Strengthen Collegiate Recovery Programs

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:

• 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.

• 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.

• 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 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.

• 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. 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.

• 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.

• 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. 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.
  • "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.
  • "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.
  • "Where Are the Students?" A slideshow summarizing the tensions, barriers, and approaches related to student engagement with collegiate recovery initiatives.
  • "Making the Case: Fostering Buy-in for Recovery Support." This slideshow summarizes approaches to collegiate recovery advocacy among professionals and potential partners.
  • 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.
  • "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.

• 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.

• The National Center on Safe and Supportive Learning Environments. This is a webinar titled "Supporting Recovery and Building Resilience on Campus: The Role of Collegiate Recovery Programs."

• The National Council on Patient Information and Education offers a toolkit to prevent and address prescription drug abuse on college campuses.

• 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. 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.

• 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.

• 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.

• 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.

• UC Davis Health published "Can fentanyl be absorbed through your skin?“ in which a toxicology expert dispels myths around fentanyl exposure.

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.

• 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).

• 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.