On this page

Back to top

PhD Student Guide: Substance Use Disorder Awareness & Support

The pressures of academia as a graduate student could lead you to unhealthy coping behaviors such as substance abuse. Learn more about the causes and symptoms of a substance use disorder, strategies for prevention, and intervention and resources for support. 

Written By

Rebecca Newman, MSW

Last updated

Jun 09, 2023

The pressures you feel while earning a PhD are real: As you’ve risen through the levels of academia, you’ve likely worked hard to obtain funding, succeed in school, and simultaneously manage some semblance of work-life balance. All this stress can leave you vulnerable to the lure of alcohol and drugs as coping mechanisms. Unfortunately, consistent use of ineffective coping strategies can quickly turn into a substance use disorder. 

It may be helpful to know you’re not alone: Research supports that the stressors inherent to academia correlate with increased occurrence of substance use disorders, often in tandem with mental health challenges. And scientists see evidence that studying in some disciplines carries more risk than others, with engineering students demonstrating less occurrence of substance use and mental health problems. In comparison, students in the arts and humanities have an almost eight times greater risk.

If you’re a PhD student struggling with current substance use or someone who simply wants to prevent dependency proactively, you have resources at your disposal — and this guide is one of them. Below, find strategies for prioritizing your well-being, advice for seeking help, and ways to pivot into more adaptive coping strategies. 

Reasons for Substance Abuse Among PhD Students

It’s helpful first to understand why PhD students specifically have such a high incidence of a substance use disorder, and the answer may simply come down to access. When you’re a PhD student, you’re likely over the legal drinking age. Therefore, you encounter fewer barriers to accessing these ineffective escape mechanisms: Alcohol and certain drugs are readily available and typically easy to procure. 

And sometimes, doctoral students inaccurately see drugs and alcohol as a means to overcome certain challenges in their life, thus increasing their risk for dependence. Here are common reasons they may turn to drugs and alcohol:

Coping with Stress

During times of stress, we look for ways to accelerate our parasympathetic nervous system response, which takes us out of fight-or-flight mode. While the body will eventually find stasis on its own, we sometimes look to something outside of ourselves to soothe. Sometimes this can be food, physical contact, or another pleasurable activity. But when time is limited due to the demands of being a PhD student, alcohol or drugs can feel like an accessible and accelerated path to feeling calmer.

Getting Comfortable in Social Situations

Between forming and maintaining relationships in your program to the networking required of PhD students to make connections in their respective fields, graduate study is full of abundant social situations. The nickname for alcohol as, “liquid courage,” may come to mind to manage these occasions, although what began as a way to disinhibit or quiet nerves can quickly get out of hand and become an unhealthy habit.

Peer Pressure or Societal Norms

Alcohol and other drugs play a part in the overall culture of college in general, not to mention that most adult socializing centers on alcohol. Some examples include attending a happy hour, going to a bar to watch a sporting event, using alcohol to incentivize attendance, or feeling compelled to keep up with others’ drinking. With all of this in mind, it can be difficult to hold your own true north with your values and limits as they relate to alcohol and other substance use.

You are Doing Poorly in School

While we sometimes use substances to celebrate our victories, we also may turn to them in what feels like moments of personal failure. Misusing substances, unfortunately, then becomes a self-perpetuating cycle where your performance potential is diminished by your substance use. Then you continue to use substances to ease the pain or frustration of performing poorly.

Easy Access to Substances

Unlike the early years of undergraduate education, before you had reached the legal age to purchase alcohol, graduate students are typically of legal drinking age and may have more connections to buy other drugs as desired. Gatherings for your program may also include alcohol at no cost to attendees, making it easier to consume without dipping into your personal budget. 

Family History of Substance Use Disorders

Students who earn admission to competitive doctoral programs are certainly high achievers. They are often the best and brightest in their respective fields and look forward to a promising career. Some may think this exempts them from a family history of substance use disorders because of their high achievement. However, family history remains a firm predictor for developing substance use disorders, and those whose families are affected (which is most people!) should consider the cautious use of alcohol and other drugs.

What are the Common Substances Used by Doctoral Students

Doctoral students likely have access to any number of substances, but some are more commonly compatible with a PhD student’s lifestyle. They may believe these substances (based on fact or myth) will increase productivity; they can easily hide or are readily available. Some of these most commonly misused substances include:


Alcohol is one of the most accessible mood-altering substances, yet it has some of the most impairing effects and potentially lethal consequences. PhD students can purchase alcohol in a retail store or at a bar, and alcohol can cause uncharacteristic or inappropriate behavior, erratic mood swings, impaired judgment, or “blackouts” where you don’t remember events. 

Alcohol tolerance, or requiring more to achieve the same result, can habituate the body to that much alcohol and inspire potentially lethal withdrawal if someone suddenly reduces or abstains from drinking. Additionally, very high blood alcohol levels can induce a coma, irreversible brain damage, or even death. 


Access to cannabis varies widely in the U.S. due to ever-evolving laws toward legalization for medicinal or recreational use; however, it has historically been available through illicit networks to those interested in its use. With the prevalence of manufactured cannabis products, including edible forms with standardized doses, cannabis is increasingly accessible to PhD students. 

People use cannabis to experience a mind-altering “high” and achieve a euphoric mood. While the body does not develop dependency the way it may on other substances, prolonged cannabis use carries a higher risk of problems with memory, attention, and learning, in addition to risky behaviors in which a person engages while intoxicated and with impaired judgment.  


Whether in powder or solid form, cocaine is a highly addictive stimulant that is obtained through illicit channels. Cocaine’s effects occur almost instantly upon ingestion, including euphoria, mental alertness, increased sensitivity to sound, sight, and touch, and increased energy. However, other short-term effects of cocaine can also include paranoia, muscle twitches or tremors, trouble with balance, anxiety, restlessness or irritability, not to mention more severe disturbances like psychosis or cardiac dysfunction. 

Cocaine tolerance upon repeated use is common, as the brain adapts to the presence of the drug to experience pleasurable emotions. 

Nicotine & Vaping

Smoking and vaping are very effective nicotine delivery systems, though nicotine has a short half-life — meaning its effects don’t last long. Therefore, nicotine is one of the most addictive substances readily available to consumers. 

While public perception is that vaping has reduced some of the damaging effects of tobacco products, all nicotine use carries inherent risks. Nicotine use can cause pleasurable effects at its point of use, but the complications are numerous and severe. They include lung disease, cancer, heart disease, diabetes, eye problems, infertility and impotence, pregnancy complication, oral disease, and greater susceptibility to respiratory infection.

Painkillers and Opioids

Many people believe that they are not susceptible to opioid use disorder, but the reality is that anyone who uses opioids in any way is at risk of developing dependence. They work by releasing endorphins in the brain, which quiet the body’s perception of pain and increase feelings of well-being and pleasure. When the effects wear off, the user typically wants to feel that way again, particularly if they are experiencing chronic pain and will use opioids repetitively for the same effect. 

Opioids are typically available by prescription only, but there are illicit networks for their purchase, whether for intended recreational or pain-management use. Opioids are highly addictive and cause the body to slow its production of endorphins, leading to the feeling of needing more to have the same effect, all while facing the extreme discomfort of opioid withdrawal.

Psychedelic or Dissociative Drugs

Psychedelic and dissociative drugs include psilocybin, LSD, ketamine, PCP, MDMA, and salvia, all of which intend to alter the user’s mood state and induce euphoria. These drugs are typically available through illicit channels and misappropriation of medications (such as ketamine). 

While these drugs are not typically habit-forming in the way other substances are, they can cause negative neurological effects, including exacerbation of existing bipolar illness or schizophrenia, and can cause short-term episodes of psychosis. Other undetectable colorless and odorless substances like fentanyl can be mixed with these drugs, causing unintended and potentially lethal effects.

Stimulant Medication

While some students require medicinal stimulants for their neurodivergent brain, others utilize these stimulants recreationally for weight loss or to increase academic performance. These medications are available by prescription if an individual is diagnostically suitable or through illicit means. 

Some effects of the stimulant medication include increased activity, grandiosity, restlessness, increased dopamine production, decreased appetite, euphoria, talkativeness, or dangerously, changes in heart rate, blood pressure, or even arrhythmia. While these drugs may seem harmless, they can also lead to changes in brain chemistry, dependence, and withdrawal, leaving the user caught in a cycle of necessary use to function.

Impacts of Long- and Short-Term Use

The human brain is an extremely advanced ecosystem with a delicate balance of chemicals, neurotransmitters, and other activities that we still don’t fully comprehend. While it is a powerful organ, it does require supplementation at times to address health challenges such as depression or other neurological issues. 

But drug and alcohol use presents an intentional override of brain function, inspiring a feeling of euphoria. Frequent or habitual use of outside substances can alter brain chemistry and make it more difficult for the brain to function typically. Additionally, the evolution of behaviors associated with addiction may compromise your goals and relationships. Many people wish to consider their substance use episodic, as simply looking for a moment of relief or pleasure. However, substance use can quickly slip into chronic misuse, having more global effects on your life.

Here are some of the consequences you can expect when you routinely misuse drugs or alcohol:

Decreased Academic Performance

In the present, an altered state can make it more difficult to complete schoolwork (although some drugs seem to propel academic performance in the short term), both in terms of dissociation from responsibilities and a lack of motivation. However, even if drugs are supposedly increasing your performance, the long-term effects of drug and alcohol use have damaging effects on your brain function, motivation, and health. When in a compromised state, including substance withdrawal, it is almost impossible to maintain your academic output.

Questions on Your Integrity and Conduct

We would like to think that others retain their trust in us, even if we have lapses in judgment. But in reality, many people become skeptical or suspicious of someone who has been engaging in frequent substance use. Whether you behaved inappropriately at a function or felt pressure to engage in academic dishonesty to “catch up,” the impact of these behaviors, regardless of intent, can affect others’ perception of and trust in you.

Risky or Dangerous Behaviors

While on mood-altering substances, many people are more likely to engage in risky or dangerous behaviors. These can include “daredevil” behaviors or stunts, denying current intoxication and driving in an altered state, or engaging in sexual contact without typically utilized safer sex practices or with unvetted partners. As someone continues down their substance use path, they may repeat these decisions if they did not experience an adverse outcome the previous times they have engaged in them.

Poor Health

Our health suffers when we spend our time and efforts seeking euphoria while already stretched thin based on the demands of graduate school. From skipping routine health screenings to engaging in risky behavior to the negative health effects of drugs and alcohol, there is a clear correlation between substance abuse and poor overall health. After all, the mind and body are interconnected systems — when one is suffering, so will the other.

Loss of Relationships

It is difficult to remain alert, attentive, and empathetic to those around us in the throes of the self-focused urges of substance use disorder. Additionally, many people become frustrated when a loved one develops a substance use disorder, as their behavior can become more erratic, verbally abrasive or abusive, financially exploitative, and less supportive. Seeking the desired mood alteration from substances typically becomes the primary “relationship” in one’s life in addiction, often requiring substantial amends to heal upon abstinence. 

What feels like casual drug or alcohol use can have immediate and lasting legal consequences, no matter how few times you engage in these behaviors. You could be arrested the first and only time you purchase illicit substances in a sting operation, traffic substances across state or international borders, or drive/operate a vehicle while intoxicated. While you may think, “It can’t happen to me,” it can. Therefore, you must consider the consequences carefully each and every time you engage in risky behavior while intoxicated.


The bottom line is this: Many people die every day from drug and alcohol misuse. Drug use is, directly and indirectly, responsible for 11.8 million deaths per year. Whether the result of overdose or chronic health problems from long-term use of alcohol and other drugs, the effects on the body and increased mortality are undeniable. In the U.S. alone, illegal drug use is the third-leading preventable cause of death in the country, and the fourth is alcohol-related death

Signs of PhD Student Addiction

Given the intense demands of graduate education at the doctoral level, students become habituated to intense periods of stress, which can normalize unhealthy behaviors and may obstruct some of the signs that a PhD student is abusing substances. It is important to look at some of these signs, especially changes in a student’s typical behavior, to detect whether that student is engaging in problematic drug or alcohol behavior, which can aid in early intervention.

Skipping Out on Academic Responsibilities

PhD students have historically demonstrated their commitment to academic pursuits and attention to detail. However, if you notice that a student is slipping on responsibilities or has become less thorough in their assignments, something bigger may be going on.

Disruptive Behavior in Class

While intoxicated, many people experience a reduction in or loss of inhibition, often causing erratic or uncharacteristic behavior. Additionally, students experiencing a hangover or the low from coming off a substance may be irritable. If a student presents to class in either of these states, they may be quite disruptive.

Lack of Care of Personal Appearance

Grooming can be a good indication of mental and physical wellness. If someone is feeling well and tending to their necessities and hygiene, they are typically doing well. Conversely, someone engaged in substance use may omit these positive habits and behaviors in favor of spending more time intoxicated.

Avoid Family and Friends

Our loved ones know us best and are most likely to detect a disturbance in our typical habits and behaviors. If someone is withdrawing from family and friends, this could be a sign of worsening mental health or substance use, both of which require prompt attention.

Lying or Denial of Addiction

Once addiction takes hold, many people must tell lies to conceal their substance use. They often lie about their whereabouts, deny founded accusations of theft, or erroneously claim to have completed an important task, to name a few. Often when confronted, these people will deny having an addiction, even if signs are present.

Mood Changes

Sudden mood change is always a warning sign, and it can be an indicator of a mental health challenge or substance use disorder. Whether a positive or negative mood change, be attentive to sudden shifts, especially if they occur around the time of known substance use.

Withdrawal Symptoms

Some withdrawal symptoms are not visible to an observer, but some signs are very overt. If you notice someone experiencing sweats, tremors or shaking, or if they appear unwell, seek medical attention. Some withdrawals, like alcohol and benzodiazepines, can be life-threatening if not medically monitored. 

Continual Need for the Substance

Increased tolerance, which results in needing more substance to induce the same effect, is a common sign of substance use disorders. If you remark that a student is drinking more than they used to or are visibly increasing the use of other drugs, take note and seek support in intervention.

Rehab and Treatments Available to Doctoral Students

There is still a great deal of stigma associated with seeking mental health treatment of any kind, especially substance use disorder treatment. However, your recovery is crucial for your livelihood, not to mention the future of your PhD program and, ultimately, earning your degree. 

While it may seem impossible to take time away from school for recovery, consider it an investment in your career potential — and, most importantly, in yourself. Even though taking time away from school may “out” you to your classmates, you and your health must come first.

Many PhD students worry about falling behind, and almost every program has experienced a student who has required a medical leave of some kind (for a medical condition, pregnancy, addiction, or to care for a family member). Your institution has invested in your education and is committed to helping you across the finish line, even if you have a circuitous journey to that point.

Below are some of the common questions you may have about seeking help for a substance use disorder: 

Frequently Asked Questions

Will Insurance Cover Rehab for Doctoral Students?

Yes. Because of the Mental Health Parity and Addiction Equity Act, insurance companies must cover detox, rehab, or other indicated treatment programs if the person’s presentation warrants a need.

How Do I Take Advantage of School Counseling Services?

During your student orientation, you likely received a brochure or other material with contact information for your student counseling center. If you cannot locate it, speak to a faculty member or personnel at your student health center.

How Do I Talk to a Friend About Substance Abuse? (Do’s and Don’ts)

Do: Express your concern for your friend in a constructive and honest manner using your observations. For example, “I’ve noticed that you have been absent from class and have been completing fewer assignments on time. I have also noticed that you drink more than you used to when we go out, and you have told me that you drink at home alone. I’m concerned.”

Don’t: Accuse or confront with “evidence” of their addiction. For example: “Jack saw you taking money out of Kate’s wallet at the lunch-and-learn. We know you’re using that money for drugs.”

If I Go to Rehab, Will I Miss School?

Possibly, and sometimes for the better. When in treatment, your care must be your top priority to optimize your chances for recovery. However, with online education, you may be able to continue your coursework with the support of your faculty advisor or dean.

Healthy Coping Mechanisms: How to Bolster Recovery

If your recovery requires detox or rehab, it can be difficult to extend those skills back into the environment that fostered your addiction. If you have achieved abstinence on your own, you still require support to bolster your recovery efforts to take them from white-knuckle abstinence to a global spirit of recovery.

It is crucial to set realistic expectations for this time, manage perfectionistic tendencies, and strengthen your personal resilience to prevent returning to substance use as a dysfunctional coping mechanism.

How to Avoid Triggers

“Avoid people, places, and things” is a tenet of AA for a reason. The people, places, and experiences associated with addiction can serve as a temptation to use again. While not all of these factors can be categorically avoided in recovery, take care to notice which are the most activating and develop concrete strategies for managing urges when they arise.

Managing Cravings

One of the most nuanced complexities of addiction is the notion of craving. Difficult to quantify but experienced so intensely, cravings are often an emotion-driven response to a situation. Set a timer for five to 10 minutes, engage in another activity, and see if your craving intensity changes with the passing of time.

Setbacks are Typical

We would like to think that progress in recovery happens in a perfectly upward line. While a nice fantasy, setbacks are a typical part of recovery. Experiencing the occasional setback does not mean you are doing anything wrong. You are relearning how to function without a previously routine coping mechanism, so give yourself the grace to learn while accepting these setbacks.

Identify Positive Supports

In recovery, as in life, some people are unequivocally in your corner. These are the people with whom to surround yourself during this chapter of your life. Choose supports that lift you up, leave your heart full after you spend time with them, and who support your recovery efforts.

Ask for Help

This applies both to asking for help from support if you feel your recovery efforts wavering and asking for help from school personnel. If you need more time on an assignment, help with a project, or support in meeting a deadline, talk to your professors or dean. They may not always be able to give you the help you’re asking for, but honest communication typically results in some type of concession. 

What Are Schools Doing About Student Alcohol and Substance Abuse

Institutions have become increasingly responsive to the needs of students’ mental health and substance use disorders. Upon admission, a school invests in each student whom they select, even more so for a funded PhD program. However, schools do have responsibilities to credentialing bodies to retain a certain educational standard, requiring that students meet certain milestones to earn their degrees. 

In light of increased evidence-based data on programs that foster positive mental health for students, institutions are adopting some of the following support programs and solutions:

Recovery Programs for College Students

Some institutions are participating in Collegiate Recovery Programs, an on-campus program that provides students with recovery support and a social outlet in an abstinent setting. Preliminary findings indicate positive outcomes from these piloted programs, with more research needed for long-term data.

Education and Prevention Programs

Educating students on the impact of alcohol and drug use while pursuing their studies can lead to improved prevention efforts, as Campus Drug Prevention seeks to do. This effort by the U.S. Drug Enforcement Administration offers resources, research, and publications that are extremely thorough and offer students information about how their choices affect their studies.

Counseling Services

Most institutions have a counseling center for their students offering brief model psychotherapy. Information about this center should be readily available, and clinicians in campus counseling centers are familiar with typical student issues like stress, drug and alcohol use, relationships, and more.

Friday Classes

With many students eager to begin their weekends on Thursday, it can be tempting to eschew responsibilities on Friday in favor of cutting loose. However, schools have found that holding Friday classes curbs excessive pre-weekend drinking, and students need to appear to compensate on Friday or Saturday as a result.

Offering Alternatives 

Many institutions have been implementing changes to their other social resources, like extending operating hours for libraries and gyms, which can increase health-promoting behaviors and reduce problematic drinking habits. 

Substance Abuse Resources and Support of PhD Students

  • Alcoholics Anonymous: This is the website for AA, a consistent mainstay in community support for recovery.
  • Association of Recovery in Higher Education: For students who require or are seeking sobriety-oriented socializing and support while on campus, this is a list of 151 schools that participate in Collegiate Recovery Programs.
  • Brobriety: Sobriety, Mental Health, and Wellness For Men (And Women, and the Men and Women Who Love Them): Learn about the connection between addiction, recovery, and masculinity through this podcast host’s ongoing journey.
  • Campus Drug Prevention: This is a federal round-up of research, resources, and publications about the role of drug and alcohol use on college campuses.
  • In Recovery with Dr. Nzinga Harrison: Board-certified in psychiatry and addiction medicine, Dr. Harrison’s podcast offers approaches for compassionate recovery from her call-in show. 
  • SAFE Campuses: Explore this website for support resources for students in recovery and for Collegiate Recovery Communities.
  • The Sober Gay: Explore the experiences of recovery and sobriety in the LGBTQIA+ community in this podcast. 
  • Soberful: This podcast features Veronica and Chip, who have been sober for a collective 50 years and share their advice and experiences candidly.
  • Sobriety Workbook for Women: In this workbook, you’ll learn strategies to live and thrive without alcohol. You can cultivate greater awareness and understanding of what triggers your drinking through mindfulness exercises, self-check-ins, and more.
  • Substance Abuse and Mental Health Services Administration (SAMHSA): A mainstay in mental health and substance abuse support in the U.S., SAMHSA offers resources, data, and information for professionals and individuals alike.
  • The Unexpected Joy of Being Sober: This book celebrates the joys of sobriety. Readers at all stages — from those who are sober-curious to those who are in the throes of recovery — can learn about the benefits of a drug- and alcohol-free life.

Expert Interview: Seek Treatment That is Personalized for Your Needs, Psychologist Says 

Kara Newman, PhD, is a licensed clinical psychologist specializing in addiction recovery, post-traumatic stress, prolonged grief, and suicide prevention. She earned a bachelor’s degree in neuroscience and psychology at Trinity College and completed her MS/PhD in clinical psychology at Drexel University. Newman is passionate about clinical training and supervision of early-career mental health professionals. She currently works in healthcare, focusing on increasing access to evidence-based treatments for substance use disorders.  

1. What goals should a PhD student expect from treatment or rehabilitation?

PhD students should seek out a treatment program that is personalized to their needs. Among college and graduate students, the most common substance use concerns are related to alcohol and cannabis use. Use of cocaine, opiates, benzodiazepines, or prescription sleep medication may also impact PhD students. Treatment will look different depending on what substance is impacting your life. Whether your recovery goal is to reduce or moderate your use or to stop using and achieve sobriety, you should partner with a treatment provider that is willing to listen to your current needs and explain what options are available to you. 

High-quality substance use disorder treatment programs also acknowledge the impact of co-occurring mental health conditions such as depression, anxiety, and PTSD. It is important to recognize that emotional pain is often an underlying aspect of substance use that needs to be addressed. I often recommend evidence-based interventions such as cognitive-behavioral therapy (CBT) and motivational interviewing, which are proven by research to be effective. 

2. How can PhD students balance their academic responsibilities with their recovery process if they seek substance use treatment?

It is common for PhD students to cite their academic and/or career responsibilities as a reason to defer or delay getting the treatment that they need. However, in these cases, you must also consider the adverse impact of not pursuing treatment, which may ultimately allow symptoms to worsen or snowball into other larger issues such as negative health outcomes, relationship issues, or legal problems. 

As a treatment provider, my goal is to provide clients with the least restrictive setting that will allow them to achieve their recovery goals. This means that treatment will look different depending on the individual. For some PhD students, an inpatient or residential stay is needed, which may require a total interruption of one’s academic responsibilities for a period of 30 days or longer. Extended time away from the stress in one’s prior environment can help stabilize more severe substance use concerns before stepping down to outpatient care. 

Others may benefit from simply reducing their academic load to make room for attending an intensive outpatient program (IOP). IOPs are recovery programs that include several hours of group and individual therapy at least three days per week. 

Those with mild to moderate substance use concerns may be able to continue with their full-time studies while attending weekly group or individual therapy for approximately one to two hours per week. Medication management may also be an important part of the clinical conversation for some, particularly those recovering from alcohol or opioid use disorders. This may translate to ongoing appointments with a physician. 

3. Are there any unique challenges or barriers that PhD students face in accessing substance use treatment or support? If so, what are they, and how can they be addressed?

Absolutely. The three most common challenges I hear are financial barriers, fear of public impact or professional punishment (e.g., expulsion, suspension), and hesitance to take time away from one’s academic program. For any of these reasons, a PhD student may perceive that seeking treatment would be too much of a setback or too big of an expense to be realistic. Of course, these concerns have a degree of validity. 

At the same time, it is important to do your own research about what a course of treatment may look like for you. Depending on the severity of your substance use concern, you may achieve a significant benefit from a relatively time-limited course of care that you can complete without interrupting your graduate studies, such as attending a medical consultation with your primary care physician, attending on-campus counseling services, or seeking a short-term outpatient referral for weekly sessions with a therapist specializing in substance use treatment. Search for a therapist that is in-network with your health insurance or inquire about reduced-cost or sliding-scale fees. 

You might also consider a trial visit to free community support groups, many of which have their meeting schedules online and/or have added virtual offerings since 2020. You are not obligated to disclose your substance use concerns to anyone, though some programs may require medical documentation from a healthcare provider to justify an extended absence if needed. 

Find something that feels attainable and start there. A single visit or a single phone call may make all the difference. 

4. How can PhD students recognize and address their internalized stigma associated with seeking help for substance use as someone in academia?

I have a lot to say on this one. Outdated and incorrect beliefs, like the idea that mental health and addiction recovery is somehow a matter of personal willpower or moral fortitude, persist in our society. 

Internalized stigma refers to a person’s tendency to absorb negative assumptions or external stereotypes about a particular condition and, in turn, to believe or act as if those negative labels are true. The threat of public and professional stigma following disclosure of substance use is real. This can ultimately create fear and self-criticism within the affected individual. Not only can internalized stigma increases the distress of living with a substance use issue, but it can also impact behavior by discouraging a person from seeking treatment and prolonging their suffering. 

For example, a PhD student who is high achieving in professional or academic realms might think, “I shouldn’t even be dealing with this; I just need to push through and get myself together,” or “No one can relate to what I’m going through.” We must recognize and accept that substance use affects people from all walks of life and virtually all cultural groups. No professional achievement can make us immune to this reality. 

What I often find helpful is to apply a medical comparison: If you were living with a significant medical injury that needed surgery and physical therapy, would you expect yourself to “just push through?” Most likely, no! And yet, many people hesitate to seek mental health and substance use treatment. 

If this describes you, you could also try researching public figures who have recovered from a substance use issue or achieved sobriety. It may surprise and reassure you to know that other highly successful individuals – yes, even those in your field – struggled in similar ways and are now living in recovery. 

It is a personal decision about whether to disclose past or present issues related to substance use. Whether disclosed or not, the impact of untreated substance use often shows up in other ways that colleagues or advisers may recognize, such as absenteeism, irritability or mood changes, missed deadlines, etc. 

If you are returning to academia, an important piece of the puzzle is to acknowledge areas where trust has been ruptured and then seek direct feedback on how you can get back on track. This may require difficult conversations, ongoing self-reflection, and a commitment to continuous improvement. Consider your talking points in advance, and work with a support person (such as a therapist) to set healthy boundaries on what you would like to share vs. keep private. 

6. How can PhD students who have experienced substance use setbacks or relapses regain their motivation and momentum in their academic pursuits?

No one and I mean no one, ends up in a PhD program by accident. Across the board, PhD programs have incredibly rigorous standards for admission. If you have been accepted as a graduate student, your credentials already speak for themselves. Remember that you have been chosen to be there. The challenge, of course, is regaining your footing and sense of self-confidence to find a way forward after a substance use setback. Once you generate some momentum and regain a routine, each day will get easier.

First, assess where you are in relation to your academic pursuits. Some fundamental questions to ask yourself are: “Why did I want to pursue this program in the first place? Is continuing in this area of study still in line with my personal values and my recovery needs?” There is no better day than today to get totally honest with yourself about your long-term priorities. Academic advancement and professional accolades are achievements to be celebrated, but they cannot replace a deeper sense of health and well-being.

Second, start small as you rebuild your support network. I recommend having at least one person within your program (such as a professional adviser, colleague, etc.) and one support person in your non-academic life (such as a family member, therapist, or peer in recovery) that can help provide guidance and support. 

Third, stick to your recovery plan. If you are returning to an academic environment that was previously associated with substance use, it is natural that cravings and triggers to resume your prior use will occur — sometimes even unpredictably or with strong intensity. Do not set unrealistic standards to “get over” or “move past” an addiction abruptly. Recognize the circumstances that may be red flags for you and reach out early for more support. 

7. What are your top recommendations for matriculating PhD students as they prepare for the emotional impact of graduate school? 

  • Expect stress and have a game plan on how you will cope effectively. Recognize your time in a PhD program as a unique phase of life within a high-pressure system. PhD students tend to perceive much higher stakes for achieving success. Specializing in a particular area means that the future of your desired career may become contingent upon your academic success in graduate school. Competition among peers may further exacerbate a sense of being “under a microscope.” Make your mental wellness a priority, and do not fault yourself if you begin to experience a reaction to increased stress levels. 
  • Whether it’s long hours in a classroom or lab, demanding fieldwork placements, intense exam and study schedules, or late nights on your laptop, the landscape of graduate school makes it easier to become isolated. You may begin to view academic success as the whole of your identity and self-esteem. Don’t forget to schedule time for hobbies, leisure interests, and socialization outside of your work. Personally, I will never forget when I asked a long-time psychiatrist about his secret to success in the field after a long career. “That’s an easy one,” he said. “Get a life. Get a life outside of all this. It is the only thing that can sustain you to do this work.”