recovery often take leadership<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952555/#R37</ref> positions among student government, student wellness organizations, and employment opportunities. Then, in turn, collegiate recovery can model effective peer-led recovery support for communities in which they serve and even encourage students in recovery to stay in those communities as active citizens and/or pursue further education.
* This article documents research findings which 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 have increased employment opportunities. Further, collegiate recovery initiatives effective model peer-led recovery support for communities served by the campus, and these collegiate recovery promotes continued residence by students in recovery to stay in those communities as active citizens. <ref>https://www.tandfonline.com/doi/abs/10.1080/15560350802080951</ref>


''Recent Studies:'' In college and in recovery: Reasons for joining a Collegiate Recovery Program<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852860/</ref><br/> Collegiate Recovery Communities Programs: What do we know and what do we need to know?<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952555/</ref><br/> Supporting Recovery and Building Resilience on Campus: The Role of Collegiate Recovery Programs <ref>https://safesupportivelearning.ed.gov/sites/default/files/FINAL%20IHE%20Webinar_QA%20Doc_3.28.19%20(1).pdf</ref>
* 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. <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952555/</ref>


Collegiate recovery is a young, emerging, and quickly growing field. At SAFE Project we are committed to contributing to the knowledge base through the Collegiate Recovery Census Project. To learn more about collegiate recovery as a field and/or contributing information about your university, please visit SAFE Project <ref> https://www.safeproject.us/census/</ref>.
= Impactful Federal, State, and Local Policies =


'''Relevant Research Recovery High Schools''' Teen drug and alcohol use continue to decline, but numbers still alarming<ref>https://www.drugabuse.gov/drug-topics/trends-statistics/infographics/monitoring-future-2019-survey-results-overall-findings</ref>
'''Comprehensive Addiction and Recovery Act of 2016 (CARA 2.0)''' <ref>https://www.congress.gov/bill/114th-congress/senate-bill/524/text</ref>


Teen Drug Use: Monitoring the Future 2019
This is the first major federal substance use 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.


Recovery high schools prove to be more effective in preventing return to use than traditional schools <ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629137/</ref> Recovery High Schools: A Descriptive Study of School Programs and Students
'''State Policies on Collegiate Recovery'''


= Impactful Federal, State, and Local Policies =
* 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.


'''Federal Policy'''<br/> &nbsp;<br/> '''''Comprehensive Addiction and Recovery Act of 2016(CARA 2.0)'''''<ref>https://www.cadca.org/comprehensive-addiction-and-recovery-act-cara</ref><br/> On July 22, 2016, President Obama signed into law the Comprehensive Addiction and Recovery Act (P.L. 114-198).<ref>https://www.congress.gov/bill/114th-congress/senate-bill/524/text</ref> This is the first major federal addiction legislation in 40 years and the most comprehensive effort undertaken to address the opioid epidemic, encompassing 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 processin order for it to be distributed in accordance with the law.<br/> &nbsp;<br/> Both the U.S. Department of Education and the Office of National Drug Control Policy have, in the past, endorsed expansion of recovery support services in academic settings and said they should be a priority.<br/> &nbsp;<br/> '''State Policy Collegiate Programs'''
= Available Tools and Resources =


''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.<br/> &nbsp;<br/> ''Virginia:&nbsp;''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.<br/> &nbsp;<br/> ''North Carolina:'' <ref>https://www.ncdhhs.gov/blog/2019-09-23/dhhs-supports-students-recovery-substance-misuse</ref>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<ref>https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-abuse/grants/substance-abuse-prevention-and-treatment-block-grant</ref> 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.<br/> &nbsp;<br/> ''West Virginia:&nbsp;''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&nbsp;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).<br/> &nbsp;<br/> '''State Policy Recovery High Schools'''<br/> &nbsp;<br/> Senate, No. 2058, State of New Jersey, 216th Legislature, Introduced May 5, 2014<br/> Authorizes establishment of three pilot recovery alternative high schools that provide high school education and substance dependency plan of recovery to test the effectiveness of this model.<br/> &nbsp;<br/> 2013 Rhode Island General Laws, Title 16 - Education, Chapter 16-95 - The Recovery High Schools Act<br/> Authorizes the creation of a pilot recovery high school for the purposes of demonstrating the effectiveness of this model in Rhode Island.
*'''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 use 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. <ref>https://www.samhsa.gov/sites/default/files/ssa_directory_12-03-2018_final_508.pdf</ref>


= Available Tools and Resources =
*'''The Association of Recovery in Higher Education (ARHE)''' represents CRPs and CRCs, the students involved, and the faculty and staff who support them. <ref>https://collegiaterecovery.org/</ref> ARHE provides the education, resources, and community connection needed to help change the trajectory of the lives of college students in recovery. It also offers "The Best Practices Guide" which is intended to help start planning processes. Since every campus has its own unique culture, this document is not a step-by-step how-to guide, but rather something every school can adapt in its own way to meet the needs of their students. <ref>https://collegiaterecovery.org/wp-content/uploads/2021/08/Collegiate-Recovery-Best-Practice-Guide.pdf</ref>


'''SAFE Project’s SAFE Campuses Initiative''' SAFE Project was founded in November 2017 by Admiral James and Mary Winnefeld, following the loss of their 19-year-old son Jonathan to an accidental opioid overdose. SAFE seeks meaningful metrics that strengthen our interdependent six lines of operation, and ultimately aim to achieve The SAFE Campuses initiative aims to normalize recovery on every campus in the country. They do this through a variety of programs that focus on advocating for recovery support services, providing educational opportunities for collegiate staff and administrators, collecting data to strengthen the field of collegiate recovery, and offering students in recovery leadership opportunities.
*'''American College Health Association (ACHA)''' publishes the National College Health Assessment annually. It indicates that 2.2% of all college students identify as being in recovery. <ref>https://www.acha.org/documents/ncha/NCHA-III_FALL_2022_REFERENCE_GROUP_DATA_REPORT.pdf</ref>


'''Association of Recovery in Higher Education (ARHE)'''
*'''SAFE Project.''' SAFE Campuses is one of the six lines of operation at SAFE Project. It aspires to normalize recovery on every campus in the country. SAFE Campuses offers a variety of programs, 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 and collects meaningful metrics which 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. <ref>https://www.safeproject.us/census/</ref> The following are examples of available resources:
**"Recovery Allyship Training." This slide deck provides 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.  <ref>https://www.canva.com/design/DAFQ0qNAhto/QpTNSLfudJs5rXOf-A-kOg/view?utm_content=DAFQ0qNAhto&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink</ref>
**"Supporting Harm Reduction: This webinar is part of the SAFE Project Collegiate Recovery Leadership Academy Webinar Series. Community harm reduction experts, MJ Jorgensen and Brandi Drtina, share their experiences and perspectives on the value and use of harm reduction as an approach and set of tools. <ref>https://www.youtube.com/watch?v=cub0vd0dU7Y</ref>
**"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 and strategies. <ref>https://www.canva.com/design/DAFdMYgYX1I/cWIHQhyaXJqdFbyk8oSBVQ/view</ref>
**"Where Are the Students?" A slideshow summarizing the tensions, barriers, and approaches related to student engagement with collegiate recovery initiatives. <ref>https://www.canva.com/design/DAFCUn0slNE/SEiSodRZ-kJJRXiqWk7zhw/view</ref>
** "Making the Case: Fostering Buy-in for Recovery Support." This slideshow summarizes approaches to collegiate recovery advocacy among professionals and potential partners. <ref>https://www.canva.com/design/DAFCUnEqJUA/2coDbLD5LNwF-SngErzuew/view?utm_content=DAFCUnEqJUA&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink</ref>
**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. <ref>https://www.canva.com/design/DAFd3JKSgYU/-3pnegV7b2kQ4w-PIBYcLA/view</ref>
**"Substance Use Disorder, Collegiate Recovery, & Student Accommodations." This slideshow, presented as part of the 2021 ARHE Fall Webinar Series, overviewed the relationship between disability law, substance use disorder, recovery, and student accommodations. <ref>https://www.canva.com/design/DAEsFbVT9sk/-l7kCdukKVWPrXr2fXq4PA/view?utm_content=DAEsFbVT9sk&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink#1</ref>


<ref>https://collegiaterecovery.org/</ref> is the association that represents collegiate recovery programs (CRPs) and communities (CRCs), the faculty and staff who support them, and the students who represent them. The Association of Recovery in Higher Education provides the education, resources, and community connection needed to help change the trajectory of recovering student’s lives.
*'''Inside Higher Ed (IHE)''' published "Students Are Learning to Stop Opioid Overdoses." This article shares a number of perspectives from colleges and universities making the overdose-reversal drug Naloxone widely available to counter the the rise of Fentanyl and other opiates. <ref>https://www.insidehighered.com/news/2022/08/15/narcan-increasingly-common-college-campuses</ref>  


'''Young People in Recovery (YPR)''' <ref>https://youngpeopleinrecovery.org/</ref> 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.
* '''The National Center on Safe and Supportive Learning Environments.''' This is a transcript of a Q&A session following a webinar titled "Supporting Recovery and Building Resilience on Campus: The Role of Collegiate Recovery Programs."  <ref>https://safesupportivelearning.ed.gov/sites/default/files/FINAL%20IHE%20Webinar_QA%20Doc_3.28.19%20(1).pdf</ref>


'''Texas Tech’s Guide''' As one of the pioneers in the collegiate recovery field, Texas Tech is a model for what many Collegiate Recovery Communities and Programs can look like. In recent years Texas Tech created a Collegiate Recovery Communities Curriculum > for campuses who are interested in replicating their model. <ref>https://www.depts.ttu.edu/hs/csa/replication.php</ref>
*'''Florida State University''' The All-Recovery Meeting holds a ”Self-Healers Book Club” based on a curriculum from the book "How To Do The Work" by Dr. Nicole LePera, a clinical psychologist. The text offers readers the support and tools that will allow them to break free from destructive behaviors to reclaim and recreate their lives. Nothing short of a paradigm shift, this is a celebration of empowerment that will change the way we approach mental wellness and self-care. <ref>https://drive.google.com/file/d/1uGHfCUm0Lgn6MW-N4H83AGZr6Mf3_I88/view</ref> The FSU Center for Health Advocacy & Wellness created Recovery Bingo, an activity used to build community in the CRC/P and as an outreach activity with student orgs across campus. <ref>Cryderman, Jacob. J, Thompson, Zabe., Shore, C.D., Gundrum, G., Gomez, M., (2023, March 8th – 10th). Alcohol and Other Drugs Bingo: Gamifying Health Education [Presentation – Breakout Session]. 2023 Southern College Health Association Annual Meeting in Greenville, North Carolina, United States of America. retrieved at https://drive.google.com/file/d/1srLJKBqlshPADuOHBu2Rw1WLDmFKlmEx/view</ref>


'''SAMHSA''' https://www.samhsa.gov/ 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.</span></span></span></span></span>
*'''Mississippi State University'''provides the "Collegiate Recovery Community Replication Model." Since collegiate recovery programs are incredibly diverse, this provides context for how large southern campuses have established their programs. The model 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 equips the CRC to enhance a student's recovery.<ref>https://drive.google.com/file/d/1ifTnN6Ffd0ZkXaCpvMwP3I4TPpN44mT2/view</ref>  


'''Single State Agencies (SSA)''' Every state has a designated Single State Agency that oversees federal grant applications for programs that aim to prevent, treat, and rehabilitate those with substance use disorders. Below is a state-by-state directory of agencies.  
*'''Texas Tech''' is one of the pioneers in the collegiate recovery field and is a model for what many CRCs and CRPs can look like. Texas Tech created the "Collegiate Recovery Communities Curriculum" for campuses who are interested in replicating their model. <ref>https://www.depts.ttu.edu/hs/csa/replication.php</ref>


http://samhsa.gov/sites/default/files/ssa_directory_12-03-2018_final_508.pdf
*'''UC Berkeley.''' University Health Services (UHS) at the Health Promotion Department offers the Party Safe Toolkit." 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. It strives to engage, educate and motivate stakeholders to:
Directory of Single State Agencies for Substance Abuse Services
**Put well-being, safety, harm reduction, and equity at the center of alcohol and other drug choices
<ref>https://www.samhsa.gov/sites/default/files/ssa_directory_12-03-2018_final_508.pdf</ref>
**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
**Support noticing problematic behaviors and situations and addressing them in timely, effective, and compassionate ways.  <ref>https://uhs.berkeley.edu/sites/default/files/partysafe_toolkit.pdf</ref>


'''The Association of Recovery Schools (ARS)''' <ref>https://recoveryschools.org/</ref> is the only association exclusively representing recovery high schools while supporting and inspiring recovery high schools for optimum performance, empowering hope and access to every student in recovery. ARS offers technical assistance, accreditation, and support to members.
*'''UC Davis Health''' published "Can fentanyl be absorbed through your skin?“ in which a toxicology expert dispels myths around fentanyl exposure. <ref>https://health.ucdavis.edu/news/headlines/can-fentanyl-be-absorbed-through-your-skin/2022/10</ref>


= Promising Practices =
= 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) 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. <ref>https://www.ncdhhs.gov/blog/2019-09-23/dhhs-supports-students-recovery-substance-misuse</ref>
* '''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.
* '''West Virginia.''' In 2019, the Alliance for Economic Development of Southern West Virginia was awarded $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).


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.
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''' 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). <ref>https://www.aurariarecoverycommunity.com/</ref>
*'''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). <ref>https://www.aurariarecoverycommunity.com/</ref>


*'''Baylor and Saint Joseph's University''' are examples of faith-based, private institutions serving students in recovery. <ref>https://www.baylor.edu/barc/</ref>
*'''Baylor and Saint Joseph's University''' are examples of faith-based, private institutions serving students in recovery. <ref>https://www.baylor.edu/barc/</ref>

Latest revision as of 09:59, 25 September 2024

Introductory Paragraph

Collegiate Recovery is an 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, and researchers learning more about recovery every day. Although the first collegiate recovery program started in the 1970s, the field as a whole is still 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 substance use can access the full benefits of higher education without having to put their recovery at risk.

Key Information

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 Alcohol and Drug Counselor. This 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 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: [1]

  • 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.

Almost all collegiate recovery supports focus on peer support and sober social activities. Approximately one third of them include counseling or clinical support. There is significant diversity in recovery support initiatives because of the unique culture, structure, and needs of each university. However, there are four general types, or levels, of collegiate recovery initiatives. These include collegiate recovery programs (CRP), collegiate recovery communities (CRC), recovery residency programs, and recovery support referral. 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, either from substance use or behavioral health disorders. 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 identify 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 commonly 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

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
  • 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

  • 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. [2]
  • This article documents research findings which 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 have increased employment opportunities. Further, collegiate recovery initiatives effective model peer-led recovery support for communities served by the campus, and these collegiate recovery promotes continued residence by students in recovery to stay in those communities as active citizens. [3]
  • 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. [4]

Impactful Federal, State, and Local Policies

Comprehensive Addiction and Recovery Act of 2016 (CARA 2.0) [5]

This is the first major federal substance use 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 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

  • 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 use 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. [6]
  • The Association of Recovery in Higher Education (ARHE) represents CRPs and CRCs, the students involved, and the faculty and staff who support them. [7] ARHE provides the education, resources, and community connection needed to help change the trajectory of the lives of college students in recovery. It also offers "The Best Practices Guide" which is intended to help start planning processes. Since every campus has its own unique culture, this document is not a step-by-step how-to guide, but rather something every school can adapt in its own way to meet the needs of their students. [8]
  • American College Health Association (ACHA) publishes the National College Health Assessment annually. It indicates that 2.2% of all college students identify as being in recovery. [9]
  • SAFE Project. SAFE Campuses is one of the six lines of operation at SAFE Project. It aspires to normalize recovery on every campus in the country. SAFE Campuses offers a variety of programs, 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 and collects meaningful metrics which 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. [10] The following are examples of available resources:
    • "Recovery Allyship Training." This slide deck provides 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. [11]
    • "Supporting Harm Reduction: This webinar is part of the SAFE Project Collegiate Recovery Leadership Academy Webinar Series. Community harm reduction experts, MJ Jorgensen and Brandi Drtina, share their experiences and perspectives on the value and use of harm reduction as an approach and set of tools. [12]
    • "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 and strategies. [13]
    • "Where Are the Students?" A slideshow summarizing the tensions, barriers, and approaches related to student engagement with collegiate recovery initiatives. [14]
    • "Making the Case: Fostering Buy-in for Recovery Support." This slideshow summarizes approaches to collegiate recovery advocacy among professionals and potential partners. [15]
    • 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. [16]
    • "Substance Use Disorder, Collegiate Recovery, & Student Accommodations." This slideshow, presented as part of the 2021 ARHE Fall Webinar Series, overviewed the relationship between disability law, substance use disorder, recovery, and student accommodations. [17]
  • Inside Higher Ed (IHE) published "Students Are Learning to Stop Opioid Overdoses." This article shares a number of perspectives from colleges and universities making the overdose-reversal drug Naloxone widely available to counter the the rise of Fentanyl and other opiates. [18]
  • The National Center on Safe and Supportive Learning Environments. This is a transcript of a Q&A session following a webinar titled "Supporting Recovery and Building Resilience on Campus: The Role of Collegiate Recovery Programs." [19]
  • Florida State University The All-Recovery Meeting holds a ”Self-Healers Book Club” based on a curriculum from the book "How To Do The Work" by Dr. Nicole LePera, a clinical psychologist. The text offers readers the support and tools that will allow them to break free from destructive behaviors to reclaim and recreate their lives. Nothing short of a paradigm shift, this is a celebration of empowerment that will change the way we approach mental wellness and self-care. [20] The FSU Center for Health Advocacy & Wellness created Recovery Bingo, an activity used to build community in the CRC/P and as an outreach activity with student orgs across campus. [21]
  • Mississippi State Universityprovides the "Collegiate Recovery Community Replication Model." Since collegiate recovery programs are incredibly diverse, this provides context for how large southern campuses have established their programs. The model 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 equips the CRC to enhance a student's recovery.[22]
  • Texas Tech is one of the pioneers in the collegiate recovery field and is a model for what many CRCs and CRPs can look like. Texas Tech created the "Collegiate Recovery Communities Curriculum" for campuses who are interested in replicating their model. [23]
  • UC Berkeley. University Health Services (UHS) at the Health Promotion Department offers the Party Safe Toolkit." 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. It strives to engage, educate and motivate stakeholders 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
    • Support noticing problematic behaviors and situations and addressing them in timely, effective, and compassionate ways. [24]
  • UC Davis Health published "Can fentanyl be absorbed through your skin?“ in which a toxicology expert dispels myths around fentanyl exposure. [25]

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) 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. [26]
  • 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.
  • West Virginia. In 2019, the Alliance for Economic Development of Southern West Virginia was awarded $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).

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). [27]
  • Baylor and Saint Joseph's University are examples of faith-based, private institutions serving students in recovery. [28]
  • North Carolina A&T State University is the largest HBCU. [29]
  • Northampton Community College is a community college serving students in recovery. [30]
  • The Ohio State University and University of Michigan are examples of very large public institutions serving students in recovery. [31] [32]

Sources

  1. ↑ https://www.yoursafesolutions.us/backups/Collegiate-Recovery-Census-2017.pdf
  2. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852860/
  3. ↑ https://www.tandfonline.com/doi/abs/10.1080/15560350802080951
  4. ↑ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952555/
  5. ↑ https://www.congress.gov/bill/114th-congress/senate-bill/524/text
  6. ↑ https://www.samhsa.gov/sites/default/files/ssa_directory_12-03-2018_final_508.pdf
  7. ↑ https://collegiaterecovery.org/
  8. ↑ https://collegiaterecovery.org/wp-content/uploads/2021/08/Collegiate-Recovery-Best-Practice-Guide.pdf
  9. ↑ https://www.acha.org/documents/ncha/NCHA-III_FALL_2022_REFERENCE_GROUP_DATA_REPORT.pdf
  10. ↑ https://www.safeproject.us/census/
  11. ↑ https://www.canva.com/design/DAFQ0qNAhto/QpTNSLfudJs5rXOf-A-kOg/view?utm_content=DAFQ0qNAhto&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink
  12. ↑ https://www.youtube.com/watch?v=cub0vd0dU7Y
  13. ↑ https://www.canva.com/design/DAFdMYgYX1I/cWIHQhyaXJqdFbyk8oSBVQ/view
  14. ↑ https://www.canva.com/design/DAFCUn0slNE/SEiSodRZ-kJJRXiqWk7zhw/view
  15. ↑ https://www.canva.com/design/DAFCUnEqJUA/2coDbLD5LNwF-SngErzuew/view?utm_content=DAFCUnEqJUA&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink
  16. ↑ https://www.canva.com/design/DAFd3JKSgYU/-3pnegV7b2kQ4w-PIBYcLA/view
  17. ↑ https://www.canva.com/design/DAEsFbVT9sk/-l7kCdukKVWPrXr2fXq4PA/view?utm_content=DAEsFbVT9sk&utm_campaign=designshare&utm_medium=link&utm_source=publishsharelink#1
  18. ↑ https://www.insidehighered.com/news/2022/08/15/narcan-increasingly-common-college-campuses
  19. ↑ https://safesupportivelearning.ed.gov/sites/default/files/FINAL%20IHE%20Webinar_QA%20Doc_3.28.19%20(1).pdf
  20. ↑ https://drive.google.com/file/d/1uGHfCUm0Lgn6MW-N4H83AGZr6Mf3_I88/view
  21. ↑ Cryderman, Jacob. J, Thompson, Zabe., Shore, C.D., Gundrum, G., Gomez, M., (2023, March 8th – 10th). Alcohol and Other Drugs Bingo: Gamifying Health Education [Presentation – Breakout Session]. 2023 Southern College Health Association Annual Meeting in Greenville, North Carolina, United States of America. retrieved at https://drive.google.com/file/d/1srLJKBqlshPADuOHBu2Rw1WLDmFKlmEx/view
  22. ↑ https://drive.google.com/file/d/1ifTnN6Ffd0ZkXaCpvMwP3I4TPpN44mT2/view
  23. ↑ https://www.depts.ttu.edu/hs/csa/replication.php
  24. ↑ https://uhs.berkeley.edu/sites/default/files/partysafe_toolkit.pdf
  25. ↑ https://health.ucdavis.edu/news/headlines/can-fentanyl-be-absorbed-through-your-skin/2022/10
  26. ↑ https://www.ncdhhs.gov/blog/2019-09-23/dhhs-supports-students-recovery-substance-misuse
  27. ↑ https://www.aurariarecoverycommunity.com/
  28. ↑ https://www.baylor.edu/barc/
  29. ↑ https://www.ncat.edu/campus-life/student-affairs/departments/counseling-services/collegiate-recovery-community.php
  30. ↑ https://www.northampton.edu/ncc-crp.htm
  31. ↑ https://swc.osu.edu/services/collegiate-recovery-community/
  32. ↑ https://uhs.umich.edu/recovery
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