Everything to Gain

Conference highlights leadership’s role in addressing campus substance use

In November 2019, The Mary Christie Foundation and the American Council of Trustees and Alumni (ACTA) convened a group of higher education leaders, trustees, and clinical experts for an event focused on addressing college drinking and drug use.

“Everything to Gain: How Higher Ed Leadership Can Confront Substance Use,” held at the Edward M. Kennedy Institute in Boston, featured presentations and panel discussions with national experts and researchers, presidents and trustees leading the fight to combat campus substance use and promote student success.

Mary Grant, the President of the Edward M. Kennedy Institute, and a former college president, welcomed the assembled guests to the Senate Chamber room at the Institute — an exact replica of the United States Senate Chamber in Washington, D.C. — framing the issue of student substance use as a collective responsibility.

“We can’t afford to lose a young, bright leader with future potential that will make a difference in our communities,” she said. “It’s not just the role of student health services to deal with this, it’s the role of faculty, it’s the role of peers, it’s the role of college presidents, of board members, of alumni, of community. It’s all of us, to help create and foster a healthy, productive, welcoming campus environment that allows students to do their very best work and thrive in these complicated times.”

ACTA’s President, Michael Poliakoff, then set the tone for the day, underscoring the importance of finding solutions to the persistent issue with the lofty goal of entirely changing the culture of campus substance use.
“Our purpose today is to explore strategies that work to address the problem comprehensively,” he said. “It is our hope that today’s discussions will be the springboard to create campus cultures of vibrant learning and personal growth. Campuses equipped for effective therapeutic intervention but even more important, campus communities where substance use has lost its allure.”

The morning’s opening presentation explored the most up-to-date research surrounding college substance use, and presented findings from Addressing College Drinking and Drug Use, a report published by ACTA in partnership with the University of Maryland School of Public Health.

The guide for trustees and administrators, co-authored by Dr. Amelia Arria, Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health, and Greta Wagley, Research Associate and Editor at ACTA, called for a new level of awareness and collaborative action by presidents and trustees to address student alcohol and drug use and includes examples of successful, evidence-based programs implemented at institutions across the country.

Dr. Arria led the audience through existing challenges, explained how substance use is connected to student success outcomes, discussed factors that contribute to the problem, and outlined the evidence-based strategies that can be used to interrupt those factors.

Arria presented data on the decreasing rates of binge drinking that, she says, prove that progress is possible. She also reported increases in marijuana use among college students, and the staggering increases in potency that pose serious threats to student mental health.

Arria described the wide variety of consequences of college student alcohol use, including injuries, poisonings, assaults, and other costly health outcomes. She presented research that substance use interferes with young people’s ability to take full advantage of opportunities afforded during college.

According to Arria, the neurocognitive deficits of substance use not only make it more difficult for students to absorb information, but disrupt a motivational pathway, so that learning is no longer meaningful. Arria told the audience that this can result in missed classes, falling grades, increased likelihood for dropout, and ultimately lack of readiness for employment and attenuation of goals.

In addition to these direct effects, Arria expounded on the secondhand consequence of alcohol use, or the impact to individuals who don’t use alcohol. These include interruptions to studying or sleeping, property damage, or unwanted sexual advances.

In order to make positive change, Arria said, “We have to understand what’s driving the problem and try to address the multiple factors that are responsible.”

Arria listed several factors that drive substance use, including individual characteristics like genetics, risk-taking propensity, and preexisting mental health conditions. She stressed though, that a student could have none of these and still become involved in drug use. Many environmental factors are at play as well, including the influence, both positive and negative, of peers, adults and caregivers.

Dr. Arria underlined the importance of using evidence-based strategies, and reaffirmed the report’s endorsement of a multilevel, multi-component approach to address the complexity of the problem.

“I can’t emphasize enough that we don’t have a single program” she said. “We don’t have a silver bullet.”
She did list several effective strategies, including policy enforcement, parental notifications of policy infractions, and engaging and training facilitators.

Dr. Arria promoted intercampus working groups, sharing her experience with the Maryland Collaborative, a network of 17 colleges and universities across the state whose presidents have agreed to work together with community partners to reduce alcohol use on their campuses using evidence-based policies and practices.

In 2015, the Collaborative was successful in changing state law – banning extreme-strength alcohol after the Collaborative’s presidents worked together to put the measure in front of the state legislature.

Arria praised the leadership of Johns Hopkins University President Ronald Daniels and University System of Maryland Chancellor Robert Caret, both in attendance, for their leadership in growing the collaborative from its original eight institutions to its current size.

Dr. Arria ended with explaining the effect that strong leadership can have when addressing this issue. She challenged the notion that substance use is a rite of passage for college students.

“College is an opportune time to address these issues that for some can become lifelong struggles” she said. “But by strengthening the academic mission of the university and promoting the idea that substance use is inconsistent with that mission — that substance use is not a benign, inevitable rite of passage but can interfere with student potential, I think we can make some substantial progress.”

THE CAMPUS CHALLENGE OF SUBSTANCE USE
The first panel of the day, The Campus Challenge of Substance Use: Facing the Problem and Overcoming Institutional Challenges, featured Dr. Joseph Lee, Medical Director for the Hazelden/Betty Ford Foundation, Robert DuPont, President of the Institute for Behavior and Health, and two college presidents – Ronald Daniels of Johns Hopkins University and Shirley Collado of Ithaca College.

The panel was moderated by Deirdre Fernandes, the higher education reporter for The Boston Globe.

The panelists provided insight on the pervasiveness and impact of campus drug and alcohol use, debated ways to combat the problem and suggested ways to overcome institutional reluctance to addressment.

When asked why students use alcohol and drugs, panelists attributed blame to an increasing sense of isolation and loneliness, decreased resilience, capitalistic markets preying on consumers, and a biological drive, among other factors. Dr. Lee explained that students reenact the cultural norms embedded in them by their parents, friends, and mainstream and social media.

The panelists were concerned about the trend of intenstity alcohol and drug users. Dr. DuPont said that while there is an increase in the number of students who are not using any alcohol or drugs, another trend is emerging: a group of young people using much higher amounts of alcohol and drugs. High risk students congregate together, as do the lowest risk students, according to Dr. Lee.

“Different substances have different harms, but it’s really about high-risk people.” And focusing attention on high-risk students is important, as those groups will “continue to foster maladaptive cultural norms on your campuses.”

Dr. Dupont emphasized the need for prevention, “to de-normalize drug use” on campus.

President Daniels explained how, at Johns Hopkins, they are “Trying to, at least right from the moment the students get on campus, signal the concerns that we have about the pernicious role that alcohol and drug use has on their performance.” Daniels believes that students have a central role in changing the norms around campus substance use. He said, “The students, who are themselves so important in perpetuating these norms, have to have a sense of their central role in helping achieve this shift.”

Dr. Lee named a number of evidence-based solutions, many of them low-cost environmental regulations on the price of alcohol and outlet density near campus.

“Having pro-social activities is really important,” he said. “Having screening across the board is really important.” He also urged having mental health professionals trained to detect substance use disorders, and advocated for collegiate recovery communities.

According to Dr. Lee, recovery communities “change the dialogue” around substance use and “create places where people do feel safe to go talk or find advocacy.”

Panelists repeatedly stressed the impact of strong, clear leadership, from both college administration and trustees. President Collado commented that trustees, in particular, should expand their understanding of their fiduciary responsibility for risk management to include alcohol and drug prevention and student wellbeing.
While student affairs topics have not traditionally been included in the conversation for boards of trustees, Collado says expectations are shifting. In order for boards to have those conversations, Collado said, there is a “dire need for trustees to fundamentally be educated on the research and understand what’s going on.”
She suggested shaping a strategic plan that “affirmatively states objectives and values around student wellness” that the board will adopt and endorse.

President Daniels, too, expressed the importance of educating boards on the most current data. Their support is especially important when confronted with difficult policy decisions, such as those around Greek life or alumni expectations.

“This is where, in some sense, the data really matter,” Daniels said. “That is having relatively clear, dispassionate discussions around the impact that alcohol and drug use are having on our campuses. Making that real to the board …the extent to which these behaviors are creating grave risk for the academic performance of the students. They’re creating grave risks for serious injury and death. They’re creating significant risks in terms of sexual assault.”

Presidents Collado and Daniels both promoted the virtues of collaboration, which, Daniels said, provides the opportunity to share best practices, compare across institutions and lobby for statewide policy changes.
On his experience successfully lobbying for a ban on high-proof alcohol with the Maryland Collaborative, President Daniels said, “This is a real benefit of having this institution in place, where you’ve got the academic leadership of the state that are convening regularly, you have the imprimatur of the data and the public health expertise. That gives us opportunities to influence the legislative outcome, which has been very important for us in reducing the environmental risk for some of these really dysfunctional behaviors.”

Dr. Lee captured the agreement of the panelists in underscoring the importance of strong, consistent leadership; the commitment to evidence-based solutions, and a plan to create real cultural change. He said, “More than ever, I think all of us leaders need a focused vision and a plan… informed by science and best practice to create the healthiest college culture possible.”

STRATEGIES FOR STUDENT SUCCESS
In the afternoon panel, Strategies for Student Success, four college leaders discussed their experience creating change on campus, and the role of campus leadership and the governing board. The panel, moderated by Brandon Busteed, president of Kaplan University Partners, formerly with Gallop Research, featured Phil Hanlon, the President of Dartmouth College, Damon Sims, Vice President for Student Affairs at Penn State University, Michael Poliakoff of ACTA, and the Mary Christie Foundation’s President, Dr. John Howe, III.

The Power of Trustees and Alumni
President Hanlon described his experience of allying his administration with trustees and alumni in the fight against substance use on campus. In January 2015, President Hanlon announced “Moving Dartmouth Forward,” an initiative aimed at eliminating high-risk behavior that would make large, structural changes to student life and hold students and student organizations to a higher standard of behavior. Traditionally believed to be foes of any change that would affect the social scene at Dartmouth, the alumni embraced the changes. Hanlon found the trustees and alumni to be some of his strongest motivators and allies.

“The alumni have been some of our strongest supporters in trying to reform the social scene at Dartmouth and reduce harmful behaviors,” Hanlon said. And many of them say, “I’m so sick of reading about Dartmouth in the news in a negative way. We’re ready for a change.”

Hanlon said that trustees and alumni at Dartmouth have “been educating themselves about high risk behaviors, sexual assault and violence and high-risk drinking and substance abuse for some time.” When he began his tenure, Dartmouth’s reputation was in peril.

“Our applications dropped 14%, we were under active investigation by the office of civil rights, all of this in the wake of a very damaging article that appeared in Rolling Stone about hazing at Dartmouth,” he said. “And basically, my first meeting with the trustees, they said ‘fix this, get this straightened out.’”

As a student affairs administrator, Damon Sims said he has experienced some pushback and resistance from the trustees when trying to make changes to Greek life, often stemming from their own fraternity experiences.
However, Sims has witnessed at Penn State and at colleges across the country that political will to make change often rises out of moments of tragedy caused by alcohol or drug use. Sims estimates that half of trustees and alumni he encounters are supportive of policy changes around alcohol use; the other half are resistant.

“It’s impossible, maybe it’s just the size and complexity of the place, but it’s impossible to think of any of those groups monolithically around these issues,” he said. “Except, in those moments when a tragedy strikes and suddenly people step back from their native impulses… and we’ve been able to pivot as an institution.” Sims said that it is partly due to the support in those moments of tragedy that they have been able to make changes at Penn.

Dr. Howe, who is a member of the Board of Trustees at Boston University, urged institutions to share knowledge and solutions and called for more collaborative approaches among colleagues at all leadership levels, including governing boards. “Campuses can address these issues in a way that they learn from each other and use models that can be implemented across more than one campus.”

Dr. Poliakoff believes that while every trustee takes the wellbeing of the school seriously, moving from thought to action can be a real hurdle. Poliakoff said that well-meaning trustees are often willing to be quiet listeners rather than tough questioners, when they should be asking difficult questions of the institution they serve.

“The great necessity now is for proactivity,” he said. “In other words… our plea to trustees all around the nation, don’t wait until you read about the tragedy.”

Telling a Story with Data
In engaging trustees and alumni on the necessity for change, President Hanlon uses data. And not just the prevalence data, or data on hard-alcohol consumption, medical transport numbers, and medical transports with high blood alcohol content. Hanlon also uses metrics to prove wrong the conventional wisdom that when you make changes to the alcohol and drug policy, it will hurt enrollment.

Hanlon said that when the school launched Moving Dartmouth Forward, “there was definitely a voice in the community that worried this was going to be a disaster. No one would want to come to Dartmouth. They like Dartmouth because it’s a heavy drinking place.” The data has shown it to be the opposite, with freshman yield increasing 50% to 64% over the last six years. The data effectively diffused the argument.

Sims also said that he’s experienced similar concerns and what he says is “a persistent view that changes can’t be made without compromising enrollment, that you will give students the impression that the school is not a fun place to be, and students won’t show up.” Sims said in his experience, this is not the case. “You might well get a different quality of student looking for a different kind of experience,” Sims said. “And on top of that it’s the right thing to do.”

Sims said that he has observed that leadership is increasingly making the connection between substance use issues and student success and retention which he calls “necessary” to persuade those who are worried about enrollment.
“It requires presidents who are genuinely committed to this cause; they don’t necessarily have to be the ones leading it, but they empower those who are really responsible for providing leadership to these kinds of initiatives to actually do so.”

To fortify their leadership on these important issues, Dr. Poliakoff reiterated the need to keep trustees informed, and hoped for the continued sharing of knowledge among this group.

“This conference cannot be a one and done, a one-shot affair,” he said. “We heard today wonderful ideas and emerging best practices,” he said. “It’s up to all of us to continue our work. Every one of the partnering organizations here is committed to that ongoing process.”

Nick Motu, VP and Chief External Affairs Officer at the Hazelden Betty Ford Foundation, closed the program and reiterated the promise for partners to continue to spread the word through similar forums and continued research.
“We all come at this concern from different perspectives but with shared goals and a commitment to use evidence and best practices to light the pathway for improved outcomes for our students,” he said.