RUNNING HEAD: DRUG USE IN HIGHER EDUCATION: GENERATION RX May 1

Drug Use in Higher Education: The Evolution of Generation Rx

Laura May

Salem State University

DRUG USE IN HIGHER EDUCATION: THE EVOLUTION OF GENERATION RX May 2

The purpose of this paper is to understand the historical development of drug usage in

higher education and its implications on current student affairs practice. Understanding the

historical significance of the evolution of use in American higher education provides a

comprehensive foundation for the complex succession of drug types. Drug use appears as four

waves in American higher education through scholarship: the age of exploration from 1960 to

1975, higher education just says no from 1975 to 1990, generation Rx from 1982 to 2000,

and a new wave of drugs in academe from 1990 to present (Aikins, 2015, p. 26). In 1987, the

revision of Diagnostic and Statistical Manual of Mental Disorders (DSM-IIIR) included a

diagnosis and prognosis for attention deficit hyperactivity disorder (ADHD) and hyperactivity.

The first population of children in the United States to be prescribed medication for such

diagnoses can be identified as generation Rx for the access, use, and dependence on

medication throughout childhood and into adolescence in higher education. An analysis of the

progression of drug use will be begin with the emergence of ADHD medication onto a tracking

of non-medical prescription drug use (NMPDU) to fad drugs to opioids ending with the current

use of heroin. The historical context and current practices for marijuana use at institutions of

higher education will be minimally addressed in this report. Contributing factors to drug use

involve the intrapersonal stream of influence, the social stream of influence, and the

sociocultural environment stream of influence (Bavarian, Flay, Ketcham, & Smit, 2013, p. 720).

These numerous sources of influences have created a culture within student affairs to support,

aid, prevent, and educate at universities for undergraduate students to graduate in a positive state

of well-being.

Existing research proves an abundance of preventative and awareness programs at

institutions, yet research contains gaps of current practices in response to drug use of opioids and
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heroin. For the benefit of understanding this topic, definitions of common language are provided

to understand the vernacular utilized in discussions, trainings, and scholarship. This report will

additionally outline prevention efforts through government grants, prevention efforts through

community engagement, and current drug awareness and paraprofessional trainings.

Existing at the root of most student affairs mission is the necessity to ensure a safe and

supported environment for all students. With the consulted research, understanding the

transformation of population and contributing factors can be better evaluated. Informed

practices and methods will aid in student development through ensuring such support towards

students well-being.

Definitions

Recreational drug use refers to a drug, such as cocaine, marijuana, or

methamphetamine, used without medical justification for its psychoactive effects often in the

belief that occasional use of such a substance is not habit-forming or addictive (Merriam-

Webster, 2017). The term functional drug use refers to the use of drugs to augment productivity,

improve grade and academic outcomes, or to enhance other elements of academic performance

(Aikins, 2015, p. 26). The term licit is defined as conforming to the requirements of the law, not

forbidden by the law (Merriam-Webster, 2017). The term illicit is defined as not permitted,

unlawful (Aikins, 2015, p. 26). Non-medical prescription drug use (NMPDU) refers to the use

of stimulants, opiates, and sedatives without a legal prescription and without the intention for

recreational use (Aikins, 2015, p. 32). This definition is broadened by the added occurrence of

use in a dosage that is greater than prescribed (Andes, Wyatt, Kiss & Mucellin, 2013, p. 27). A

sedative is defined as an agent that tends to calm, moderate, or tranquilize nervousness or

excitement (Merriam-Webster, 2017). An opiate is defined as drug, such as morphine or

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codeine, containing or derived from opium and tending to induce sleep and alleviate pain

(Merriam-Webster, 2017). A stimulant is defined as an agent that produces a temporary increase

of the functional activity or efficiency of an organism or any of its parts (Merriam-Webster,

2017). The term lysergic acid diethylamide, LSD, refers to a semisynthetic illicit organic

compound that induces extreme sensory distortions, altered perceptions of reality, and intense

emotional states, that may also produce delusions or paranoia, and that may sometimes cause

panic reactions in response to the effects experienced (Merriam-Webster, 2017). The term

DSM-IIIR refers to the 1987 revision of the Diagnostic and Statistical Manual of Mental

Disorders, in which stimulant medications as prescriptions were included to individuals with

hyperactivity or attention deficit hyperactivity disorder (ADHD) (Aikins, 2015, p. 31).

Historical Context: First Wave

During the age of exploration, there were several entry points for drug use at institutions.

This timeframe between 1958 and 1975 is described as a hotbed for so-called cognitive-

enhancement drug use due to the nature of drug introduction (Aikins, 2015, p. 27). The

generational revolution led by baby boomers, individuals born between 1946 and 1964, created

a surge in drug use (Aikins, 2015, p. 26). Institutional research was the entry point for

undergraduate students and faculty researchers to discover the effects of popularized

psychoactive substances, such as the timely preferred drug choice of marijuana and the timely

trendy drug choice of LSD (Aikins, 2015, p. 27). Reports state that during this timeframe,

marijuana was the recreational drug of choice at several institutions: University of California Los

Angeles, Harvard, Yale, and Princeton (Aikins, 2015, p. 27). Use of LSD was found most
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present in varsity athletes and among the academically superior. Institutional research

heightened the usage and broadened the populations using.

In 1958, Stanford University conducted government-sponsored research by Dr. Leo

Hollister. Dr. Hollister recruited undergraduate and graduate students to take psychotomimetic

drugs, later identified as psychedelics. In 1960, Harvard Professor Timothy Leary led the

Harvard Psilocybin and Harvard Psychedelic Research, both involving the administration of

drugs to undergraduate students and the creation of a counterculture through the slogan turn on,

tune in, drop out (Aikins, 2015, p. 28). Legitimizing drug use through government-funded

studies and institutionally led research created a counterculture of acceptable trends and habits

that were difficult to redirect. Following this heightened culture were parent-type regulations

within student life. A shift in opinion previously in favor of drug use occurred in response to

alcohol and drug related deaths of various public figures Jimi Hendrix, Janis Joplin, Jim

Morrison, and John Belushi (Aikins, 2015, p. 29).

With the decline of drug use in response to these deaths, a rise of amphetamine occurred

in the mid-1960s to the early 1970s. The first United States amphetamine epidemic appeared in

1969, which led to a governmental response of added policies and heightened regulations. Prior

to these enacted misuse and dependent use of amphetamine was present in 6% of Americans.

Public figures such as Elvis Presley, Mickey Mantle, Marilyn Monroe, and President John F.

Kennedy were found to either misuse or dependently use amphetamine (Aikins, 2015, p. 30).

Countercultures within higher education shifted from active drug use of marijuana, LSD, and

amphetamine to focusing on prevention efforts through President Richard Nixon.

Historical Context: Second Wave

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The second wave of drug use at universities occurs from 1975 to 1990, a timeframe noted

as higher education just says no (Aikins, 2015, p. 27). President Richard Nixon declared the

war on drugs in 1972 by enacting the Controlled Substances Act and establishing the Drug

Enforcement Agency (DEA) in 1973. The result of these decisions led to President Ronald

Reagan introducing even stricter policies, added regulations, and mandatory sentencing

minimums for drug use and possession (Aikins, 2015, p. 30). Some researchers reported that the

death of a notable athlete, Len Bias, was more impactful to students attending higher education

than the combination of Nixon and Reagans policies (Aikins, 2015, p. 31). Len Bias, a

University of Maryland basketball star, overdosed on cocaine intoxication in his dormitory less

than 48 hours after being drafted by the Boston Celtics in 1986 (Aikins, 2015, p. 31). Each of

these combined factors, along with 1986 being a presidential year, led to the immediate passing

of the Anti-Drug Abuse Act of 1986 known informally as the Len Bias law (Aikins, 2015, p. 31).

Following the death of Len Bias, a valued undergraduate athlete, the first preventative initiative

was introduced into populations of youth. The prevention campaign entitled Drug Abuse

Resistance Education (DARE) was expensive and unsuccessful through its policy driven

approach. Longitudinal research documented showed that while hallucinogen and narcotic use

was declining in college students, illicit stimulants of cocaine and amphetamine were present on

college campuses in 16-22% of undergraduate students. Until the mid-1980s, each mentioned

drug was used for recreational and illicit use.

Historical Context: Third Wave

The population of individuals born between 1982 and 2000 are referred to as generation Rx

(Aikins, 2015, p. 32). In 1987, the revision of the DSM-IIIR included stimulant medication to be

prescribed for functional use. Aikins states that the expanding criteria for the disorder led to a
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7% rise in ADHD prevalence in the United States (2015, p. 32). The presence of generation Rx

led to the birth of cognitive neuroscience following the advent of functional magnetic

resonance imaging (MRI) scanning in 1992 (Aikins, 2015, p.32). Licit and illicit use of ADHD

medications began to increase rapidly following the distribution of prescription for functional

use. Individuals that engaged in drug use through this fashion aided in creating a new trend of

using illicitly diverted prescription drugs. In 2006, non-medical prescription drug use reached an

all-time peak within 15 years, confirming the dependence and use through licit and illicit ways

by generation Rx (Aikins, 2015, p. 33).

Historical Context: Fourth Wave

The fourth wave of drug use noted by Aikins occurs between 1990 to present day,

identifiable as a new wave of drugs in academe (2015, p. 27). Prescription stimulants are

noted as highly coveted possessions of college students for academic and recreational purposes

(Aikins, 2015, p.33). At institutions with more selective admissions standards, prescription

stimulant use is higher while ability to obtain stimulant medications was noted as easy to

somewhat easy (Aikins, 2015, p.33). Andes et al. emphasizes this ease of ability translating into

a burgeoning market for sharing and selling medications (2013, p. 29). While this market for

medication is thriving, there are students simultaneously feeling pressured to illicitly share their

prescribed medications for functional and recreational use. As NMPDU is recently being

identified as a source of concern, there are no published strategies for students to successfully

engage in to divert requests or manage pressures (Andes et al., 2013, p. 37).

Generation Rx continues to demonstrate the use of ADHD medication for functional use

such as improving concentration, study habits, organization, grades, reducing hyperactivity, and

treating undiagnosed ADHD (Aikins, 2015, p. 34). Recreational use is also present within this
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generation with motives of getting high, partying, curiosity, augmenting exercise and a

reappearance of the motive to experiment (Aikins, 2015, p. 34). ADHD, remaining the most

commonly diagnosed neurobehavioral childhood disorder in the United States in children

ranging in age from 4-17 (Aikins, 2015, p. 34). Shockingly, reports from 2006 state that

Americans consume 97% of the global stock of prescription opiates (Aikins, 2015, p. 34).

Between 1990 and 2001, the production of Ritalin rose 900% and production of Adderall

increased 5767%. The spike in production led to a nationwide shortage, which led to stimulant

medication being classified with a high potential for abuse (Aikins, 2015, p. 35). College

students who misused or illicitly used either substance experienced headaches, sleep

disturbances, paranoia, psychological dependence, strokes, cardiac arrest, violent behavior, and

suicidal ideation (Aikins, 2015, p. 35). These reactions were particularly challenging to remedy

through university services and adequate programming. Aikins article provides a basis for

understanding NMPDU as it acted as a catalyst for the need of drug-prevention programs within

higher education. Policy driven programs, such as DARE, were driven by formula and logic.

Adjusting the forms of prevention education will shift the student populations views towards

drug use.

Prevention Efforts Through Engagement 14

The overwhelming presence of nonmedical prescription drug use (NMPDU) exceeds all

illicit drug use on campuses (2013, p. 28), a finding confirmed by Andes, Wyatt, Kiss, and

Mucellin. With the increase of NMPDU at college campuses, the act of transferring gathered

data and noted practice into methods used by student affairs professionals is critical and time

sensitive. Andes et al. state the importance of campus practitioners understanding the campus

community of NMPDU drug users or distributors in order to provide appropriate and educated
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response. Three types of prevention that are suggested include universal, selective, and indicated

(Andes et al., 2013, p. 29).

Campus collaboration within student affairs, when guided and coordinated, is often

successful in the goals of reflecting institutional mission, creating initiatives, and providing

supportive services. The field of Alcohol and Other Drugs (AOD) abuse prevention

acknowledges the lack of direction regarding how to synthesize the dichotomy between

prevention and intervention methods as well as how to advocate for the necessary policy

changes (Andes et al., 2013, p. 36). The field of AOD functions best when each relevant

stakeholder possesses the knowledge, insight, and skills to provide leadership in several means

of prevention efforts (Andes et al., 2013, p. 29). This is a challenging task to champion when

direction, resources, and personnel are not available to develop upon. With the aid of informed

health care professionals and knowledgeable community outreach, a well-supported and

resourcefully multifaceted prevention effort can be developed into fruition.

Utilizing the Council for the Advancement of Standards in Higher Education (CAS), a

student affairs practitioner can understand that there is no singular formula for determining the

correct program or approach (Andes et al., 2013, p. 32). Instead, it is important to include

substantial assessment and intentional programming to guide campus prevention and intervention

efforts to best serve the institutions population. NMPDU research must be further conducted

and interpreted

Controversial Strategies 16

While campuses are creating and utilizing prevention efforts to minimize the presence of

drugs on college campuses, other institutions are demonstrating progressive efforts to offer harm-

reducing strategies. Medical aid and Good Samaritan policies are present at several institutions
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on an individual basis, at campus events and during residence life paraprofessional duty

response. In response to the national rise of opioid overdoses, safeguarding the student body in

various manners provides practices that are educationally based on education (Schmidt, 2016).

Allowing students to provide emergency response leads to bystander empowerment and a

knowledgeably engaged student body. Good Samaritan policies, allowing a pardon to be granted

if aiding self or others, are a heavily debated discussion within University leadership. Similarly,

harm-reducing practices and policies are highly controversial and debated between various

opinions at institutions.

One manner of safeguarding practices is utilizing kits to test the quality and contents of

illicitly obtained drugs. This practice at Reed College, a private university, aims to ensure that

students experience the least amount of harm, if able, when using (Schmidt, 2016). These kits,

available on a student-to-student basis from a student group, allow for students to avoid

poisoning or overdosing. Being aware of the unusual of excess components prevent harmful

reactions from occurring. Reed College had developed a reliable and trusting system for

students to rent and return these drug kits anonymously.

A second manner of safeguarding practices appears at Dickinson College through

offering medical response at campus events. For performances with anticipated drug use among

student attendees, Dickinson College sets up emergency trained technicians and student leaders

to hydrate, offer aid, and coordinate with roommates for a safe return to their residence halls

(Schmidt, 2016). This tactic is to ensure that students, under the influence through their own

control or not, will receive aid under the Good Samaritan policy. The Good Samaritan policy

can be defined through higher education terms of offering immunity or leniency to students

found to have violated rules governing substance abuse in the course for seeking medical help
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from themselves or for a peer (Schmidt, 2016). Currently, within the institution at which I serve

as a Conduct Hearing Officer for, the Good Samaritan policy solely covers incidents which

involve the use of alcohol. If a student requests aid for themselves or a peer for a situation

regarding drug use for any purpose, the student will not be pardoned from conduct sanctions. It

is challenging to provide bystander training and appropriate protocol strategies while answering

questions from the residential staff regarding the limitations of the institutions Good Samaritan

policy.

A third manner of safeguarding practices is administering Naloxone, a harm-reducing

strategy appearing at both University of Texas Austin and University of Central Florida

(Schmidt, 2016). Naloxone is a medication that revives individuals who have a significantly

high dosage, an overdose, on heroin or a similar opioid. This third manner is controversial due

to the audience that is receiving Naloxone training. At University of Central Florida, campus

police is being trained, yet at University of Texas at Austin, dormitory resident advisors are

receiving training. Each institution holds varying standards for their residential life staff,

depending on geographical location, fiscal resources, and population of staff. However, the

responsibility to respond to crisis can naturally be a catalyst for negative emotional or

psychological response. The added responsibility to administer a medication that will revive a

peer is challenging to cope with as a full-time student with limited training, as Schmidt informs

readers in his article (2016). Naloxone training is a strategy that seems to be utilized at several

institutions, depending on need, geographic location, and as a means for prevention.

Conclusion

Evaluating the historical context of American drug use in a college environment setting

will provide implications for future research and practice within the field of student affairs. As
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current research indicates, drug use is ever-shifting and contributing factors vary in impact. As a

student affairs professional who responds to crisis daily and holds responsibility for providing

substantial programming to residential students, it is imperative that professionals remain current

with trends, language, popular culture, and appropriate trainings. For the benefit of higher

education, research on American drug use must contain a focus of successful campus

collaboration, strategies to combat the emergence of heroin use, and education on NMPDU of

Adderall. A persisting central mission of providing safety and education for undergraduate

students anchors student affairs professional practice. Continuing to address drug use with avid

research will ensure that each institution can provide knowledgeable resources and personnel

while challenging students to make informed decisions while being educated on strategies to aid.
DRUG USE IN HIGHER EDUCATION: THE EVOLUTION OF GENERATION RX May 13

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