Ready or not, Fall Semester 2024 is HERE, and emotions are ping-ponging from anticipatory excitement to near-panic fear of the unknown. After a decade as both a mom of college students and as an experienced on-campus physician, I’m here to share four critical tips for a successful year!
SOMETHING OLD: HOMESICKNESS
2023 data shows 56% of today’s first-year college students will experience significant homesickness, especially during their first semester. Social media often makes homesickness worse, offering nonstop images of your old friends clearly having more fun. (Meanwhile, they’re viewing your stories thinking the same.)
Try this RULE of THREE to Prevent Homesickness:
1. JOIN three completely unrelated clubs with OPEN memberships, which will introduce you to a diverse group of potential friends who share at least one common interest. Think broadly! Google the most fun/unusual/popular clubs at your university and you’ll find they range from professional college circuses to crazy coed intramural games; from community volunteering, dancing, singing, movie or foodie clubs to raising therapy pets; and from religious or political groups to academic major-based clubs. (Side note: joining elite clubs with auditions or recruitment in addition to open membership clubs is great…if you get in. Many students put all their eggs in one basket and feel devasted if they are not accepted into their top choice, which can be an incredibly rough way to start the year.)
2. Immediately put three campus events on your calendar for the first three weeks! Again, the more diverse the better, so you will start creating different friend groups, and be that generous person who invites others to join you. Trust me, especially during the first month of college, most students are desperate for any invitations, so put it out there in every conversation. “Hey, I’m getting a group together to go to the football game/concert/free food/dorm meeting- do you want to join? Let me add you to our group text!” Parents, even though you miss your kids, do NOT beg them to come home. Instead, please encourage your kids to stay on campus on weekends, because that’s exactly when all the new connections are forming!
3. Limit your friend-based social media browsing to 30 minutes (or 10 minutes 3 times/day) ideally not at bedtime. I recommend setting time limits on your phone. Go to Settings/Screen Time/App Limits and set automatic reminders to help you avoid getting sucked into hours of doom scrolling instead of actively creating your own new stories.
SOMETHING NEW: INTENTIONAL “BLACKOUT” DRINKING
Parents, the party culture has changed significantly from our college days of keg parties. Although roughly 20% of college students choose to avoid alcohol, binge drinking has leveled up for many others. Beer is out, vodka shots are in. Drinking to excess is disturbingly cheered on with the battle cry of “black out or back out”. ADHD stimulant medications scarily blunt the early “buzz” of alcohol, which often leads to dangerously high blood alcohol levels that seem to hit suddenly after little immediate response to doing multiple shots.
“Blackout” drinking does not refer to passing out unconscious, but to drinking fast and hard enough that rapidly rising blood alcohol levels effectively shut off the portion of the brain that converts short-term to long-term memories. Therefore, regardless of how alert a person may have appeared while drinking, the next day they will experience full or patchy memory loss- a “blacked out” chunk of time, often two or more hours, that cannot be truly recalled, despite any reminders (or revealing videos.)
Obviously, “blackout drinking” is laden with risks- physical, emotional, and legal. Alcohol-impaired judgment can lead to impulsive, dangerous choices, whether you remember making those choices or not. Add in any physical intimacy with another person, and now you’re also dealing with multiple legal and moral issues of consent, for both the perpetrator and the victim. Please note this is by no means specific to gender or sexual preference, as sadly this is seen across the board.
What helps? Talking through unanticipated consequences.
While some students may defiantly declare “if you don’t remember what happened, it doesn’t matter”, I have been privy to far too many devasted college students dealing with a DUI or public intoxication charge, a sexually transmitted disease, an unexpected pregnancy, and/or the trauma of sexual assault. These unfortunate students can assure others that a memory blackout does not make you bulletproof to consequences.
Many underage students want Fake IDs (aka “fakes) so they can get into bars, whether they choose to drink or not. Please encourage your teen to look up and discuss with you the consequences of getting caught with “fakes” at both their university and the state where they will attend college (this is not covered by federal laws, so every state is different.) Know that while bouncers in college town bars may simply confiscate the fake ID, other enforcement professionals can charge you with a misdemeanor offense with fines up to $2000 plus or minus community service or jail time.
SOMETHING BORROWED: “STUDY” or “SLEEP” PILLS
Most college students don’t head off to university planning to use drugs, but many fall into the habit after “borrowing” a friend’s prescription medication.
Stimulant ADHD meds certainly can increase your immediate ability to focus, but despite an estimated 12.8% rate of college student non-prescription stimulant use and the widespread belief that they will improve your grades, the data does not support this notion.
Meanwhile, an estimated 7% of college students report nonmedical use of prescription benzodiazepine medications (like Xanax), most often to calm anxiety or promote sleep.
Additionally, cannabis gummies and other edible forms of THC are widely used by college students self-medicating for social anxiety or insomnia (in addition to those using it purely recreationally) whether it is legal in their state or not.
Once again, let’s talk about unintended consequences:
1. Getting caught buying or selling ADHD stimulant medications can have extremely serious repercussions ranging from huge fines to jail time and probation, with charges of a class A misdemeanor to class C felony, depending on the amount and intent of possession. A drug conviction can easily get you kicked out of school and take away your access to federal student aid.
2. Two things scare me the most about college students using “Xanax”:
a.Benzodiazepine medications like Xanax combine with alcohol in an amplified manner, both enhancing the other’s ability to suppress your nervous system and your drive to breathe, leading to unexpected overdoses and deaths.
b.Most “Xanax” pills shared on college campuses are unlikely to have been manufactured in a safe, FDA-regulated pharmacy. These “xanax” look-alikes are more likely street drugs potentially laced with Fentanyl. And no, you can’t tell the difference by looking, nor can DEA officials.
3. Parents, please stop glorifying your college partying days of smoking “pot”. Today’s “weed”, THC edibles, and concentrated products like dab and oils have extremely high concentrations of THC, making today’s products not only more dangerous for acute toxicity and psychotic episodes (paranoia, terrifying hallucinations, etc.) but they are also addictive. The low concentration THC products of the 70’s/80’s (<2%) had no recognized withdrawal symptoms and was therefore not considered addictive. Today’s average weed has ten times that concentration. Our most recent data shows that in 2022, 15-24-year-old teens and young adults had an average WEEKLY total of 2314 cannabis-related Emergency Room visits in the US. That’s over 120 THOUSAND students (plus their parents) who were impacted. Not cool.
4. Gummies (THC edibles) are a very common cause of cannabis overdose and toxicity because edibles don’t “kick in” for a minimum of 30-45 minutes, and often not for up to 90 minutes. People used to the immediate buzz of alcohol are easily tempted to take a second or even third dose after a half-hour passes and they feel “nothing”. The THC levels peak around 4 hours and can last for up to twelve hours, so there is no quick fix once you get too much. Signs of toxicity (aka “greening out”) include intense nausea and vomiting, dry mouth, racing heart, racing thoughts, extreme confusion or depersonalization, anxiety, panic, and paranoia.
SOMETHING BLUE: WHEN to CALL 911
I think every parent’s worst nightmare as their kid heads off to college is the possibility of their child having a near-fatal or lethal event, whether it is a car accident, a party-related alcohol or drug overdose, or a depression-induced attempt or death by suicide. Unfortunately, there are over 1500 alcohol-related deaths and over a thousand deaths by suicide in college students each year, so these are painfully real concerns.
What can parents do?
1. While college students are FAR better than their parents about not drinking and driving, I encourage parents who have the means to give their students UBER or LYFT gift cards to diminish drunk driving accidents.
2. Teach your teen WHEN to CALL 911 for a fellow student (who has been drinking or is otherwise impaired from cannabis or street drugs):
a. If the person cannot be woken up (& stay awake 2-3 minutes) by forcefully calling their name and shaking their shoulders, they are UNCONCIOUS. CALL 911.
b. If they have shallow breathing (<12 times/minute or stop breathing for more than 8 seconds) are struggling to breathe (gasping/snorting) or have BLUE lips or pale, clammy, cold skin. This can be from alcohol, depressant drugs, opioids, or a combination. Do NOT hesitate- CALL 911.
c. If they can’t stop vomiting or if they are vomiting at all while “sleeping” or unconscious. CALL 911.
d. If they have a seizure. CALL 911.
e. If they have extreme confusion (seem “out of their mind”, cannot communicate, or are seeing things that aren’t there or talking to voices no one else can hear). CALL 911.
f. If they have signs of a stimulant drug overdose- especially if you know they’ve been using any of these substances (cocaine, meth, Adderall, ecstasy) sweaty, hot to touch, fast breathing, racing heart, chest pain- CALL 911.
g. When in DOUBT, CALL 911.
3. Include Narcan OTC in your students’ First Aid Kit and make sure they know how and when to use it (and ALWAYS CALL 911 if you administer a dose.)
4. Please encourage your student to see a doctor or therapist if they are struggling with anxiety or depression. The biggest mistake we see is parents (& students) waiting until the student is at a crisis point before seeking help, for fear of cost or stigma. Sleeping way too much or too little, inattention to hygiene, skipping class, struggling academically, apathy, not leaving their room, constantly feeling overwhelmed, anxious, or sad, and obviously, any thoughts of self-harm are all red flags that should send your student to seek help immediately.
Please remember, armed with this knowledge, your kid should not only avoid these intimidating setbacks, but hopefully, this will help them lift up others around them who stumble. Congratulations to you and your college-bound student. May this school year be their best so far!
*This content was initially published as a series of four articles on DoctorsOnSocialMedia.com