alcohol

Naloxone Training, Social Support, and Stigma Reduction Among Top Needs of College Students in Recovery

A comprehensive analysis of students who utilize college recovery programs highlights the wide-ranging, vital services these programs should offer, especially amid waning federal support for student financial aid and mental health.

As public officials and health experts urge widespread availability of naloxone on college campuses, a new study led by a School of Public Health researcher reveals that only 37% of colleges with collegiate recovery programs (CRPs) provide training for the overdose reversal drug, and only 18% distribute fentanyl test strips. 

The findings are part of a national survey of US students in CRPs that provides new insight into the demographics and support needs of college students in recovery, and how these students utilize clinical and recovery support services. 

Published in the Journal of American College Health, the study also found that nearly 50% of CRP students identify as a sexual or gender minority, a significant increase from previous estimates of this population and a much larger percentage than the national LGBTQ+ average of 15.2% among young adults. The results revealed that one third of CRP students have been involved with the justice system, and nearly half have never received formal substance use disorder (SUD) treatment—another contrast to previous data that suggest the majority of these students in recovery have received clinical support by the time they enter college.

Both drug and alcohol use among college students are persistent public health concerns, especially as fentanyl remains a leading cause of overdose deaths among young people. As colleges respond to these challenges with renewed prioritization of students’ physical and mental well-being, these findings can inform how these programs are designed, implemented, and sustained, and ensure that CRPs provide equitable and culturally sensitive support that meets the varying and overlapping needs of college students in recovery.

“Colleges have done a good job addressing mental health on campuses, but overdose prevention still lags far behind,” says study lead and corresponding author Noel Vest, assistant professor of community health sciences. “Every student should know how to recognize and respond to an overdose—it’s basic public health. Overdose education and naloxone training should be a part of freshman orientation for all students.”

For the study, Vest and colleagues analyzed survey responses from 246 students in CRPs in the US and Canada from August 2023 to June 2024, which provided information about their demographics, recovery pathways, and utilization of support services. Other notable findings from the study include:

• Off-campus counseling and 12-step programs were the most popular recovery support choices, followed by CRP-only support.
• 27% believed they had not resolved their substance use or behavioral problem.
• 59% were juggling student loans, compared to the national average of 38% of first-time undergraduates.
• 50% felt stigmatized by their peers, and 22% felt stigmatized by their professors, for being in recovery.
• The majority of students experienced lifetime mental health conditions, such as depression (79%) and anxiety (77%).

This survey data paints a new picture of the overlapping challenges that college students in recovery are facing, and how these challenges may become more difficult to resolve as a result of recent federal actions. Last July, the Trump administration terminated funding for specialized services to LGBTQ+ young adults through the 988 Suicide & Crisis Lifeline, which had offered swift and tailored mental health treatment to more than 1.5 million youth since 2022. 

Under the 2025 One Big Beautiful Bill Act, the administration also implemented several changes to federal student aid programs, including reducing or eliminating repayment options, reducing borrowing limits, and ending graduate PLUS loan options for graduate and professional students. Among a population that is already disproportionately struggling with mental health and stable employment, these cuts may place additional financial and emotional strain on CRP students’ well-being and college experience. CRPs can help fill the gaps created from the loss of these services by providing wide-ranging support that reflects these students’ diverse needs. 

“Students in recovery are already carrying more than their share of financial stress, mental health challenges, and the weight of stigma,” says Vest. “Cutting back federal support only widens the cracks they’re trying to climb out of. Collegiate recovery programs are often the one place where these students find stability, community, and hope—and right now, those programs are needed more than ever.”

This study is just the start of this research, he adds. “Future studies should move beyond snapshots in time. The next step is large, longitudinal research that follows students over time to uncover what really drives lasting recovery and academic success.”