Over the past decade, college students have faced a notable rise in mental health issues, including anxiety and depression, with many also experiencing co-occurring substance misuse and related challenges. Among these, opioid misuse increases the risk of overdose and severe health complications. While much of the existing research has focused on alcohol, cannabis, and nicotine use, there has been relatively less attention given to the prevalence and consequences of opioid misuse. This study aims to quantify the prevalence of opioid misuse among U.S. college students, estimate the prevalence of anxiety and depression, examine help-seeking behaviors, and analyze the impact of opioid misuse on academic performance.
The study collected data from the Healthy Minds Study (HMS) between 2017 and 2020, which included 176,191 students from 375 colleges and universities across the United States. The sample consisted of students aged 18 to 25 with diverse demographic characteristics. Mental health symptoms were assessed using validated tools such as the PHQ-9 for depression and the GAD-7 for anxiety, while opioid misuse was self-reported by students based on their non-prescription opioid use in the past 30 days. Help-seeking behaviors, such as seeking counseling or informal support, and academic performance were also evaluated using survey data.
The study found that 782 students (0.44%) reported opioid misuse. Among these students, 64.3% screened positive for anxiety or depression, representing a 24.1 percentage point increase in the likelihood of experiencing mental health issues compared to students who did not misuse opioids. Despite the high prevalence of mental health problems, only 48% of students with opioid misuse sought counseling or therapy in the past year, with many relying on informal sources of support such as peers or support groups. In addition, students who misused opioids were more likely to report that their academic performance was negatively impacted by mental or emotional difficulties, with a 6.1 percentage point increase in the probability of experiencing academic challenges. This study highlights the need for enhanced coordination between substance use and mental health services on college campuses, as well as the importance of peer support for students struggling with opioid misuse.
Takeaway: Opioid misuse among U.S. college students is associated with a significant increase in anxiety, depression, and academic challenges, highlighting the need for better integration of mental health and substance use services on campuses.