Mental Health and Social Survival Tips for College Freshmen (and Their Parents)

The transition from high school to college can be a major change for teens. After living at home and often growing up with a consistent set of friends and peers, college freshmen find themselves in a completely new environment, surrounded by people they’ve never met, figuring out many aspects of life on their own for the first time. A lot has been said and written in terms of advice for incoming college freshmen regarding academic preparation, checklists for moving into university housing, selecting a major, time management, etc. But equally as important, if not more so, is having a plan to maintain mental and behavioral health. All the academic success in the world means little if an individual is physically, mentally, and emotionally unhealthy and imbalanced. The following are some suggestions to keep incoming college freshmen healthy, safe, and thriving.

Don’t Underestimate the Dangers of Alcohol Misuse/Overuse

Ideally, my suggestion would be for college freshmen to avoid alcohol use entirely. Based on volumes of data, my work with numerous young adults and their families, and my own personal experience as an individual in recovery from addiction and alcoholism, I can say with confidence that little to no good comes from alcohol use by college freshmen. While I wholly understand the temptation, peer pressure, and environment that lends itself to drinking, my encouragement is to wait until adulthood (when your brain is fully developed), or avoid it altogether.

In my nearly half a century of life, I have yet to meet one person who has expressed to me regret over not using drugs or drinking, including in college. I’ve never heard the phrase, “I really wish I had drank a lot more than I did in college.” Yet I have lost count of how many people, in sharing their stories with me, have told me, “I really regret drinking and using, especially in high school and college.” For many, including myself, the seeds of addiction and alcoholism were planted during the college years. For others, the choice to drink as a university student resulted in DUIs, other criminal charges, lost semesters, strained relationships with their parents and families, and a number of other consequences. In the worst case scenarios, some individuals lives have been lost entirely due to choices or mistakes made under the influence in college. These include fatal alcohol poisoning and overdoses, accidents, and suicides.

Yet alcohol has become so ubiquitous in college, students feel almost as if they’re expected to drink. Some worry they won’t connect with their peers if they don’t. Others feel the need to use alcohol as a social shield, a way to feel less anxious at parties, in clubs, at concerts, or other events. It was no different for me as a freshman. It was everywhere in my dorm, even at a university that had incredibly strict policies against alcohol use. It didn’t take me but a few months into my freshman year to join right along when handed a bottle in my dorm room one day. Not long after, I found myself missing classes and skipping assignments due to being so hung over.

So I understand the temptation, pressure, and curiosity. I absolutely do. I have a lot of empathy for college students, especially those who genuinely would rather not drink but find themselves giving in. But I also know there are plenty of people at universities, even during my time there, who find a way to turn it down. Even though people don’t consider it, a lot of college students don’t drink or use, yet manage to have such an incredible and memorable college experience, they’re still talking about it years later. Staying sober in college is absolutely possible. It may not always be easy, but it is possible.

If you don’t want to drink, don’t wait until you’re at college to figure out how you’re going to turn down drinks. Mentally put yourself in that situation in advance. Visualize it. Consider what you’re going to say to allow yourself to avoid alcohol. Have a plan. Stick to the plan. If you’ve figured it out in advance and have mentally practiced it, you’re more likely to successfully use it when the time comes. If you haven’t, when you find yourself in that moment of pressure and temptation, you’ll be more likely to give in.

Having said all of this, I’m also not so naive to think that every college student, including freshmen, will never drink. That’s just not realistic. So it’s important to consider what your plan is then. When you’re going out for the evening, how are you getting back? Is there a designated driver? Will you take advantage of services like Uber or Lyft?

Have a plan, know the plan, and agree upon the plan with whomever is going with you. Let them know in advance what your drink limit should be. Go out with friends. Stick with your plan. Stick with your group. Don’t get isolated from your group of friends. Doing so lends itself to other regrettable decisions and dangerous situations. It’s important to have your support there with you, especially the designated driver/sober friend who is still rational and able to talk you out of making potentially dangerous choices.

One in five women attending college will be sexually assaulted. (National Sexual Violence Resource Center)

55% of female students and 75% of male students involved in acquaintance rape admit to having been drinking or using drugs when the incident occurred. (Pepperdine University)

90% of all campus rapes occur when alcohol has been used by either the assailant or the victim. (Pepperdine University)

As many as 70% of college students admit to having engaged in sexual activity primarily as a result of being under the influence of alcohol, or to having sex they wouldn’t have had if they had been sober. (Facts on Tap: Risky Relationships)

Understand that while alcohol does not cause sexual assaults (they’re caused by the aggressor and their behavior and decisions only), it is undoubtedly a contributing factor. It absolutely increases the risk of dangerous and even devastating situations. And as you can see from the last statistic above, even in consensual situations, it can lend itself to decisions that often end with a great deal of regret.

Be Vigilant to Avoid Laced/Drugged Drinks

If alcohol on its own is a major risk factor in assaults, laced/drugged drinks can be even more concerning. Substances known as “date rape drugs” are not only used to tamper with alcoholic drinks but non-alcoholic ones as well. Someone who isn’t even consuming alcohol can be at risk of ending up intoxicated, assaulted, or the victim of a fatality. These substances are used by predators looking to incapacitate potential victims. This includes assaults that happen to college students and on university campuses.

The most common drugs used to adulterate beverages are Rohypnol AKA “Roofies” (a very powerful sedative not even available by prescription in the U.S.), GHB (gamma hydroxybutyrate – a sedative used by prescription to treat narcolepsy), and Ketamine (an anesthetic used in veterinary medicine, emergency medicine, battlefield medicine, and mental health treatment). All three of these have the ability to cause drowsiness, sedation, loss of motor control. Rohypnol and GHB can both cause significant respiratory distress. When combined with alcohol, they are even more sedating and physically dangerous as well.

To Reduce Risk of Being Drugged via a Drink:

Don’t set your drink down or leave it unattended. If your drink is out of your sight for even a couple minutes, don’t finish it. Get yourself a new drink.

Don’t accept opened drinks from anyone, even in a bar. If you’re ordering a drink in a bar or club, watch the bartender make/pour your drink.

Don’t take drinks from opened containers, punch bowls, or in bottles being passed around.

If your drink tastes strange, looks odd, is unusually cloudy, or is bubbling excessively when it isn’t a carbonated drink, get rid of it.

Notify your friends, or anyone else, if you see someone tampering with their drink in any way.

Trust your instinct – if something feels off, tell someone

What to Look Out For/Symptoms of Date Rape Drugs:

Dizziness, slurred speech, blurred vision, feeling very intoxicated despite having only one drink or a partial drink, nausea, confusion, problems breathing, distorted perception of light and sound

If You Think You or a Friend May Have Been Drugged:

Notify a trustworthy person with or near you.

Seek medical treatment immediately. Call 911 or have a sober friend drive the drugged individual to an emergency room.

Consider getting a blood/urine sample taken by medical professionals and/or law enforcement to verify with what substance you were drugged. Note that many “date rape drugs” are metabolized quickly, so this test will need to be done as soon as possible.

Report the situation to law enforcement, the university, and the venue (if it occurred within a public place such as a bar or club).

Follow up with your physician and counselor/therapist.

A variety of products have been invented in recent years to prevent people from consuming drugged drinks. These include drink covers/lids (brand names include NightCap, StopTopps, STOP Drug, etc.), and test kits that can detect the presence of certain drugs. Keeping one of these items with you is a good idea and should absolutely be part of the plan you have in advance of going out with friends. The cost on these items is low and absolutely worth it in terms of adding another layer of defense against having your drink spiked.

Don’t Use Drugs, Especially Pills or Powders

I’m going to echo here what I said about alcohol earlier: As someone who went down a nearly 20-year path struggling with drugs and alcohol, as someone who paid major consequences as a result, and as someone whose use really took off as a freshman in college, my strongest encouragement to you would be to avoid drugs during college. The risk vs. reward ratio is far too high, and whatever pros you may come up with for using, I assure you they’re outweighed several times over by the cons.

What I especially encourage you to stay away from is pills (Percocets/Percs, oxycodone/oxys, Xanax/Xanny Bars, Adderall/addys, Klonopin, Ritalin, etc.) and powders/drugs that are snorted (cocaine, crystal meth, Ketamine, etc.). I can not emphasize this enough: Stay away from pills and powders. This same sentiment would be repeated several times over by every single individual I know who works in behavioral health, everyone I know in recovery from addiction, and pretty much every physician you’ll meet. And the reason is two-fold.

One reason is the fact that all of these drugs can have significant consequences when misused. Every single one has the potential to cause chaos and destruction in your life, from addiction, to horrendous physical withdrawals, to arrests, to physical damage, to turning into someone you never want to be. I’ve seen it happen over and over. The pain and heartache that misuse of these drugs has caused can not be understated. Many of the stories would absolutely blow your mind and break your heart.

However the other, perhaps bigger reason, is that in recent years, those using these substances run the risk of accidentally overdosing and dying from fentanyl, a drug that most don’t even realize they’re using. Fentanyl, a synthetic opioid and very powerful painkiller, is 100 times stronger than morphine and up to 50 times stronger than heroin. Whereas the lethal dose of heroin, a very dangerous drug in and of itself, is 30 milligrams, it only takes two to three milligrams of fentanyl to kill someone. To give you an idea of what two to three milligrams looks like visually, think of a few grains of table salt. That’s it. That’s all it takes. That’s how powerful and deadly fentanyl is.

The reason so many people are now overdosing and dying from it is because it is frequently used in the creation of counterfeit pills known as pressed pills or “pressies.” Drug cartels in Mexico, Central America, and South America can easily buy fentanyl in bulk from Asia, and the drug itself can produce a very powerful euphoria or high. The effects mimic the effects of popular opioid painkiller drugs like oxycodone (Oxycontin, Percocet), hydrocodone (Vicodin, Lorcet, Lortab), and morphine, and only a small amount is needed. So it’s easier and cheaper for illicit drug manufacturers/cartels to buy and use fentanyl than it is to purchase actual oxycodone or hydrocodone. And if they have the right pressing equipment, they can make the counterfeit pills look almost exactly like prescription ones, right down to the correct color, brand name, imprints, etc. Drug recognition experts can’t even tell the difference between real and fake pills just by looking, so the average citizen or college student can’t either.

The majority of pills purchased illicitly now contain fentanyl, even ones that are pressed to look like completely different kinds of drugs that aren’t opioid painkillers. Fentanyl has been found in fake Xanax and Klonopin (anti-anxiety drugs) as well as fake Adderall and Ritalin (stimulants). In fact, according to 2024 info from the Drug Enforcement Administration (DEA), 70% of the pills seized off the street were found to contain fentanyl. 42% of those were found to have a lethal dose. Already in 2024, enough fentanyl has been seized by the DEA to kill 204 million people. If that’s how much is being taken off the streets, how much isn’t being found and seized? How much is ending up in the hands of people who don’t even realize they’re risking a fatal overdose? One of those whose hands it did end up in was Chase Ellison, a brilliant and beloved 18 year old son of a friend of mine, who died in January 2021 from a fake Xanax containing a lethal dose of fentanyl.

And fentanyl is not only ending up in fake prescription pills, it’s ending up in other drugs as well. It’s ending up in adulterated Molly/ecstasy doses, crystal meth, and cocaine. Anecdotally, I also know someone killed by cocaine that was tainted with fentanyl. She was an incredible artist, musician, author, photographer, small business owner, a daughter, a sister, and a special aunt to her nephews. A single line of adulterated cocaine ended her life in 2023. These stories, unfortunately, are not unique. Since 2018, over a quarter of a million Americans have died of a fentanyl overdose.

In addition to avoiding it, it’s important to know what the symptoms of use look like, what the symptoms of overdose look like, and how to help someone having an opioid overdose. Knowing these things could potentially enable you to save a life.

Signs of Fentanyl Use:

Euphoria, slowed reaction time, constricted/tiny “pinpoint” pupils, drowsiness, slurred speech, randomly falling asleep AKA “nodding off,” reduced appetite, nausea

Signs of Fentanyl Overdose:

Slowed breathing/not breathing, pale/clammy skin, deep snoring or gurgling sounds, no response to questions or verbal commands, blue or purple color in the lips, confusion, loss of consciousness

How to Help:

1. Call 911 immediately
2. Begin CPR/rescue breathing
3. Administer naloxone (brand name Narcan) by inserting spray tip into nostril and pushing the plunger to dispense spray
4. Repeat step 3 within two minutes if the individual is still not responsive/conscious

Naloxone/Narcan

Naloxone (brand name Narcan) is an opioid overdose-reversal drug that not only has the potential to save lives, it has already saved numerous people from what otherwise would have been fatal opioid overdoses. It is not a controlled substance, it is legal to possess without a prescription, it is available online via Amazon as well at nationwide pharmacies such as CVS and Walgreens. In fact, many community action agencies, treatment facilities, prevention organizations, recovery organizations, and even some public libraries provide free naloxone doses and training to the public.

Most importantly, naloxone can’t hurt someone. It is not habit forming, and it isn’t dangerous. What it does is clear out overloaded opioid receptors in the brain to reverse an opioid overdose and allow the individual who overdosed to begin breathing again. If it is given to someone who isn’t overdosing on opioids, it won’t hurt them. It has the potential to reverse fentanyl overdoses, though multiple doses of naloxone may be needed. Keep in mind, if the person is overdosing on a combination of drugs, naloxone will not be able to reverse the overdose on substances that aren’t opioids. This includes a drug called “Tranq” which is a combination of fentanyl and xylazine, a very powerful sedative that isn’t in the opioid class of drugs. This is yet another example of why you are better off not using at all.

Keep Yourself Mentally and Emotionally Healthy

The more you are able to take care of your physical, mental, and emotional health, the less you will feel tempted to use alcohol or drugs as an escape, for self-medication, or as a way to deal with life. The best way to solve a problem is to prevent it entirely. That’s why self-care is so crucial. But when you get focused on everything going on around you during your freshman year, it can be easy to let self-care fall by the wayside. Don’t let it happen. I encourage you to make the following a priority:

• Exercise
• Spend time outside
• Spend time with people who support you and make you the best version of yourself
• Hydrate – drinking plenty of water is one of the most simple ways to be kind to your body
• Prioritize sleep
• Set healthy boundaries
• Challenge yourself academically, but know your limits
• Practice mindfulness – be aware of what you’re feeling, how you’re feeling, and why you’re feeling
• Eat well
• Learn deep breathing techniques
• Learn how to limit and manage stress in healthy ways
• Take breaks – from work, from studying, from social media
• Listen to music
• Laugh – find things that give you a break from the seriousness of life
• Stay connected to your personal support network (family, friends, coworkers, classmates)
• Utilize support and counseling services on your campus
• Speak up to a trusted person if you’re struggling – don’t fight your battles alone

For Parents of College Freshmen

• Make it clear to your child that you are always available to listen and support them
• Make an effort to check in- have regular phone, Facetime, or Zoom calls
• Help them find a healthy balance of academics, social activities, and down time for themselves
• Let them know that you will always love them, even if they’ve made a mistake
• If they call you to tell you about a mistake they made, even a big one, thank them for being open with you
• Help them figure out a plan to overcome mistakes and obstacles
• Remember that their academics, as important as they may be, are not more important than their health and well-being.