College Health Professional by David Fine

College Health Professional Addiction Recovery Solutions igest

A Quarterly Digest

Issue N° 1 — Winter 2015

FAU’s Unique Program Puts Treatment Right On Campus

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Welcome to College Health Professional Addiction Recovery Solutions information for the college • 31% of college students meet the counselor and mental health criteria for alcohol and substance professional. College Health abuse and 6% for a diagnoses of Professional: Addiction Recovery alcohol dependence. Solutions will be a quarterly magazine providing information • Six percent of the 17 million college students means that well and resources to this group of professionals. over one million college students College is a time when young people begin to experience some of the freedom and responsibility associated with adulthood. It is also one of the few times in a person’s life when binge drinking is considered socially acceptable behavior. The sheer amount of alcohol and drugs available on college campuses can be staggering and indeed for many “social Consider these facts: drinkers and users” the environment is little more than a • Approximately 1,800 college distraction or an occasional students die from alcohol related weekend fling. injuries. For a small but significant amount • About% of college students drop of young people however, what out due to alcohol related issues. starts out as innocence ends up becoming a full-blown addiction. • 696,000 college students are assaulted by another student who On campus alcoholism and drug has been drinking. addiction are on the rise and the risks are great for those young • 3,360,000 students between the people who suffer from addiction. ages of 18 and 24 drive under the influence of alcohol.

Over a million college students fit the criteria for a diagnoses of • 5 9 9 , 0 0 0 s t u d e n t s a r e alcohol dependence. There are over unintentionally injured under the 570 colleges in New England alone influence of alcohol and drugs. and most provide counseling t h r o u g h S t u d e n t H e a l t h • 97,000 students are victims of Departments. There are currently alcohol and drug related sexual few addiction resources or assault and date rape. 3

would benefit from specialized substance abuse treatment. Until now resources for counselors and mental health professionals on college campuses have been limited. To fill that gap College Health Professional, Addiction Recovery Solutions will become the hub of information for the utilization of this very specialized demographic.

College Health Professional will be published quarterly with an initial mailing to five hundred colleges and universities in New England. The magazine will be not-for-profit supported by the generosity and advertising of the treatment industry. This will allow advertisers to become part of the solution for college students and a resource for college professionals when their students need help. It will also give professionals in the field the opportunity to address this college professional community with articles and papers. 180 Woodbury Street Suite 716 Manchester, NH 03102 603-657-5580

On Campus FAU Treatment Center Aims To Get Students Back On Track In his 12th year of recovery from substance abuse, Andrew Burki drew upon his own young adult experience in developing Life of Purpose, a treatment center for young adults that opened ?????????. The center is located at The Research Park at Florida Atlantic University in Boca Raton, which is adjacent to FAU's college campus. The center provides treatment and follow-up services to students and other young adults who have had their studies disrupted because of alcohol or drug abuse.

Addition and Substance Abuse at Columbia University.

The new center "is breaking ground in the field, let alone research parks," said Andrew Duffell, president of The Some of the professors who once Research Park, which has tenants taught Burki participate in Life of including electronic medical app Purpose, either full-time or in company Modernizing Medicine and consulting roles. The center is located an incubator of start-up technology in renovated space at the park with companies. flooring for yoga classes. Duffell said Life of Purpose was an Wes Hawkins, a professor of Burki's attractive addition to FAU's research in the School of Social Work, has park because it directly involves offered his services as consultant to professors and students, providing opportunities for their involvement and research.

Burki, 32, earned his bachelor's and master's degrees in social work at FAU. He came up with the idea of the on-campus treatment center while in school, writing a business plan as a class assignment. His own disruption came in his early college years. At 21, he came to South Florida for treatment. Then he found new purpose and passion when he studied at FAU and did social work.

the center.

Other FAU connections include Dr. Charles Norris Jr., a professor at the College of Medicine who will provide psychiatric services; and Paula Mendelson, who teaches nutrition on campus as a professor in the College of Nursing.

Life of Purpose also plans Burki's "enthusiasm is contagious," he collaboration with faculty, including said. "He has taken all the pain he's Hawkins' wife, Dr. Michelle Hawkins. had in this life and he wants to help She is the department head of the others." School of Social Work. Peter Holland Hawkins also will oversee Life of of the College of Medicine also will "I was more or less directionless. I Purpose's research, which will focus be involved. Burki additionally has became very good at video games," Burki recalls. His goal is to put young on how treatment can be improved by hired Sarah Lucas, an MBA from talking with clients and following up Harvard Business School, as chief adults coping with substance abuse on them after treatment. Burki is operating officer. back on track, to help them get an allocating 10 percent of profits toward education and into the labor force. But for Life of Purpose to be research. effective for students, it most matters The number of college students Life of Purpose, named for the goal that Burki cares, Wes Hawkins said. dealing with substance abuse can be he sets for those in recovery, is startling. In a thorough 2007 study, "You can get all the great science, but backed by $1 million in undisclosed 22.9 percent of full-time college at the core is finding people who private funds, according to Burki. The students met the medical definition of really care about you," he said. center will bill insurance for treatment substance abuse or dependence, or accept cash. mpounds@tribune.com according to The National Center on 561-243-6650 4

The Hidden Health Crisis On Campus:

Eating Disorders

Fewer than 50,000 cases of H1N1 were reported last year, according to the Centers for Disease Control and Prevention, yet this potentially deadly strain of flu was treated as a national emergency. In contrast, millions of college students have eating disorders, yet most of them receive little or no medical attention or psychological intervention. When left untreated, eating disorders can lead to permanent physical damage ranging from hair loss to damage to the heart, osteoporosis and the inability to conceive. They can even result in death. In fact, eating disorders have the highest mortality rate of any psychiatric disorder, and a suicide rate that is 50 times higher than that of the general population.

- Unwilling to seek treatment (82 percent) - Do not know that they have an eating disorder (48 percent) - Lack of awareness of treatment resources (34 percent) - Embarrassed to seek treatment (28 percent) - Lack of treatment resources (28 percent)

thin, but still talk about feeling fat. They have a distorted image of their body and continue to diet, even when they are severely underweight. Other signs of anorexia include rituals around preparing food and eating, social withdrawal and pronounced - Perceived lack of anonymity in emotional changes, such as irritability, treatment (23 percent) depression and anxiety. College - Lack of knowledge by staff about students with bulimia typically “binge where to refer students (18 percent) and purge.” A binge is the consump- No need for treatment (8 percent) tion of a large amount of food in a short time. Purging is forced Because so few students seek treatment, it’s difficult to say just how vomiting, but students with bulimia may compensate for binging in other serious the problem is on campus. ways, such as excessive exercise, or Studies in the 1980s indicated that 4 Many people recover from eating use of laxatives or diet pills. Bingepercent to 5 percent of college disorders when they are treated at an eating disorder is characterized by early stage. Unfortunately, the longer students have eating disorders, but a uncontrollable, excessive eating, eating disorders are left untreated, the 2006 survey by the National Eating Disorders Association (NEDA) found followed by feelings of shame and more likely they are to cause serious guilt. Unlike those with bulimia, that nearly 20 percent of the more medical and psychiatric damage than 1,000 college students surveyed – college students with binge-eating symptoms. both male and female – said they had disorder typically do not purge their College students – mostly women, but or previously had eating disorders. food. College students with bingealso a growing number of men – do eating disorder typically are What to Look For not seek treatment for many reasons. overweight or obese. They may be trying to hide their Eating disorders affect both women Those with eating disorders are more disorder due to shame. They may cope and men, young and old, rich and apt to have other psychiatric disorders with the disorder by avoiding poor, yet they are especially common and they have a higher incidence of treatment. They may not even realize among women on campus. Major life substance abuse than the general that they have a serious health transitions, such as the onset of population. A growing trend on problem or may mistakenly regard puberty and going away to college are campus, for example, is “drunktheir disorder as something they will believed to be among the most orexia,” in which coeds starve grow out of. Many individuals may vulnerable times for the onset of themselves during the day so they can believe that treatment is not covered eating disorders. To recognize consume large amounts of alcohol at by their insurance, or they may not whether you or a friend have an eating night without gaining weight. seek treatment because there are no disorder, you’ll need to know enough treatment facilities on or near campus. to identify the most common disorders yH1N1 is no longer a problem because it was treated as a crisis and – anorexia nervosa, bulimia nervosa A 2010 survey of college counselors action was taken. Given the impact and binge-eating disorder. and other professionals by the Eating they have on millions of college Disorders Recovery Center found that College students with anorexia take students, its time to treat eating did not seek treatment for the extreme measures to avoid eating. disorders as a crisis, too. following reasons: They typically become abnormally 5 5

Amphetamines Increasingly Abused on College Campuses Prescription drug abuse, especially of amphetamines, is very common among college students. Whether looking for some help with schoolwork or looking to party hard, the problem is certainly there.

Reasons for Use

Accessibility

Amphetamines are used often among college students, particularly for their ability to help people focus. Commonly prescribed to treat attention-deficit hyperactivity disorder (ADHD), prescription amphetamines also produce feelings of euphoria when taken in large doses. The need to “blow off steam” from writing papers, doing research and planning projects opens students up to amphetamine abuse behaviors. Not unlike high school, college students also experience peer pressures while at the same time taking on some of the financial pressures adult shoulder. Amphetamine effects allow a means for escaping the daily pressures of college life.

College students gain access to drugs through several different routes. Friends, doctors and internet pharmacies all offer possible ways to obtain prescription amphetamines. According to USA Today, the practice of diverting amphetamines to interested drug users starts as early as the middle school years with 23.3 percent of middle and high school students reporting having been solicited for prescribed amphetamine medications. This diversion rate increases accordingly once students enter college life with 29 percent of college students reporting having sold or given their medications to friends and acquaintances. Faking ADHD symptoms has also proven a fairly successful means for obtaining prescriptions from the college health center.

Drugs, such as Adderall, Strattera and Ritalin all require a doctor’s prescription.

Known risk factors for amphetamine abuse on college campuses vary based on student motivations, circumstances as well as any possible underlying issues at work. Overall, men are more likely to misuse amphetamines than women, though risk factors for both sexes remain relatively the same.

For many students, the stressors and pressures that come with college life create the perfect hotbed environment for drug abuse habits to develop. The pressures to succeed academically push many students to enhance their abilities through amphetamine drug use. According to the American College Health Association, 5.7 percent of college students abuse amphetamines compared to 2.5 percent of their non-college peers. As with any form of addiction, accessibility to amphetamine drugs makes it that much easier to engage in drug abuse. Considering not all college students engage in amphetamine abuse behaviors, certain risk factors do play a part in determining who will use and who won’t. 6

Risk Factors

This requirement can give the impression of safety, not factoring in the addictive potential these drugs carry. Without a clear understanding of how amphetamines work in the brain, college students unknowingly leave themselves open to physical dependency and addiction. With continued use, students come to rely on amphetamines as a way to cope with daily stressors. In the process, brain functions gradually deteriorate leaving students hopelessly incapable of keeping up with daily demands.

According to the U. S. National Library of Medicine, college students who abuse amphetamines have a higher likelihood of abusing alcohol as well as other illicit drugs. In effect, amphetamine abuse in college is often indicative of a larger substance abuse problem. Students with low gradepoint averages or students performing below their own personal standards may also be at risk of amphetamine abuse. As amphetamine effects include increases in energy levels, concentration and focus, athletes may turn to amphetamines to enhance their athletic abilities.

Drunkorexia is a colloquialism for self-imposed starvation or the practice of skipping food in favor of alcohol. Research on the combination of an eating disorder and binge drinking has primarily focused on the patterns of college-aged women, but the phenomenon has also been noted among young men. Studies show that college students engage in this combination of self-imposed malnutrition and binge drinking to avoid weight gain from alcohol. A study by the University of Missouri found that 30% of female college students admitted that within the last year they had restricted food in order to consume greater quantities of alcohol. The same study found that men are more likely engage in similar behavior in order to save money for purchasing alcohol. According to the study, 67% of students who restrict calories prior to alcoholic beverage consumption do so to prevent weight gain, while 21% did so to facilitate alcohol intoxication. According to the Eating Disorder Center of Denver, of the participating college-aged females in an adjunct research study, about 75% met the criteria for alcohol abuse. 'Showbuzz', a CBS news site, has broadcast that, "Drunkorexia is a media coined term reflecting an alarmingly real trend among young women. The non-medical slang term refers to women who choose to eat less so they can party without gaining weight.â&#x20AC;? Andrew Chambers, MD, Assistant Professor, Institute of Psychiatric 7

â&#x20AC;&#x153;Drunkorexiaâ&#x20AC;?

disorders as an attempt to avoid the fabled "Freshman 15," weight gain that results from adjusting to a college lifestyle.

A 2001 CASA report estimated that 30-50% of individuals with bulimia and 12-18% of individuals with anorexia had previously abused or were currently dependent on alcohol. 35% of those with alcohol or drug Research and Director, Laboratory for dependency reported a concurrent Translational Neuroscience of Dual eating disorder. Results demonstrated Diagnosis Disorders notes that many a clear correlation between individual celebrity blog sites report similar histories of eating disorders and binge patterns of behavior among young drinking and/or alcohol dependence. actresses such as Lindsay Lohan and The National Association of Anorexia Paris Hilton, and that the condition Nervosa and Associated Disorders could be mimicked within the reports that 72% of women who admit entertainment industry and to alcohol abuse also classify as contemporary youth culture at large. suffering from an eating disorder. A 2002 study from O'Malley and The combination of self-starvation Johnston reviewed data from the and alcohol abuse can lead to an array national College Alcohol Study, the Core Institute, Monitoring the Future, of physical and psychological and the National College Health Risk consequences. For example, drinking Behavior Survey affirming that 70% in a state of malnutrition can predispose individuals to a higher rate of participating college students of blackouts, alcohol poisoning, reported consuming alcohol within the prior month and 40% had engaged alcohol-related injury, violence, or illness. Drinking on an empty in binge drinking. First-year college stomach allows ethanol to reach the students have been identified as blood system at a swifter pace and uniquely predisposed to binge raises one's blood alcohol content drinking. with an often dangerous speed. This According to disclosure from the can render the drinker more National Eating Disorder Association vulnerable to alcohol-related brain in 2006, approximately 20% of damage. In addition, alcohol abuse college students, both male and can have a detrimental impact on female, admitted to suffering from an hydration and the body's retention of eating disorder at some point in their minerals and nutrients, further life. Clinical eating disorders exacerbating the consequences of encompass binge eating, chronic malnutrition and denigrating an dieting, fasting or purging and the use individual's cognitive faculties. This of laxatives to control weight. can ultimately have a negative impact Furthermore, first-year college on academic performance. students are predisposed to eating 7

Binge Drinking

Binge drinking or heavy episodic drinking is a modern epithet for drinking alcoholic beverages with the primary intention of becoming intoxicated by heavy consumption of alcohol over a short period of time.It is a kind of purposeful drinking style that is popular in several countries worldwide, and overlaps somewhat with social drinking since it is often done in groups. The degree of intoxication, however, varies between and within various cultures that engage in this practice. A binge on alcohol can occur over hours, last up to several days, or in the event of extended abuse, even weeks. Due to the 8

long-term effects of alcohol misuse, binge drinking is considered to be a major public health issue.

adolescents who binge-drink also consume other psychotropic substances

Binge drinking is associated with a profound social harm, economic costs as well as increased disease burden. Binge drinking is more common in males, during adolescence and young adulthood. Most binge drinkers are not familiar with the risks associated with binge drinking. Heavy regular binge drinking is associated with adverse effects on neurologic, cardiac, gastrointestinal, hematologic, immune, musculoskeletal organ systems as well as increasing the risk of alcohol induced psychiatric disorders. A US-based review of the literature found that up to one-third of adolescents bingedrink, with six percent reaching the threshold of having an alcohol-related Approximately one in 25 women binge-drinks during pregnancy, which can lead to fetal alcohol syndrome and fetal alcohol spectrum disorders. Binge drinking during adolescence is associated with traffic accidents and other types of accidents, violent behavior as well as suicide. The more often a child or adolescent binge drinks and the younger they are the more likely that they will develop an alcohol use disorder including alcoholism. A large number of

Binge drinking has the propensity to result in brain damage faster as well as more severely than chronic 'non stop' drinking (alcoholism), due to the neurotoxic effects of the repeated rebound withdrawal effects. The tolerance that occurs during chronic ('non-stop') drinking delays alcohol-related brain damage compared to binge drinking, which induces immediate and repeated insults to the brain. The neurotoxic insults to the brain are due to very large amounts of glutamate being released on a repeated basis, which overstimulates the brain after each binge finishes, resulting in excitotoxicity. The developing adolescent brain is thought to be particularly susceptible to the neurotoxic effects of binge drinking, with some evidence of brain damage occurring from drinking more than 10 or 11 drinks once or twice per month.

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Miscellany What Is College Health?

nutritionists, and pharmacists. Some college health services extend to include massage therapists and other holistic health professionals. College health professionals are often members of a national body, such as the American College Health Association. Another national body College Health is a field of medicine among college health is the National that exclusively deals with the Collegiate EMS Foundation medical care of college age students (from age 18 through 28 years). Many (NCEMSF), which is dedicated to the promotion and support of emergency colleges and universities campuses medical services on college and offer some sort of student health service, but there is wide variability in university campuses. the healthcare resources available from campus to campus, with models of student health ranging from first aid stations employing a single nurse to large multi-specialty clinics with hundreds of employees. The vast majority of college health services are set up as service units rather than academic departments. The educational aspect of college health is While the health risks that can come sometimes referred to Health with college may Promotion in Higher Education. seem

Long-term Health Effects of a College Degree

In 1988, it was estimated that there were approximately 27.3 college health staff per 10,000 students, which if amortized to the 20.7 million students attending the more than 3,400 colleges and universities in the United States (in 2003) ),] suggests that there are approximately 56,500 college health professionals in the United States. College health professionals include physicians, physician assistants, administrators, nurses, nurse practitioners, mental health professionals, health educators, athletic trainers, dietitians and 13

intimidating, overall, college tends to be good for a person's body and mind.

Higher levels of education generally correlate to better health, as well economic success and family stability, which can indirectly lead to better health outcomes. People with higher levels of education tend to have improved brain development, less biological aging and better understanding and compliance with healthy behaviors, studies show.

Furthermore, research shows that education is associated with a longer life. According to the National Longitudinal Mortality Study, men who finished college lived 2.5 years longer than college dropouts, while women with a college degree lived 1.1 years longer than their dropout counterparts. The difference was even greater when comparing college graduates to high school dropouts -college graduates live at least five years longer on average than people who did not finish highÂ school.

The study also showed the positive health outcomes extend into the next generation: the mortality rate of children born to college graduates was 4.2 percent, while the mortality rate of those born to women who did not finish college was 6 percent. Thus, while college life can present some challenges, the research still supports sticking it out at school. Follow us @livescience, FacebookÂ or Google+. Article originally on LiveScience.

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