The odds are good that you know someone at college who has a drug or alcohol problem. Substance use in college-aged adults is alarmingly high. For example: 

  • 69% of college students who reported illicit drug use had negative consequences from it
  • 44% of students reported having driven a car while high on drugs
  • 28% of students reported being moderately concerned about their own drug use

Out of students who are worried about their own use, 76% are interested in getting some kind of help. That could be treatment, counseling, medication, or therapy. 

Despite that, it can be hard to pull the trigger on getting help without motivation and social support. That’s where you can come in as a resource for your friend. 

It’s possible that your friend already knows that they have a substance use disorder (SUD), but they aren’t sure how to get help. 

Or they might be ashamed of the social stigma associated with SUD, especially in a college environment where drugs and alcohol are accepted. 

You can squash that stigma by being the rock that your friend needs. Here’s what you need to know about: 

  • Recognizing if your friend needs help
  • Approaching your friend about a sensitive topic
  • Handling the conversation about treatment
  • Being a supportive friend to someone with SUD

Does Your Friend Need Addiction Treatment?

If you suspect your friend needs addiction treatment, then you’ve probably already recognized the signs that their substance use is becoming a problem. Some of them may include: 

  • Slipping grades and class attendance
  • Going to another bar (and another, and another) after last call
  • Getting into legal trouble or trouble on campus
  • Using substances on school days and/or in the morning and afternoon
  • Physical signs of drug use, such as nosebleeds from cocaine use or injection marks from heroin use

If your friend is dependent on a substance, then you may notice the following:

  • An inability to stop using or control their use
  • Using larger amounts to get the same effect (known as tolerance)
  • Losing time getting drugs or recovering from using them
  • Neglecting activities and relationships to use drugs

The biggest sign of SUD is withdrawal when your friend tries to stop using. Sometimes withdrawal symptoms can set in just hours after the last dose, so you may catch your friend feeling irritable after a long class or lab.

The withdrawal symptoms are different depending on the type of drug your friend is withdrawing from, but they might include: 

  • Cravings
  • Mood changes
  • Muscle and joint pain
  • Headaches

Your friend’s SUD is likely to affect you too, especially in college, where friends are close-knit. You may be affected by their SUD if you: 

  • Have felt embarrassed by their behavior in public
  • Spend a significant amount of time worrying about their substance use and their safety
  • Have missed classes or neglected studying to take care of your friend or bail them out
  • Have had your own safety threatened by their substance use

Any combination of these signs can indicate that your friend needs treatment. The more symptoms, the higher the chance that there’s a significant problem. It can be hard to seek treatment when you’re balancing the responsibilities of college, but your friend’s safety could be at stake. 

Should You Approach Someone About Getting Treatment?

If you’re worried about your friend, then you should consider approaching them about getting treatment. 

It’s common to worry that you’re invading their boundaries by asking your friend to get treatment but think of it this way. Like you, your friend is living on their own in a college environment for the first time. 

College is a time full of pressures, stressors, responsibilities, and expectations. That’s why 43% of college students report illicit drug use. At first glance, it’s an easy way to cope with all of these problems, feel good, and chill out with your friends. 

But in reality, drug overdoses are on the rise in college-aged adults. You’re on your own for the first time without your hometown social circle and family to look out for you. And it’s much harder to ask for help when nobody knows you need it. 

That’s why you should approach your friend about addiction treatment. You could be the only social support who realizes that they need help. And your support at this time could help decide their entire college career and life path. 

How to Talk to Your Friend About Addiction Treatment

It’s critical to take a thoughtful approach to your conversation. Your friend is probably already self-conscious that other people are noticing their problem. Taking up a conversation at the wrong time or in the wrong place could make them feel attacked. 

Still, the right conversation with the right approach can be life-changing.

Before you talk to your friend about their addiction problem, you should think about the following: 

  • Pick the right time and location: Start the convo in a safe place where you have one-on-one time with your friend. This fosters a sense of intimacy and safety, so they’re less likely to get defensive (or worry who’s going to overhear). The time matters too; avoid talking about sensitive issues if your friend is already stressing about grades or social problems. 
  • Start the conversation sober: Neither of you should be under the influence of anything when you have this conversation. That might be easier said than done if your friend uses substances often, so be prepared to jump on the opportunity when it does come up.
  • Don’t generalize or bring up other relationships: Talk to your friend about how you are concerned about their SUD, or how you are affected by it. There’s no reason to bring other people into the conversation. Saying “We’re all worried about your alcohol use” makes it feel like everyone is talking behind your friend’s back when that’s (hopefully) not the case.
  • Use “I” statements: Try to keep your statements blameless and focus on the way you feel and what you’re observing. Don’t say “You always come back to the dorm drunk.” Instead, say “I get worried when you come back from the bar way too late.” This is another way to keep your friend from feeling like they’re being put on the spot.
  • Be specific about what’s concerning you: It’s not enough to talk vaguely about the dangers of substance use. It’s easy for your friend to deny there’s anything wrong if there isn’t action pointing to a problem. Have specific examples of actions and behaviors that you’re noticing. They can include things like sleeping through class, missing night labs to drink, or staying in bed all day when they’re in withdrawal.
  • Have resources ready before you talk: If your friend is open to getting help, you want to be able to act right away before they change their mind. Before you talk, take the time to find local and campus resources for recovery and treatment. That can include the phone number of a local treatment center or your collegiate recovery program (CRP).

How to Support Your Friend While Getting Them Help

If the conversation goes well, hopefully your friend agrees to getting help in some form. That can include inpatient or outpatient treatment, as well as aftercare. 

Your role doesn’t stop when your friend agrees to rehab. The next steps are to support your friend through pre-treatment until they reach detox and rehab, if that’s in their path. You’ll support them through and beyond rehab, too. 

To prepare yourself to give that support, you should: 

  • Get educated: Learn as much as you can about SUD, especially involving the drug that your friend uses. Learn about the most effective treatments and the signs of relapse. You can do this on your own by using online resources or even taking a class about substance use disorders.
  • Contact resources on- and off-campus: If your friend doesn’t have a treatment or aftercare plan in place yet, then you can take some of the burden off them by contacting resources yourself. For starters, you should get in touch with local treatment centers, your CRP, and the college counseling center.
  • Talk to your counseling center: You should make an appointment at the counseling center, not for your friend, but for yourself. Your school’s counseling center has substance use specialized counselors who have been in your situation. They’ll be able to advise you on how to handle different situations that come up before, during, and after treatment.
  • Make time for sober activities: Whether you’re in recovery yourself or not, schedule in activities that don’t involve drugs or alcohol so you can bond with your friend. It doesn’t matter if it’s a hike, a sober music festival, or a night at the coffeehouse. Social support is a huge factor in SUD relapse, so helping your friend feel included and accepted is more necessary than you know.
  • Talk to them: Ask your friend how their recovery is going. Talk to them about their struggles and give them reassurance that they’re on the right path. Recovery can make your friend feel as if no one understands, but you can be their safe outlet whether you’re experienced in SUD or not.
  • Stay involved: Don’t let yourself become less of a friend when recovery changes the friendship. It’s too common for friendships to drift away when someone starts dealing with SUD or another mental disorder. Substance use disorder is alienating, and if you don’t keep in touch, your friend might suffer.

Help Your College Friend Choose Recovery

If you’re sure that your friend is struggling with substances, don’t hesitate to take action. 

Recovery is a difficult choice to make when you’re faced with barriers like social stigma. It often feels easier to keep living your college life regardless of the consequences that drinking and drugs have on your grades and performance. 

You can be the catalyst to change in your friend’s life. Talking to your friend about their substance use and their need for treatment can save them from a lifetime of SUD or even overdose. Now is the time to talk to your friend about SUD treatment. 


  1. College Student Drug Use: Patterns, Concerns, Consequences, and Interest in Intervention
  2. Monitoring the Future: College-Age & Young Adults
  3. How college students can end up in vicious cycle of substance abuse, poor academics, stress
  4. How To Recognize a Substance Use Disorder
  5. How to Find Help

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