Drug recovery is now US national policy. Campuses need to step up

In late January, the White House announced the Great American Recovery Initiative, a new federal effort to coordinate prevention, treatment, harm reduction and addiction recovery support across public systems. The initiative signals a long-overdue recognition that addiction recovery is not peripheral to public health: it is central to it.

Colleges and universities, which educate and house millions of young adults during the highest-risk years for substance use disorders and overdose, must be part of this national response. Yet current practices show that higher education is lagging behind.

An estimated 600,000 college students are in recovery – defined as ongoing efforts to reduce or stop substance misuse. Unfortunately up to 60 per cent of people in recovery experience a relapse, and the risk is probably even higher for college students, who are surrounded by high levels of peer drinking and drug use.

To be fair, university-based recovery programmes have expanded substantially across college campuses, increasing more than sixfold over the past decade. But my research shows that many programmes are not yet equipped to meet the realities of today’s campus environment.

As it stands, college recovery programmes remain small, fragile and dependent on short-term funding. There are just under 6,000 institutions of higher education across the US, yet we only identified slightly more than 170 college recovery programmes, leaving the vast number of students without access to these services. Meanwhile, most of these programmes are not fully integrated into campus health systems, meaning students often rely on fragmented or external services for clinical care, with limited coordination with counselling and other medical support. And with their funding constantly in flux, many programmes struggle to match the growing demand for recovery support on campus.

At the same time, many programmes lack the flexibility that is integral to making them as effective as possible. Recovery is not one-size-fits-all. Students rely on an array of support, from counselling and harm reduction approaches to peer- and campus-based recovery housing programmes. Yet some programmes emphasise abstinence as the only goal, which unintentionally overlooks students navigating recovery in different ways. Meanwhile, others focus entirely on harm reduction approaches, without offering pathways linking prevention, treatment and long-term recovery.

These shortcomings are just part of the story. Efforts to curb substance use are generally thought of in two phases. The first is treatment, when individuals receive acute care for their addiction. The second is recovery, when individuals receive sustained support to prevent relapse. Programmes on college campuses have been set up as part of the second phase.

Yet given the fractured state of our healthcare system, my research has found that only about half of students in recovery programmes have received formal substance use treatment before entering them. That means they are lacking the skills typically developed during treatment: managing triggers, regulating emotions, building supportive networks and responding to relapse.

It is also important for recovery programmes to be tailored to the students they are meant to serve. For instance, nearly half of participants in college recovery programmes identify as LGBTQIA+, far outpacing national averages. These students experience disproportionate stress, stigma and mental health challenges that further impact their recovery.

College recovery programmes can and should do more to meet students where they are in their recovery journeys. For instance, they should also be visibly affirming – through trained staff, affinity groups and intentional partnerships with campus LGBTQIA+ centres.

In addition, more programmes should offer practical, low-barrier supports, such as structured peer mentoring, skills-based workshops on managing cravings and stress, facilitated connections to counselling and medical care, and clear pathways back into support following relapse. Such support could include a variety of tools that many students have never been formally taught but urgently need. Without this shift, campuses will continue to shoulder the recovery phase while leaving students without the preparation needed to succeed.

All of this will also require more institutional investment, including stable funding streams and better integration and coordination with the larger campus. Without this level of institutional commitment, programmes will remain fragmented and fail to play their part in a long overdue national commitment to embedding recovery supports into the institutions people rely on every day.

Noel Vest is assistant professor at the Boston University School of Public Health and a NIDA-funded researcher studying addiction recovery support and overdose prevention.