Your college years may be a time for experimenting and trying new things. But with this newfound freedom, it's important to make safe and smart decisions regarding alcohol and substance use, gambling, thoughts of suicide and mental health.
If you or someone you know is struggling in any of these areas, Your Life Iowa is here to help you.
Are you a parent or university/college staff member? Our college healthcare provider toolkit can help you have conversations about mental health, substance use and problem gambling with college students.
While it may seem like college culture revolves around drinking and partying, many college students don't drink. According to NSDUH data, only 15% of those 12-20 consumed alcohol in the past month. That means almost 85% of those under 21 did not drink alcohol.1
If you are of legal drinking age, it's important to know and practice safe alcohol consumption guidelines and remember it is possible to have or develop a problem with alcohol in college. According to NSDUH, 13% of college students ages 18-22 meet the criteria for an alcohol use disorder.2
Responsible Alcohol Consumption
This is for people who are 21 and older, not pregnant and who have not experienced problems with alcohol or other substances in the past. Remember to talk to your doctor if you are taking any medications that could react negatively with alcohol before consuming alcohol.
Tips for responsible alcohol consumption include:3
- Pace yourself
- For women: no more than 1 drink per day and no more than 7 in one week
- For men: no more than 2 drinks in one day or 14 in one week
- Know what you're drinking and stick to standard drink sizes
- Avoid drinking out of jungle juices, borgs, tall boys, Four Lokos, etc.
- Don't play drinking games
- Avoid taking shots
- ALWAYS eat before and drinking drinking
- Make sure you stay hydrated and drink water
- Do not mix drugs with alcohol (this includes marijuana and medications prescribed by your doctor)
- NEVER drive after consuming alcohol
It may be common knowledge that the legal drinking limit is 0.08 BAC but what exactly does that mean and how does blood alcohol content affect your body?
Remember a person's blood alcohol content differs based on how much and how fast they drink and may be different from person to person due to factors such as height, weight and gender.
Over one third of college students admitted to binge drinking,2 and Iowa ranks in the top 10 states with the highest rates of underage binge drinking.6 With binge drinking being so common among college students in Iowa the risk for alcohol poisoning and overdose increases.
Alcohol poisoning is very serious and can have deadly consequences. In the United States alone it is averaged that every day 6 people die from alcohol poisoning.7 Don't think it can't happen to you or someone you know. Learn the signs and symptoms and how to respond to save a life.
Someone experiencing alcohol poisoning may have:4
- Choking, no gag reflex
- Dulled/slowed responses
- Slowed or irregular breathing (less than 8 breaths a minute)
- Clammy/sweaty skin
- Slowed heart rate
- Hypothermia/low body temperature
- Pale or blue skin
What to Do
If you think someone may be experiencing alcohol poisoning, you should:8,9
- Seek medical attention immediately, don't leave them to just “sleep it off”
- Stay with the person and monitor them
- Prevent them from choking by sitting them upright or laying them on their side
- Try to keep them awake
- Get them to drink water if they are conscious
- Keep them warm
- Try to recall details about the person for emergency responders (allergies, how much they drank and how fast, age etc.)
What is a "standard drink?"
Did you know that just because you order one drink it doesn't mean that it's equivalent to drinking one standard serving of alcohol? Popular drinks that contain more than a standard drink size are:
- Long Island = 4 standard drinks
- Tallboys = 1.5 - 2 standard drinks
- Margaritas = 1.7 standard drinks
- 1 bottle of wine = 5 standard drinks
Alcohol's Effects on Health
National Institute on Alcohol Abuse and Alcoholism (NIAAA) webpage titled "Harmful and Underage College Drinking."
National Institute on Alcohol Abuse and Alcoholism (NIAAA) website on alcohol and health.
Standard Size Drink Comparison
UCLA Police Department resource with standard drink comparisons.
1 Highlights for the 2021 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration.
2 Alcohol's Effects on Health: Harmful and Underage College Drinking. National Institute on Alcohol Abuse and Alcoholism.
3 What are the U.S. guidelines for drinking? Rethinking Drinking.
4 Alcohol's Effects on Health: Understanding the Dangers of Alcohol Overdose. National Institute on Alcohol Abuse and Alcoholism.
5 Blood Alcohol Content (BAC). Cleveland Clinic.
6 Underage Binge Drinking Varies Within and Across States. Substance Abuse and Mental Health Services Administration.
7 Alcohol Poisoning Deaths. Centers for Disease Control and Prevention, 2015.
8 Alcohol Poisoning. Mayo Clinic.
9 Alcohol Poisoning. Cleveland Clinic.
It's important to know how to identify a drug overdose and know where to go for concerns or questions about substance use while in college.
In Iowa in 2020, 4% of young adults aged 18-25 misused prescription pain relievers, 5% used cocaine and 34% of young adults used marijuana.1
Don't put your life at risk and say no to drug use. If you or someone you know is struggling with drug misuse call, text or chat Your Life Iowa for free support.
Overdose & Naloxone
Call 911 immediately if you notice signs of a drug overdose in someone. Iowa's Good Samaritan law protects people from prosecution if they call emergency services as soon as they notice a drug overdose. There are other good resources to have when someone is experiencing an overdose, one of these being Naloxone or Narcan.
Naloxone is an opioid antagonist meaning it knocks opioids off the receptors reversing and blocking the effects of an opioid overdose. Naloxone should be administered anytime an overdose is suspected. However, naloxone will only be effective in cases of opioid overdose, this includes fentanyl, heroin, oxycodone, hydrocodone, codeine, and morphine. It has no effect on someone without opioids in their system.
Based on how much opioid is in a person's system Naloxone may need to be administered more than once.2 Check to see if naloxone is available on your university campus or learn more about how to use naloxone.
How to Purchase Naloxone
Did you know you don't need a prescription to purchase naloxone? See these resources to find out how you can get naloxone.
Identifying an Opioid Overdose
Someone experiencing an opioid overdose may:3,4
- Slowed breathing and heart rate
- Pale or clammy skin
- Limp body
- Fingers or lips have turned blue or purple
- Loss of consciousness and unresponsive to surroundings
- Making choking or gurgling noises
- Dizziness and confusion
Driving while misusing drugs is extremely dangerous and can also result in an OWI (operating while under the influence). In 2016, drugged driving was responsible for more fatal car crashes than drunk driving.5
It's a common belief that driving while using marijuana is safe, 33% of Iowa teens think that driving while using marijuana is legal.6 Driving while using marijuana is illegal and extremely dangerous and can result in an OWI. In 2016 marijuana was detected in 51% of Iowa’s drug impaired fatal car crashes making it the most cited drug detected.6
Mixing Drugs and Alcohol
Whether you're prescribed a medication that's unsafe to consume with alcohol, or you use illicit drugs while consuming alcohol for increased effects and longer nights partying they are equally dangerous. Even mixing alcohol with some over the counter medications is unsafe.
Mixing alcohol with certain drugs like Adderall or other stimulants dulls the effects of both drugs causing individuals to drink more, increasing the chances of an overdose.7 The dangers of mixing alcohol with stimulants otherwise known as “uppers” like Adderall, cocaine and meth could lead to heart attacks, stroke, brain injury and liver damage.8
Always check with your doctor about any medications you're taking before consuming alcohol. Visit the National Institute on Alcohol Abuse and Alcoholism for a list of common medications and how they interact with alcohol consumption.
Understanding Naloxone - National Harm Reduction Coalition
National Harm Reduction Coalition webpage covering opioid overdose basics.
Harm Reduction Principles - National Harm Reduction Coalition
National Harm Reduction Coalition webpage covering harm reduction practices and strategies.
Harmful Interactions - Mixing Alcohol With Medicines
National Institute on Alcohol Abuse and Alcoholism webpage on the risks of mixing alcohol and medications.
Association of Recovery in Higher Education
Website for the ARHE, the only association exclusively representing collegiate recovery programs and collegiate recovery communities.
1 Alcohol, Tobacco, & Substance Use Among Young Adults. Iowa Substance Abuse Brief: Substance Use Among Young Adults, 2022.
2 Naloxone DrugFacts: What is Naloxone? National Institute on Drug Abuse.
3 Opioid Overdose. Substance Abuse and Mental Health Services Administration.
4 Opioid Overdose Basics: Recognizing Opioid Overdose. National Harm Reduction Coalition.
5 Drugged Driving DrugFacts. National Institute on Drug Abuse.
6 Drug Trends in Iowa: Evolving Health, Safety & Response Issues. Governor's Office of Drug Control Policy, 2021.
7 Alcohol and Other Substances. Centers for Disease Control and Prevention.
8 Polysubstance Use Facts. Centers for Disease Control and Prevention.
Vaping is a lot more dangerous to your health than you might think.
There haven been over 2,500 hospitalizations due to vaping, and the highest percent of those hospitalized were ages 18-24.1
Around 25% of young adult Iowans reported ever using any type of tobacco product.2 It's never too late to quit vaping.
Understanding Social Smoking/Vaping
Social smoking is extremely common among college students and on college campuses. In fact 70% of college students who smoke are characterized as social smokers.3 Smoking or vaping only when in a group setting with friends or only when going out/drinking is still dangerous and harmful to a person's health.
The biggest danger of social smoking is that it can easily lead to a nicotine addiction and smoking or vaping more regularly.4 Other dangers of “social smoking” are an increased risk for heart disease, lung and throat related cancers and respiratory infections.5
Ingredients Found in E-cigarettes
Do you really know what you're inhaling? Most e-cigarette juices contain the following ingredients:6
Quitting vaping may not be easy, in fact it may take you multiple tries to quit and that's okay. There are many resources out there to help you quit, these are just a couple of quitlines you can use to receive support to quit vaping. Quitlines can provide information, answer questions, offer a listening ear and more.
Knowing some of the withdrawal symptoms before you experience them may help you be better prepared. Symptoms may peak within the first week and start to go away after only the first month.7 Withdrawal symptoms include:8
- Increased appetite/hunger
- Restlessness and difficulty concentrating
- Irritability and anger
- Intense cravings
E-Cigarette (or Vaping) Products Visual Dictionary
CDC PDF with illustrations and information about different vaping products.
National Institute of Health website with resources for anyone wanting to quit smoking or vaping.
Know the Risks: E-Cigarettes & Young People
U.S. Department of Health and Human Services website with resources and support to quit vaping.
Quitline Iowa: Success Stories
Quitline Iowa webpage with success stories from adults who have quit tobacco.
1 Outbreak of Lung Injury Associated with the Use of E-Cigarettes, or Vaping, Products. Centers for Disease Control and Prevention.
2 Iowa Young Adult Survey. Centers for Social and Behavioral Research, University of Northern Iowa, 2019.
3 Characteristics of Social Smoking Among College Students. National Library of Medicine, 2010.
4 Social smoking among US college students. National Library of Medicine, 2004.
5 Light and social smoking carry cardiovascular risks. Harvard Health Publishing, 2018.
6 Vaping (E-Cigarettes), Cleveland Clinic.
7 Handling Nicotine Withdrawal and Triggers When You Decide to Quit Tobacco. National Cancer Institute.
8 Vaping Addiction and Nicotine Withdrawal. Smokefree.gov.
Every year, 14% of Iowans will experience a problem related to gambling.1 Problem gambling affects many people and may disproportionately affect teens and young adults.2
Sports gambling is particularly popular with college students - one national study3 found that 67% of students living on campus had participated in sports betting. Six percent of survey respondents had lost more than $500 in a single day - a pattern that can significantly impact your financial stability.
If you think you or someone you know may be experiencing problem gambling please reach out.
Signs of problem gambling:
These symptoms can indicate an issue with gambling:4,2
- Feeling anxious or restless when not gambling
- Placing increasingly large bets
- Lying to friends and family about the extent of your gambling
- Borrowing money to either gamble or payback a debt from gambling
- Trying but not being able to quit
- Thoughts of suicide
- Considering committing an illegal act to get money to gamble
Your Life Iowa’s payout wizard lets you choose what game you want to play and how much you want to bet. It will then calculate how much you're going to lose on average for each bet you make. Click the link to see how much you could lose.
College Athletes and Problem Gambling
It is found that student athletes have a greater risk for developing problems related to gambling. Factors that may contribute to this are certain personality traits like being highly competitive and a need for excitement, which are common traits among athletes.2
Even though the NCAA has prohibited all kinds of sports gambling for student athletes, many athletes continue to choose to engage in sports gambling. In fact the NCAA found that at least 1 in 4 male student athletes reported engaging in sports betting.5
College Gambling Facts and Statistics
National Council on Problem Gambling PDF with facts, warning signs and risk factors for gambling in college.
International Center for Responsible Gaming's college gambling website for current and perspective students, campus administrators, campus health professionals and parents to address gambling and gambling-related harms on campus.
Problem Gambling webpage
Villanova University webpage with information problem gambling and support options for seeking help.
National Council on Problem Gambling
NCPG website with extensive information on problem gambling and seeking support.
About Gambling with Your Life Iowa
YLI webpage with details on gambling, the psychology behind gambling, phases of gambling, effects on the brain and more.
1 Are you or a loved one facing a problem with gambling? Your Life Iowa.
2 College Gambling Facts and Statistics. National Council on Problem Gambling, National Council on Responsible Gambling REAP, and CollegeGambling.org.
3 Addressing Sports Wagering. NCAA, 2023.
4 Warning Sings - Gambling, Your Life Iowa.
5 Mind, Body and Sport: Gambling among student athletes. Sport Science Institute, NCAA.
College can be a difficult time for some. It can be easy to feel isolated and alone.
Many people are impacted by thoughts of suicide. In Iowa over 18% of young adults 18-24 answered yes to experiencing serious thoughts of suicide.1
If you or someone you know is experiencing thoughts of suicide you're not alone. Thoughts of suicide can be treated. Your Life Iowa is here to help you.
Someone who is having thoughts of suicide may experience one or multiple of these warning signs:2
- Self-isolation and withdrawing from activities, friends and family
- Giving away belongings and saying their goodbyes
- Saying things such as “I wish I was never born” or “I wish I were dead”
- Talking about killing themselves
- Feelings of hopelessness
- Feeling like a burden to others or that they have no reason to live
- Anxiety and depression
- Sleeping too much or too little
- Abusing drugs or alcohol
- Worsening of grades or class attendance
- Poor hygiene or changes in physical appearance
How to talk to someone considering suicide
Suicide is a difficult topic and may feel uncomfortable to talk about at first, but talking about suicide saves lives.
If you're not sure how to start the conversation, here are some things to do or say when discussing the topic of suicide.3
- Approach the topic gently by asking how the individual is doing. Talk about any concerning behaviors you've noticed.
- Make sure they know you are taking their thoughts seriously by asking them clearly and directly “have you been experiencing thoughts of suicide?”
- Offer your support and give them your full attention.
- Offer to stay with them and help them contact a crisis line or helpline like Your Life Iowa. You can also see if there are any resources your university offers on campus to help individuals experiencing thoughts of suicide.
- Some things NOT to do when talking about suicide is use phrases like “You're not thinking of doing something silly, are you?” or “Are you thinking of hurting yourself?” These phrases are not clear and may make the person feel as if their thoughts of suicide are not being taken seriously.
- Never promise to keep the information secret. Thoughts of suicide are serious and a person may need treatment to feel better. If you suspect someone may be experiencing thoughts of suicide reach out, dont assume someone else will.
- If you think the person is in immediate danger of harming themselves, do not leave them alone. Stay with them and get help immediately. Call or chat with Your Life Iowa, or if it's an emergency, call 911.
- Make sure to check in and take care of yourself, as well. Access mental health supports if you feel they would help you after this experience.
Suicide Loss Survivors- American Association of Suicidology
AAS webpage with resources for people who have lost a loved one to suicide.
American Foundation for Suicide Prevention
AFSP website with support for thoughts of suicide, family and friends, educators and more.
Know the Signs
Take Action for Mental Health Campaign webpage with warning signs, help for talking about suicide, and support for reaching out.
Suicide Awareness Voices of Education
National organization working to prevent suicide through public awareness, education and as a resource for suicide survivors.
CDC webpage on suicide
Centers for Disease Control and Prevention webpage on suicide.
2 Risk factors, protective factors, and warning signs. American Foundation for Suicide Prevention.
3 If Someone Tells You They're Thinking About Suicide, Talk Away the Dark.
Did you know that 75% of mental illnesses begin by the age of 24.1 This means that even if you've never experienced a problem with your mental health it's still important to know how to care for it. Make sure to prioritize taking care of your mental health.
In Iowa, nearly half a million adults have a mental health condition.2 If you or someone you know is experiencing a mental health crisis call, text or chat with Your Life Iowa to talk to a trained professional.
You may experience more stress in college dealing with academic stressors like harder classes, tests, and homework. Learning to navigate living on your own and being independent for probably the first time in your life can be overwhelming. Practicing healthy coping mechanisms can help you deal with the everyday stressors of college life.
Some stress can actually be a good thing but when stress becomes overwhelming and chronic that's when it may be time to take a break and seek help. Too much stress not only affects your mental well-being, but your physical health as well.
Tips for Coping with Stress
These practical steps can help you reduce your stress or better manage it when it occurs.3
- Avoid drugs and alcohol
- Spend time doing activities you enjoy
- Spend time with friends and family
- Get enough sleep
- Eat a healthy meal
- Meditation or relaxation techniques
Warning Signs of a Mental Health Concern
If you or a loved one are feeling any of these symptoms regularly, it could be a cause for concern:4
- Headaches, nausea, upset stomach
- Shoulder, neck and back pain
- Changes in eating and sleeping habits
- Feeling anxious or depressed
- Feeling overwhelmed or more emotional
- Trouble remembering and keeping track of things
Anxiety is one of the most common mental health problems college students face. In fact it is so common that over 38% of college women and over 17% of college men reported being diagnosed with anxiety.5 Anxiety comes in many forms and there are many different kinds of anxiety. Some common anxiety disorders are generalized anxiety, panic disorder, social anxiety, and obsessive compulsive disorder (OCD).
Generalized anxiety is defined as experiencing long lasting anxiety for months or even years. It is not triggered by life events and is often unprovoked. Symptoms include restlessness, fatigue, irritability, difficulty sleeping and concentrating.6
Panic disorder is when an individual experiences frequent panic attacks. A panic attack is a sudden period of extreme fear when there is no actual danger. Symptoms of panic attacks include racing heart, shortness of breath and tightness in the chest and throat.7
Social anxiety is when an individual experiences intense fear of being negatively judged in social situations. Someone experiencing social anxiety may be extremely self-conscious and easily embarrassed.8
Obsessive Compulsive Disorder (OCD) is when a person experiences obsessive thoughts, compulsive actions or both. Obsessions are repetitive thoughts or images that cause anxiety. Compulsions are repetitive behaviors often in response to obsessive thoughts.9
Another common mental health problem among young people is depression. Similar to anxiety, depression comes in many forms, some commonly diagnosed types of depression are major depression, persistent depressive disorder, seasonal depression and bipolar disorder. Some common symptoms of depression are persistent feelings of hopelessness, sadness, feeling empty, and losing interest in activities that once brought joy. Depression can also cause changes in sleep and appetite, decreased energy, and difficulty concentration.10
Major depression is when an individual experiences symptoms of depression for 2 weeks and symptoms interfere with their daily functions.
Persistent depressive disorder is when individuals experience less severe symptoms of depression lasting for at least 2 years.
Seasonal depression is when someone experiences symptoms of depression during specific seasons, usually fall and winter.
Bipolar disorder happens when a person goes back and forth between experiencing manic episodes and periods of depression.
Student Stress 101: Understanding Academic Stress
The Jed Foundation webpage on understanding academic stress in college.
NAMI: Mental Health in College
National Alliance on Mental Illness webpage on mental health in college.
MHA: Life on Campus
Mental Health America webpage on managing mental health on college campuses.
NAMI: What are the warning signs of depression in college students?
National Alliance on Mental Illness webpage on how to identify depression in college students.
Website focusing on men's mental health, substance use and more.
MHA: 5 minute guide to men's health
Mental Health America infographic on men's mental health.
1 Warning Signs of Mental Illness. American Psychiatric Association.
2 Mental Health in Iowa, National Alliance on Mental Illness, 2021.
3 Coping With Stress, Centers for Disease Control and Prevention.
4 Emotional Stress: Warning Signs, Management, When to Get Help. Cleveland Clinic.
5 National College Health Assessment, Executive Summary. American College Health Association, 2022.
6 Anxiety Disorders, National Institute of Mental Health.
7 Panic attacks and panic disorder, Mayo Clinic.
8 Social anxiety disorder (social phobia), Mayo Clinic.
9 Obsessive-Compulsive Disorder, National Institute of Mental Health.
10 Depression. National Institute of Mental Health.