Abstract
Objective:
To characterize the demographics, recovery pathways, and support needs of students enrolled in collegiate Recovery Programs (CRPs) across the U.S. and Canada.
Participants:
246 students from 77 institutions who were currently enrolled in CRPs during the 2023–2024 academic year.
Methods:
Students completed an online survey assessing demographics, recovery history, mental health diagnoses, academic status, and use of on- and off-campus recovery supports.
Results:
Only 54.1% reported prior formal SUD treatment. Nearly half of participants identified as LGBTQIA+, and one-third reported justice system involvement. Most had co-occurring mental health conditions, particularly depression (79.3%) and anxiety (76.8%). Recovery pathways included 12-step programs (57.3%), counseling (53.3%), CRP only (47.6%), and harm reduction (22.0%).
Conclusions:
CRP participants reflect a diverse population with complex and evolving needs. Findings underscore the importance of inclusive, flexible recovery supports and highlight CRPs’ role in advancing health equity and reducing stigma in college settings.
Keywords: Addiction recovery, alcohol use disorder, college student health, collegiate recovery program, recovery pathways, substance use disorder
1. Introduction
College student drug and alcohol use remains a significant public health challenge.1–3 Social norms of college drinking can significantly harm students including those in recovery by fostering an environment that promotes alcohol consumption and marginalizing those who abstain.4–6 Few students see substance use disorder as a chronic medical condition7 and stigma related to students with substance use disorders is a barrier to seeking help.8 Alternative college student health and wellness narratives which champion recovery experiences, recovery allyship, and abstinence or reduced substance use are needed to combat stigma and improve health and safety among this population.
Collegiate Recovery Programs (CRPs) are services and structured and supportive environments that facilitate social support and academic success for students in or seeking addiction recovery.9–11 CRPs represent a unique effort to bridge the gap between educational aspirations and recovery needs for the many young adults who experience substance use disorders and behavioral addictions.12 These programs typically offer a range of services designed to help students navigate the challenges of supporting their recovery while pursuing their educational goals, including peer support, sober activity coordination, recovery or substance free housing, and academic assistance.13–15 The Substance Use and Mental Health Services Administration recently provided guidance suggesting “additional research and researchers are needed to impact policy and augment funding for collegiate recovery programs and services—both at the institution-level and nationally” which underscores the urgent need for comprehensive research on CRPs.16
There are currently 176 CRPs in the US17 which constitutes a six-fold increase since 2015 when only 29 programs were operating.9 Despite the increasing number of CRPs and the urgent call for comprehensive research by national agencies, evidence regarding the characteristics of the students the programs serve remains limited. The demographic diversity, recovery pathways, and academic trajectories of students enrolled in CRPs are not well-documented, creating a gap in the literature that hinders understanding of these programs and the needs of the current student population. The only previous studies characterizing CRP students were completed over ten years ago9 and during the COVID-19 pandemic,10 limiting our understanding of collegiate recovery’s current state. Additionally, no studies have reported the types and preferences of mutual help meetings attended, preferred recovery pathways, or off-campus recovery support that students are utilizing.
Understanding the demographic characteristics of CRP students is essential because these profiles can inform how programs are designed, implemented, and sustained. CRPs serve students with overlapping risks related to substance use, mental health, financial strain, and stigma.11 Without current demographic data, institutions may lack the insight needed to develop equitable and culturally responsive supports that address the needs of students most likely to engage with CRPs, such as those from low-resourced communities or with justice involvement. By identifying who CRPs serve today, we can better tailor programming, allocate resources, and guide future implementation efforts to ensure these programs meet the evolving needs of students in recovery.
This study aims to address the noted research gap by examining a broad range of individual-level and program-related characteristics among students enrolled in CRPs across the United States and Canada in the 2023–2024 academic year. Specifically, the study addresses three major research questions: 1) What are the demographic characteristics of students in CRPs? 2) What are the substance use, mental health, and academic characteristics of students in CRPs? 3) What are the programmatic and institutional characteristics of colleges and universities where CRPs are embedded? Our findings can inform the development of tailored and effective recovery supports within higher education institutions.
2.0. Method
2.1. Participants
Potential student participants were contacted via email with a flyer distributed through CRP directors and the Association for Recovery in Higher Education listserv for all recognized CRPs in the US and Canada, providing a link to the survey. CRP directors were invited to post a physical copy flyer in prominent physical locations and to email the flyer to all students participating in the program, urging students to share the flyer with their peers. Students were invited to participate in the survey if they were currently in a CRP and at least 18 years old. Current student status was verified by requiring proof of current college enrollment in a school with a CRP (i.e., informed consent submitted from a qualifying .edu email or .ca address was required). Only participants who completed the survey were included in the final sample (n = 246). Thus, this convenience sample reflects only the students who elected to participate and may not reflect all students in CRPs nationally. Participants provided informed consent prior to participation and were reimbursed $20 for completing the survey. This study was approved by the Institutional Review Board of the Boston University Medical Center. Additionally, we followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines to ensure rigorous and transparent reporting.
2.2. Procedure and measures
Recruitment occurred between August 2023 and June 2024. Upon providing informed consent, participants were presented with the full questionnaire. Survey items began with demographic information, including age, race, gender, sex at birth, sexual orientation, employment, housing, and criminal justice experiences. Subsequent questions asked about academic variables, including academic class, enrollment status (full-time or part-time), grade point average (GPA), student debt incurred, financial assistance received, and length of involvement in their institution’s CRP. Participants were asked whether they had a substance use or mental health diagnosis and their treatment history, including medications, as well what disorders they considered themselves to be in recovery from. Lastly, participants answered questions related to their institution’s CRP and their involvement. These questions included self-help groups attended, frequency of group attendance, utilization of off-campus recovery supports, and school- and CRP-level overdose prevention activities.
2.3. Data analysis
We used descriptive statistics to characterize the sample. We computed statistics in R version 4.3.018
3.0. Results
3.1. Demographics
Four hundred fifty-seven students completed the initial consent form. However, 183 consents were invalidated due to fraudulence, repeated email, or a non-student (not .edu or .ca) email address submitted. Of the remaining 274 students, 26 did not start the survey after three reminder emails and two were too young to participate. The final analytic sample included 246 student participants from 77 institutions of higher education. The number of students from an institution ranged from 1 to 20.
Participant demographic characteristics are presented in Table 1. Participants had a mean age of 27.1 years (range: 18–57). The majority of participants identified their race as white (82.1%) and ethnicity as non-Hispanic (88.2%). More participants identified their sex at birth as female (62.6%) than male (36.2%). Likewise, more participants identified their gender as woman (50.4%) than man (36.2%), genderqueer/gender nonconforming/non-binary (12.2%), or questioning/self-identified/prefer not to state (1.2%). In addition, 7.7% of the sample identified as transgender and 1.2% identified as having intersex traits. Because sex at birth, gender identity, intersex traits, and transgender identity were asked in separate items, these categories were not mutually exclusive. A slight majority (51.6%) of the sample identified as heterosexual, with most of the remainder identifying as bisexual (22.0%), queer (10.6%), and gay/lesbian (9.3%). Many students were employed part- (48.4%) or full-time (25.2%). Many students lived off campus (61.8%) or off campus with parents/caregivers (7.3%), though many lived on campus (28.5%). A small student group (2.4%) reported no current permanent housing. Criminal justice involvement (arrest → incarceration of more than one year) was reported by 32.9% of the sample, and of those respondents 65.4% reported that the involvement included incarceration (approximately 20% of overall sample). More students were undergraduates (68.7%) than graduate or professional students (28.4%), and more participants were enrolled full-time (84.1%) than part-time (15.9%). Among those reporting GPA (n = 239), the mean GPA was 3.5 (on 4.0 scale). Most respondents had been involved with the CRP for 0–1 (36.2%) or 2–3 (32.1%) semesters. Many students reported having student loans (59.3%) while some noted that they received scholarships from the CRP (26.4%).
Table 1.
Individual-level demographic variables in the sample of students enrolled in collegiate recovery programs, 2023–2024 (n = 246).
| Characteristic | n (%) or m (SD) |
|---|---|
|
| |
| Age, m (SD) | 27.1 (8.3) |
| Age of first use (any substance), m (SD) (n = 219) | 14.2 (3.3) |
| Racea | |
| American Indian/Alaska Native | 5 (2.0%) |
| Asian | 21 (8.5%) |
| Black | 18 (7.3%) |
| Native Hawaiian or Pacific Islander | 2 (0.8%) |
| White | 202 (82.1%) |
| Self-identified | 15 (6.1%) |
| Ethnicity | |
| Hispanic or Latino/a/x | 26 (10.6%) |
| Non-Hispanic | 217 (88.2%) |
| Self-identified | 3 (1.2%) |
| Gender | |
| Woman | 124 (50.4%) |
| Man | 89 (36.2%) |
| Genderqueer, gender nonconforming, or non-binary | 30 (12.2%) |
| Questioning, self-identified, or prefer not to state | 3 (1.2%) |
| Transgender | 19 (7.7%) |
| Intersex | 3 (1.2%) |
| Sex at birth | |
| Male | 89 (36.2%) |
| Female | 154 (62.6%) |
| Prefer not to disclose | 3 (1.2%) |
| Sexual Orientation | |
| Straight | 127 (51.6%) |
| Gay/Lesbian | 23 (9.3%) |
| Bisexual | 54 (22.0%) |
| Asexual | 4 (1.6%) |
| Queer | 26 (10.6%) |
| Questioning | 7 (2.8%) |
| Prefer not to state | 2 (0.8%) |
| Self-identified | 3 (1.2%) |
| LGBTQQIA+ | |
| Yes | 118 (48.0%) |
| No | 128 (52.0%) |
| Employment | |
| Part-time | 119 (48.4%) |
| Full-time | 62 (25.2%) |
| Volunteer | 9 (3.7%) |
| Unemployed | 56 (22.8%) |
| Housing | |
| Live on campus | 70 (28.5%) |
| Live off campus | 152 (61.8%) |
| Life with my parents or caregivers | 18 (7.3%) |
| No permanent housing | 6 (2.4%) |
| Criminal justice involvement | |
| Yes | 81 (32.9%) |
| No | 165 (67.1%) |
| Criminal justice involvement level (n = 81) | |
| Arrested no jail or incarceration | 28 (34.6%) |
| Drug court or related diversion program | 13 (16.0%) |
| Incarcerated less than 30 days | 12 (14.8%) |
| Incarcerated 31 to 365 days | 11 (13.6%) |
| Incarcerated more than 1 year | 17 (21.0%) |
| Academic class | |
| Freshman | 22 (8.9%) |
| Sophomore | 34 (13.8%) |
| Junior | 48 (19.5%) |
| Senior | 65 (26.4%) |
| Master’s student | 44 (17.9%) |
| PhD student | 22 (8.9%) |
| Law school student | 3 (1.2%) |
| Medical school student | 1 (0.4%) |
| Other | 7 (2.8%) |
| Enrollment | |
| Full-time | 207 (84.1%) |
| Part-time | 39 (15.9%) |
| GPA, m (SD)b | 3.5 (0.6) |
| CRP length of involvement | |
| 0–1 semesters | 89 (36.2%) |
| 2–3 semesters | 79 (32.1%) |
| 4–5 semesters | 43 (17.5%) |
| 6–7 semesters | 18 (7.3%) |
| 8+ semesters | 17 (6.9%) |
| School has financial assistance (scholarships) from CRP | 144 (58.5%) |
| Receives financial assistance (scholarships) from CRP | 65 (26.4%) |
| Has student loans | |
| Yes | 146 (59.3%) |
| No | 85 (34.6%) |
| Prefer not to respond | 15 (6.1%) |
| Student loan amount (n = 146) | |
| Less than $10,000 | 28 (19.2%) |
| $10,000 to $29,999 | 64 (43.8%) |
| $30,000 to $49,999 | 23 (15.8%) |
| $50,000 or more | 31 (21.2%) |
Note: LGBTQQIA+ = lesbian, gay, bisexual, transgender/nonbinary, queer, questioning, intersex, asexual, and all other gender- and sexual orientation-expansive identities.
Not defined as mutually exclusive. All other demographic categories sum to 100%.
7 missing GPA.
3.2. Substance use and mental health-related variables
As shown in Table 2, the majority of participants reported having resolved a substance use or behavioral problem (73.2%). Many were in recovery from an alcohol use disorder (57.3%), substance use disorder (69.9%), recovery from a mental health disorder (51.6%) and/or disordered eating (27.2%). Because these items were not mutually exclusive, participants could endorse multiple domains, though comorbidity (e.g., recovery from both substance use and mental health simultaneously) cannot be determined from this dataset. Just over half (54.1%) of participants reported a history of substance use disorder treatment. Over a fifth of participants in recovery from an alcohol or other drug use disorder reported using alcohol use medication (24.1%) and/or opioid use disorder medications (22.7%) respectively. Participants had a mean self-reported recovery time of 3.0 years (SD = 3.4; median = 2.0; range 0–21), and mean time since last intake of drugs or alcohol of 2.3 years (SD = 3.0).
Table 2.
Frequencies of individual-level substance use and mental health variables in the sample of students enrolled in collegiate recovery programs (CRP) in the United States, 2023–2024 (n = 246).
| characteristic | n (%) or m (SD) |
|---|---|
|
| |
| Have resolved a substance use or behavioral problem | |
| Yes | 180 (73.2%) |
| No | 66 (26.8%) |
| In recovery from | |
| Alcohol use disorder (AUD) | 141 (57.3%) |
| Substance use disorder (SUD) | 172 (69.9%) |
| Mental health disorder | 127 (51.6%) |
| Disordered eating | 67 (27.2%) |
| Process disorder | 29 (11.8%) |
| Other | 7 (2.8%) |
| Not in recovery | 14 (5.7%) |
| Substance use treatment history | |
| Yes | 133 (54.1%) |
| No | 113 (45.9%) |
| Medications | |
| Opioid use medication (n = 172; those in recovery from SUD) | 39 (22.7%) |
| Alcohol use medication (n = 141; those in recovery from AUD) | 34 (24.1%) |
| Recovery time (months), m (SD) (n = 242) | 41.0 (40.7) |
| Time since last intake of drugs or alcohol (months), m (SD) (n = 203) | 33.4 (37.0) |
| Recovery pathway | |
| Abstinence-based 12-step | 141 (57.3%) |
| Professional therapy or counseling | 131 (53.3%) |
| Involvement in CRP is recovery | 117 (47.6%) |
| Harm reduction | 54 (22.0%) |
| Medication-assisted | 38 (15.4%) |
| Place of worship | 36 (14.6%) |
| Abstinence-based non-12 step | 33 (13.4%) |
| Moderation management | 25 (10.2%) |
| Other | 22 (8.9%) |
| Mental health diagnoses | |
| Depression | 195 (79.3%) |
| Anxiety | 189 (76.8%) |
| ADHD | 89 (36.2%) |
| Multiple diagnoses | 69 (28.0%) |
| Other | 59 (24.0%) |
| Bipolar disorder | 46 (18.7%) |
| Autism spectrum disorder | 11 (4.5%) |
| Schizophrenia | 3 (1.2%) |
| Completed mental health treatment | |
| Yes | 115 (46.7%) |
| No | 66 (26.8%) |
| Currently in treatment | 65 (26.4%) |
| Sources of stigma on campus due to recovery status | |
| Other students | 124 (50.4%) |
| Professors | 54 (22.0%) |
| None of the above | 115 (46.7%) |
| Sources of stigma on campus due to engagement with CRP | |
| Other students | 63 (25.6%) |
| Professors | 24 (9.8%) |
| None of the above | 181 (73.6%) |
Note: Time since last intake of drugs or alcohol (years) and (months) – marked as NA one person who said 999.
The most common recovery resources/pathways were abstinence-based 12-step (57.3%), professional therapy or counseling (53.3%), CRP involvement (47.6%), or harm reduction (22,0%; categories were not mutually exclusive). The mean age of first use of any substance was 14.2 years (SD = 3.3). Many survey participants reported lifetime mental health diagnoses, most commonly depression (79.3%) and/or anxiety (76.8%), and many were currently (26.4%) or formerly (48.7%) in mental health treatment. Although many students reported feeling stigmatized by their peers (50.4%) and professors (22.0%) due to being in recovery, fewer felt stigmatized specifically for their involvement in the CRP, with 25.6% reporting stigma from other students and 9.8% from professors.
3.3. CRP- and institution-related variables
Frequencies of variables related to the CRP offerings and institution are presented in Table 3. Respondents commonly attended self-help groups including Alcoholics Anonymous (AA; 66.7%) and/or Narcotics Anonymous (NA; 47.2%), followed by SMART Recovery (21.1%) and/or All Recovery (13.4%). Among those reporting lifetime attendance at AA and NA, the mean number of meetings in the past 3 months was higher for AA (m = 21.7, SD = 31.4) than for NA (m = 7.6, SD =14.6). Fifteen percent of participants reported no lifetime attendance at a self-help group. Many participants made use of recovery supports off campus, most commonly professional counseling (52.0%) and/or 12-step-based mutual aid organizations (51.2%), though 16.3% of participants reported no off-campus recovery supports. Many schools (37.4%) and/or CRPs reported having Naloxone training programs, and some offered fentanyl test strips (18.3% of schools and/or CRPs). A table providing a comparison of demographic, mental health, and substance use variables across this study and previous studies characterizing CRP students is presented in the Supplement, though these differences may reflect changes in recruitment strategies or sampling variation rather than definitive demographic shifts.
Table 3.
Frequencies of CRP- and institution-related variables in the sample of students enrolled in collegiate recovery programs (CRP) in the United States, 2022–2024 (n = 246).
| Characteristic | n (%) or m (SD) |
|---|---|
|
| |
| Whether reporting lifetime attendance at self-help groups | |
| Alcoholics anonymous (AA) | 164 (66.7%) |
| Narcotics anonymous (NA) | 116 (47.2%) |
| SMART recovery | 52 (21.1%) |
| All Recovery | 33 (13.4%) |
| Cocaine anonymous (CA) | 26 (10.6%) |
| Celebrate Recovery | 19 (7.7%) |
| Marijuana anonymous (MA) | 17 (6.9%) |
| Crystal methamphetamine anonymous (CMA) | 14 (5.7%) |
| Moderation management | 3 (1.2%) |
| Women for sobriety | 2 (0.8%) |
| Dual diagnosis anonymous (DDA) | 2 (0.8%) |
| LifeRing secular recovery | 0 (0%) |
| Secular organization for sobriety (S.O.S) | 0 (0%) |
| Other recovery groups | 57 (13.2%) |
| I have never attended any self-help group | 37 (15.0%) |
| Average number of meetings attended in the past 3 monthsa | |
| Alcoholics Anonymous (AA) (n = 164) | 21.7 (31.4) |
| Narcotics Anonymous (NA) (n = 116) | 7.6 (14.6) |
| Marijuana Anonymous (MA) (n = 17) | 3.3 (4.7) |
| Cocaine Anonymous (CA) (n = 26) | 2.2 (4.8) |
| Crystal Methamphetamine Anonymous (CMA) (n = 14) | 1.6 (2.9) |
| SMART Recovery (n = 52) | 2.1 (4.6) |
| Celebrate Recovery (n = 19) | 3.4 (4.0) |
| All Recovery (n = 33) | 4.8 (4.9) |
| Recovery supports off campus | |
| Professional counseling | 128 (52.0%) |
| Mutual aid, 12-step | 127 (51.6%) |
| Church or religious affiliation | 44 (17.9%) |
| Advocacy activities | 41 (16.7%) |
| Mental health support group | 33 (13.4%) |
| Mutual aid, non-12 step | 25 (10.2%) |
| Recovery community organization or recovery café | 24 (9.8%) |
| Disordered eating group | 7 (2.8%) |
| Process disorder support group | 3 (1.2%) |
| Other | 10 (4.1%) |
| No off-campus recovery supports | 40 (16.3%) |
| Overdose prevention activities | |
| School has Narcan training program | 92 (37.4%) |
| CRP has Narcan training program | 92 (37.4%) |
| School offers fentanyl test strips | 45 (18.3%) |
| CRP offers fentanyl test strips | 45 (18.3%) |
| Neither my school nor my CRP have Narcan training program | 71 (28.9%) |
| Other | 38 (15.4%) |
Note:
category was mutually exclusive and based on only those reporting lifetime attendance in the respective self-help group. All other categories were not mutually exclusive.
4. Discussion
This study surveyed students participating in CRPs across North America during the 2023–2024 academic year. Our findings provide valuable insights into the diverse demographics, recovery journeys, and support experiences of students participating in CRPs. However, as a self-selected subsample, these results cannot be generalized to all CRP students or programs. The sample included participants from a wide range of institutions and backgrounds, with one third reporting prior justice system involvement, and notable representation of gender and sexual minority groups. Many students faced overlapping challenges related to mental health, substance use, and financial strain, yet demonstrated adaptability in their recovery journeys through various pathways, including CRP participation, 12-step programs, harm reduction, and professional counseling. Though these results do not establish causality, they underscore the potential importance of CRPs in meeting the needs of an underserved student population and highlight the value of inclusive, flexible, and stigma-free supports in fostering recovery and academic success.
These findings highlight potential demographic shifts among current CRP students.9,10 A smaller proportion of students identified as male (37%), while LGBTQQIA+ (lesbian, gay, bisexual, transgender, queer, questioning, intersex, and asexual) representation increased to 48%, significantly higher than the national averages of 5.5% among adults and 15.2% among young adults.19 However, this finding aligns with recent data showing higher rates of LGBTQQIA+ identification among current college students (27%)20 and Generation Z (28%).21 This overrepresentation is consistent with literature documenting substance use disparities in the LGBTQQIA+ population, including higher prevalence of use,22,23 using to cope,24,25 substance use disorder,26,27 and barriers to treatment access.28,29 Our findings are also in line with recent research documenting that 30% of CRP program directors identify as LGBTQQIA+.30 Thus, prioritizing visibly affirming practices, such as displaying community symbols (e.g., pride flags, pronoun pins), offering LGBTQQIA+ affinity spaces, collaborating with campus LGBTQQIA+ organizations, and hiring LGBTQQIA+ individuals in recovery as staff, is essential. In this way, CRPs can leverage their access to LGBTQQIA+ students in recovery to foster health equity on college campuses by offering visibly affirming practices and culturally responsive recovery supports.
We found that other marginalized groups were represented within CRPs in substantial amounts. Specifically, 32.9% of CRP students reported justice system involvement in their lifetime. This student group may be vulnerable to stigmatizing attitudes above and beyond their identity as a person in recovery. The survey also highlights an encouraging result: a highly marginalized population segment is not only finding recovery but also building recovery capital through education, fostering optimism and hope, and sustaining remission. We also found that 59.3% of CRP students were taking out student loans. This rate far exceeds the 38% national average for first-time undergraduate students at US universities,31 suggesting that financial burdens are disproportionately experienced by students in recovery. The high prevalence of student loan use among CRP students indicates greater financial vulnerability and may indicate limited family support, reduced access to scholarships, or costs associated with the collateral consequences of addiction (i.e., probation, drug treatment, job discrimination). Similarly, recent research on justice system involvement among students in CRPs found that previously incarcerated students worked more hours than their non-incarcerated peers.32 Thus, CRPs may benefit by collaborating with financial aid offices to provide tailored loan counseling, connect students with recovery-specific scholarships, and advocate for job placement assistance for this group.
We found that the self-reported recovery resources utilized or “pathways” of students in CRPs varied. While a majority reported an abstinence-based 12 step approach, some received professional counseling, or some preferred nontraditional approaches including harm reduction and moderation management. Just under half reported that involvement in the CRP was their primary recovery pathway. This array of resources utilized by respondents speaks to the importance of CRP offerings that respect multiple pathways to recovery and the flexibility to identify new pathways or resources as they emerge. Importantly, the item “Have you resolved a substance use or behavioral problem?” was drawn from the National Recovery Survey33 and relies on respondents’ self-definition. Notably, only 73.2% of CRP students endorsed this item, underscoring the variability in how students conceptualize recovery and suggesting that many may engage with CRPs while still actively navigating substance use, be in primary recovery from a mental health disorder, or in recovery from other behavioral or process addiction challenges.
Although a significant portion of adults in long-term recovery are known to have never participated in formal substance use treatment9,34,35 found that 82.5% of students in CRPs had previously completed formal substance use treatment. In contrast, our survey found that just over half of the participants (54.1%) reported a history of formal substance use treatment, marking a notable departure from earlier CRP research. This potential shift away from the traditional continuum of care (prevention → treatment → recovery) has significant implications for CRPs. For these programs to be most efficacious, they may now need to go beyond offering traditional “recovery-related resources” and instead provide training and skills typically delivered in residential and outpatient treatment settings. For example, students entering CRPs without prior treatment experience may lack coping strategies, relapse prevention training, and foundational knowledge about the disease model of addiction. That said, the fact that this large group without formal treatment has already achieved several years of continuous recovery on average, may signify that they already have acquired and are practiced at successfully deploying recovery coping skills of various kinds. Still, it may be that at least having relapse prevention coping skills and other groups available could be useful for many regardless of prior formal service utilization. Additionally, our findings indicate that while students, on average, reported 41 months in recovery, their average time since last substance use was 33.4 months. This may suggest that returning to substance use is often part of the recovery journey for students in CRPs, with a critical tipping point for sustained recovery occurring around seven months. Further research is needed to explore the factors contributing to this potential inflection point and how CRPs can best support students navigating early recovery challenges.
In addition to difference in formal treatment noted above, when comparing our findings with prior national CRP surveys (Supplement 1), several trends emerge that may signal shifts in the student populations served. Smith et al.10,who collected data during the COVID-19 pandemic, found higher average participant age and somewhat lower representation of gender-diverse identities than our study. Our findings highlight increased representation of genderqueer, non-binary, and transgender students, as well as higher proportions of students identifying as LGBTQIA+ compared to both Laudet et al.9 and Smith et al.10 Rates of depression and anxiety were also higher in our sample at 79.3 and 76.8%, respectively compared to 67.1 and 62.9%, respectively in the10 study, suggesting that CRPs may be increasingly serving students with substantial co-occurring mental health needs. Additionally, one-third of our sample reported justice system involvement, pointing to the role CRPs may play in supporting students with intersecting vulnerabilities. It is important to note that recruitment strategies and sampling differences across studies may contribute to the observed demographic changes, and thus these findings should be interpreted with caution when considering broader trends in CRP populations. Future studies using systematic sampling across multiple time points are needed to disentangle whether these trends indicate broader changes in the recovery student population or program-level variation.
Public stigma of addiction has been shown to be a barrier for people entering treatment for substance use and may have a negative impact on their clinical care during and after treatment.36,37 This has also been important for students in collegiate recovery as students report that stigma negatively affects their academic experiences, social integration, and personal recovery journey. Specifically, research has documented that students in CRPs often feel marginalized within campus communities, as the dominant cultural norms around substance use on college campuses conflict with their recovery identities.8 In this study, we found that half of the participants experienced stigma related to being in recovery from fellow students, while just under a quarter reported stigma from professors. However, participants felt substantially less stigma for being part of the CRP, both from other students and professors, highlighting the crucial role CRPs play in reducing stigma simply through their presence on college campuses. Stigmatization from peers and faculty can lead to isolation and reluctance to disclose recovery status, further intensifying feelings of marginalization. Additionally, professors’ lack of awareness about recovery or implicit biases may unintentionally create barriers in the classroom, negatively impacting students’ academic confidence and performance. These findings align with broader literature showing that stigma toward individuals with substance use disorders extends beyond treatment settings into educational and social environments.10,13 Addressing stigma may require broad based interventions, such as campus-wide education about recovery, fostering recovery-affirming campus cultures, and implementing policies that explicitly support students in recovery. These measures can help mitigate stigma and support the dual goals of academic success and sustained recovery for students in CRPs.
5.0. Limitations
This study has several limitations. First, our data come from a self-selected subset of CRP students, which may not reflect the characteristics of the entire CRP student population. Second, its cross-sectional design prevents us from assessing the efficacy of CRPs or their core components over time or making claims about their impact on recovery or wellbeing. Third, we did not account for potential school-level factors, which may have influenced some of the outcomes. Fourth, ours was a self-selecting convenience sample of current CRP students—without offering a sense of the size of the entire CRP student population – which limits the generalizability of our findings. Lastly, the study provides only a snapshot of the characteristics of CRP students and their programs during the 2023–2024 academic year. Future research should consider utilizing longitudinal designs to assess the efficacy of CRPs and their core services over time, incorporating school-level covariates to account for their impact on outcomes. Additionally, efforts should be made to recruit participants from a broader range of CRPs to enhance the generalizability of findings.
5.1. Summary
This study provides a descriptive snapshot of the demographics, use of clinical and recovery support services, and recovery profiles of students engaged in CRPs across the US and Canada. Compared to prior surveys, our findings suggest increased representation among LGBTQQIA+ students and those experiencing financial vulnerabilities, alongside notable rates of justice system involvement. While these results may not represent all CRP students or students in recovery broadly, they highlight the value of CRPs in reaching these populations. The findings point to the importance of wide-ranging, flexible, and multifaceted supports that accommodate varied recovery pathways, including those without prior formal treatment. Additionally, participants’ experiences underscore the pervasive impact of stigma on academic and social life, suggesting a need for campus-wide recovery-affirming cultures. Although this study cannot establish causal effects, it indicates that CRPs may play an important role in mitigating stigma and supporting students in recovery.
Supplementary Material
Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2025.2573107.
Acknowledgements
A special thanks to the students of collegiate recovery programs for taking the time to participate in this study.
Funding
Dr. Vest was supported by the National Institute on Drug Abuse (NIDA) of the National Institutes of Health under award numbers K01DA053391 and L30DA056944. Additionally, funding was reported from the Department of Veterans Affairs, Health Services Research and Development Service (RCS 00–001 to Dr. Timko; RCS 14–141 to Dr. Humphreys). Dr. Kelly reported funding from the National Institute on Alcohol Abuse and Alcoholism under award K24AA022136. The views expressed are the authors’ and do not necessarily reflect the official position of any government agency.
Footnotes
Conflict of interest disclosure
The authors have no conflicts of interest to report. In adherence of the Declaration of Helsinki, written consent was obtained for each participant. The authors confirm that the research presented in this article met the ethical guidelines, including adherence to the legal requirements, of the United States of America and received approval from the Institutional Review Board of the Boston University School of Medicine.
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