DuWell

Drug Education and Harm Reduction

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Substance misuse can impact all dimensions of your wellbeing. We are here as a resource to provide you with educational opportunities, social host trainings, and organizational risk management workshops so you can safely enjoy your time here at Duke. Whether you are looking for information or strategies for yourself, a friend, or for a larger organization, DuWell can work with you to develop an action plan for reducing the potential harm stemming from high-risk behaviors and activities.  

 

Alcohol and Other Drug Information

Information and resources to support healthy choices.

A key component of a healthy relationship with alcohol is to experience its positive effects by drinking the least amount possible. Alcohol takes time to enter your bloodstream, so pacing your drinks is very important. By giving your body time and paying attention to how you're feeling can help you understand how intoxicated you are.

  • Don’t Drink: Not everyone drinks, so don't feel like you're missing out.
  • Know the Size of a Standard Drink: Knowing these sizes can help prevent you from over consuming.
    • Beer: 12oz at 5% alcohol
    • Hard Seltzer: 12oz at 5% alcohol
    • Wine: 5oz at 12% alcohol
    • Liquor: 1.5oz at 80 proof alcohol
  • Ride the Wave: To stay in this zone it's typically one or two drinks in the first hour, no more than one drink per hour after, with a max of three drinks for the entire time you're drinking.
  • Set a Drink Limit Based on Your Ride the Wave Zone: This is typically no more than three total (3) drinks, spaced out over two to three hours. A BAC calculator can help you estimate how many drinks it takes to reach .06 and remain in the Ride the Wave Zone. Notice how sex, weight, and drinking speed all affect a person's BAC as well.
  • Make Your Own: Always make and measure your own drinks so you know how much and what is in them. Drinks made by others have a greater chance of containing other substances. Steer clear of communal drinks that are often found it coolers - there's no way to tell how much alcohol it contains.
  • Eat Before, During, and After: Eating before and during drinking helps slow the absorption of alcohol into your system which gives you a better feeling.
  • Don't Mix Alcohol with Medicine: Mixing alcohol with certain medications can cause a variety of dangerous symptoms. Click here for more info.

Unlike alcohol, there is currently no definitive amount of cannabis that defines a standard dose. This means there is no quantifiable low to high-risk amounts on which to base recommendations. The National Institute on Drug Abuse has recently established 5 milligrams of delta-9-THC (the primary psychoactive component and what causes the effects that people most associate with getting “high”) as a standard unit of measurement for which researchers will base studies off. This offers some confidence that we will be able to provide similar guidance for cannabis as we do with alcohol in the near future. 

Not all cannabis is created equal. Different strains of cannabis have THC concentrations that vary widely so when a person smokes cannabis (flower), one puff, drag, or hit is not equal to the next. The same is true of THC concentrates, which also vary widely and often start at much more potent levels. Edible products also come in different levels of THC and therefore each has different serving sizes. All of this complicates the ability to know and exact "dose" from one product to the next.

Because cannabis can be consumed in multiple ways, and the route of administration can significantly affect the way in which the body metabolizes and synthesizes the compounds in the plant, it can cause experiences to vary widely from the type of cannabis and from person to person. With that in mind, here we explore all the factors to be mindful of when choosing to consume cannabis and what to look out for as signs that a person has consumed too much.

 

Smoking/Vaping/Dabbing

When smoked, vaped, or dabbed THC enters the bloodstream almost instantly and the effects are felt within minutes. When people make claims that cannabis is not harmful they are typically referring to when people are smoking flower as it can be hard to ingest significant enough levels of THC this way to pose a serious risk from the drug alone. However, higher THC concentrations found in strains produced today can be harmful when consumed in large quantities. Subsequently, THC concentrates, sometimes containing as much as 80% THC or more, pose an increased risk when smoked/vaped/dabbed because it only takes a small amount of a concentrate to equal or surpass the amount of THC that would be contained in a full joint or bowl of flower.

Edibles

When THC is consumed by eating or drinking an infused product (edibles) the body processes the THC more slowly and differently. When THC is processed through the GI tract and liver, the body converts delta-9-THC into the more potent 11-Hydroxy-THC. This can result in far more intense highs and adverse health effects. 

 

How Long Does The High Last?

It is extremely important to understand that the effects of THC can last far longer than you may expect or want them to. Below are some general guidelines from Drugs and Me, but know that this can vary by person and by how much THC you have ingested.

  • Smoking or vaping. The effects peak around 10 minutes after consumption and typically last 1 to 3 hours, though they can linger for up to 8 hours.
  • Eating. The effects of edibles usually peak around 2 hours after consumption and can last up to 24 hours.
  • Dabbing. Similar to smoking/vaping, the effects of dabbing usually last 1 to 3 hours. If using a high THC concentrate, you could feel the effects for an entire day.

 

Know the Law and Policy

Regardless of cannabis being legalized recreationally and medicinally in other states, North Carolina law and Duke Policy prohibits members of its community, both individuals and student groups, from manufacturing, selling, delivering, possessing, using, or being under the influence of cannabis without legal authorization. As a reminder, just because a substance is legal, various risks associated with use still remain.

 

Tips to Lower Your Risk

  • Don’t Use. Not everyone uses cannabis, so don't feel like you're missing out. There are a variety of personal reasons why individuals choose to abstain.
  • Only use products purchased from a reputable source. There is no way to guarantee what may be in cannabis purchased outside of a dispensary. Dispensaries have an obligation to provide as much information as possible on each product and not sell anything that is tainted or laced with other substances.
  • Start low. Always start with a small amount and/or low THC strains (one hit from a joint or bowl, or one serving of an edible with no more than 5mg of THC)
  • Go slow. Pace yourself. Don’t keep ingesting cannabis until you feel the effects and understand how your body is reacting. This can mean waiting hours between re-dosing.
  • Avoid concentrates. The high level of THC in a concentrate makes it easier to overdose.
  • Avoid homemade edibles. These products can contain high amounts of THC or are unable to guarantee how much THC is in the product.
  • Do not combine cannabis with other substances. Substances when combined can have dangerous effects putting your health at increased risk. Alcohol and cannabis can result in nausea, vomiting, dizziness, sweating, and increased impairment.
  • Do Not Drive. THC does impair a person’s motor functions and judgment resulting in impaired driving abilities putting both the driver and others at risk.
  • Take a tolerance break. If you notice you are consuming more than before it may be time to take a break and reset your body’s tolerance to THC.
  • Speak to a provider about your substance use. Email duwell@studentaffairs.duke.edu to discuss current use, questions, and any concerns you have.
Source: Northwestern University. (2021). Know Your Limit - Cannabis: Alcohol and Other Drug Resources.

Tobacco use has been on the decline for decades. Unfortunately, much of the work to curb traditional cigarette smoking rates is being threatened by the rise in vaping among youth. While some view vaping as a less harmful form of nicotine use or even as a way to stop smoking, much is still unknown on the long-term adverse effects vaping has on a person’s health. Chemicals contained in the aerosols produced by vaping are known to be carcinogenic. Vaping is NOT risk free and is not an FDA approved form of smoking cessation.

Support Resources:

If you are currently using tobacco or nicotine products, including vapes, there are numerous resources to help you be free from nicotine.

Most college students do not misuse prescription medications, and the opioid crisis that is affecting many people in the United States has luckily not affected the college environment to the same degree. However, misperceptions around prescription stimulant use in the college environment exist and warrant more awareness around the negative effects of misusing this class of substances.

The Impact of Misusing Prescription Stimulants Video

 

Storing your Medication

When prescribed a prescription medication, store it in a secure location such as a lockbox, medication safe, or other lockable spaces. Avoid storage places where others have easy access, such as drawers, nightstands, or counters/cabinets.

 

Disposing of Medication

Once finished with a prescription medication, you have options for safely disposing of it:

  • OPTION #1: Place the medication in a drug drop box. To find a drop box in your area, visit: www.rxdrugdropbox.org  
  • OPTION #2: Take advantage of community drug take-back programs that allow the public to bring unused medications to a central location for proper disposal. Call your local law enforcement agency or ask your pharmacist to see if a take-back program is available in your community.
  • OPTION #3: Dispose of the medication at home. Before completing these steps, we encourage you to follow any disposal instructions on the drug’s label or patient information sheet. If disposal instructions are not given, complete these three steps:
    • Step 1: Remove the pills from the original container and mix them with an undesirable substance such as used coffee grounds or kitty litter.
    • Step 2: Throw away the sealed mixture into the trash.
    • Step 3: Remove the prescription label and dispose of the empty bottle. NOTE: In general, you should not flush medications down a toilet or drain; however, the FDA still recommends the disposal of certain drugs by flushing.

 

Legal Considerations

  • Possessing prescription medications without a valid prescription is illegal.
  • Giving or selling your prescription medication to another person is illegal.
 
Source: Northwestern University. (2021). Prescription Drugs/Stimulants: Alcohol and Other Drug Resources.

Caffeine

  • Caffeine - The most widely consumed drug can be found naturally in foods like chocolate, coffee, and tea; is added to many brands of soda pop and energy drinks, and is a common additive in some medications. While you may reach for a caffeinated drink to wake up in the morning, consuming it later in the day can disrupt your ability to fall asleep, resulting in drowsiness and irritability the next day.
  • If you are trying to cut back or cut caffeine out entirely, be aware of caffeine withdrawal so that you aren’t caught off guard and can successfully make the change without suffering.
  • Avoid mixing high levels of caffeine (or any stimulant) with alcohol as this can create a false sense of sobriety and potentially lead to serious negative outcomes.

 

Cocaine

  • Cocaine - Derived from the cacao bean, cocaine is an illicit stimulant. Cocaine is highly addictive and can cause serious negative health outcomes such as high blood pressure, stimulant psychosis, heart disease, and heart attack.

 

Heroin

  • Heroin - Produced by synthesizing a compound found in the opium poppy plant, heroin acts as an opioid (pain killer) in the human body and is of increased concern due to the opioid epidemic causing some people to turn to heroin use in lieu of prescription opioids. It is highly addictive and lethal.

 

Psychedelics/Hallucinogens 

  • Psychedelics/Hallucinogens - a diverse group of drugs that alter a person’s awareness of their surroundings as well as their own thoughts and feelings. Hallucinogens naturally occur in certain plants and can also be synthetically produced. 
  • Common hallucinogens - LSD, MDMA (Ecstasy/Molly), Psilocybin mushrooms, Peyote, Ayahuasca, Ibogaine, PCP, Ketamine, Salvia

 

Methamphetamine

  • Methamphetamine - a powerful, highly addictive stimulant.
  • Health Risks - Chronic use of meth can cause paranoia, hallucinations, repetitive behavior, and delusions of parasites or insects crawling under the skin that can lead to obsessive scratching. Long-term use, high dosages, or both can bring on psychosis usually coupled with extreme paranoia. Methamphetamine use can also cause severe dental problems, convulsions, changes in brain structure, strokes, heart attack, and death.

 

Kratom

  • Kratom is a tropical tree (Mitragyna speciosa) native to Southeast Asia, with leaves that contain compounds that can have psychotropic (mind-altering) effects. Symptoms of psychosis have been reported by users. Additional side effects include constipation, upset stomach, lethargy, anxiety, irritability, depression, or insomnia.
  • Kratom is illegal and products are unregulated. It is NOT FDA approved and lacks clinical trials to test the safety and any perceived medical benefits.

 

Ketamine

  • Ketamine is a dissociative hallucinogenic and anesthetic used for both humans and animals. Its effects cause a person to feel detached from reality.
  • Ketamine can result in experiences that involve a terrifying feeling of almost complete sensory detachment that is likened to a near-death experience often referred as the “K-hole.” Low-dose intoxication from ketamine results in impaired attention, learning ability, and memory. In high doses, it is known to cause delirium, amnesia, impaired motor function, high blood pressure, depression, and potentially fatal respiratory problems.
  • Ketamine Assisted Psychotherapy is a treatment that can be used to help treat conditions including trauma, anxiety, and depression. Always consult with your healthcare provider before starting any new treatment. Ketamine Assisted Psychotherapy must be conducted by a licensed and trained psychiatrist.

 

Source: Northwestern University. (2021). Additional Other Drugs: Alcohol and Other Drug Resources.

What is alcohol poisoning?


Alcohol poisoning is a serious - and sometimes deadly - consequence of consuming large amounts of alcohol in a short period of time. Drinking too much, too quickly can affect your breathing, heart rate, and gag reflex and potentially lead to coma and death.

What are the symptoms of alcohol poisoning?

  • Breathing gets shallow
  • Heart rate slows down
  • Eyes roll back into head
  • Skin is clammy/skin color may change
  • Vomits while passed out
  • Cannot be awakened from a passed out state

What do I do if I think someone has alcohol poisoning?

If you suspect that someone has alcohol poisoning — even if you don't see the classic signs and symptoms — seek immediate medical care. Here's what to do:

  • Call 911 or Duke Police/EMS 919-684-2444 immediately. Never assume the person will sleep off alcohol poisoning.
  • Be prepared to provide information. If you know, be sure to tell EMS the kind and amount of alcohol the person drank, and when.
  • Don't leave an unconscious person alone. Because alcohol poisoning affects the way the gag reflex works, someone with alcohol poisoning may choke on their own vomit and not be able to breathe. While waiting for help, don't try to make the person vomit because he or she could choke.
  • Help a person who is vomiting. Try to keep them sitting up. If the person must lie down, make sure to turn their head to the side — this helps prevent choking. Try to keep the person awake to prevent loss of consciousness.

If you seek medical help on behalf of someone with alcohol poisoning, formal disciplinary action for a violation of the campus substance use policy will not be taken.

Source: Alcohol poisoning. Mayo Clinic.

It is possible to ingest too much cannabis, which can result in unpleasant and serious conditions that can last for multiple hours. Never leave a person in this condition alone. Always seek medical attention if they are unresponsive, in distress or symptoms worsen. 

Internal Signs & Feelings External Signs & Behavior
  • Paranoia
  • Anxiety
  • Hallucinations
  • Altered sense of perception or delusions
  • Decreased blood pressure/dizziness
  • Fast heartbeat
  • Pale skin
  • Incoherent
  • Extreme Confusion/Memory Problems
  • Unresponsiveness
  • Vomiting and/or nausea
  • Shaking that’s hard to control

What do I do if I think someone is overdosing on cannabis?

If you suspect that someone is experiencing a cannabis overdose — even if you don't see the signs and symptoms — seek immediate medical care.

Here's what to do:

  • Call 911 or Duke Police/EMS 919-684-2444 immediately. 
  • Be prepared to provide information. Be sure to tell EMS what signs and symptoms you are seeing and the substance(s) that the person used.
  • Don't leave the person alone. Stay with them until help arrives.

If you seek medical help on behalf of someone with alcohol poisoning, formal disciplinary action for a violation of the campus substance use policy will not be taken.

 

Source: Northwestern University. (2021). Know Your Limit - Cannabis: Alcohol and Other Drug Resources.

How We Can Help

Services and workshops to help facilitate healthy decisions involving alcohol and other drug use.

 

BASICS is for students who have had negative experiences or problems related to alcohol and/or other drug use. It is an evidence-based program that helps our students make better decisions in the future and reduce their risk. Individual BASICS provides at least one, non-judgmental session with a member of our team.

What you can expect:

  • BASICS is a casual interview process that meets the student where they are to provide them with risk reduction strategies and resources. BASICS helps students evaluate their own alcohol and/or other drug use and provides personalized feedback for self-improvement and safer choices in the future.
  • BASICS is not a counseling session. Our staff are trained facilitators that use motivational interviewing techniques to encourage positive change in behavior. We are also trained to recognize and refer students who may have more serious substance use dependence issues.

If you have been referred to our office to complete a BASICS session or you just want to know more about your patterns of use, click here to set up an appointment.

 

What is a Social Host?

Social Hosts (formerly known as Party Monitors) are members of the Duke community that are required to be present at all on-campus events where alcohol is present. Social Hosts are sober, active bystanders that assist in promoting safe, social behaviors to ensure that the event ends well for all those attending. 

What will this workshop cover?

  • Your role as a Social Host.
  • How you can promote safe, social behaviors.
  • How your organization can host a safe and successful event.
  • The risks associated with alcohol and other substance use.
  • Skills to address potentially dangerous and questionable behavior among your guests.
  • Resources that can help support your group.

Social Host Requirements

  • As a Social Host, you must remain sober before and during your shift.
  • For all events involving alcohol there must be one (1) Social Host for every 25 expected attendees. 
  • The name(s) of each Social Host must be submitted via DukeGroups when registering your event.

Workshops are now being held on an as-needed basis. If you would like to schedule a workshop for your group, email duwell@studentaffairs.duke.edu

We provide advising and consultations for student groups that are planning to host events where risk around alcohol and other substance use may be involved. We will work with your group on an ongoing basis to help develop and implement a risk management plan to help minimize the negative consequences and high-risk behavior that may be associated with your event. 

To make an appointment call 919-681-8421 or email duwell@studentaffairs.duke.edu.

This interactive workshop is designed for students/student groups and provides and opportunity for members to come together to safely identify and discuss impact of substance use on campus and within your group, current use, perspectives and attitudes. It provides space for members to have a conversation about how to create a group culture to support the wellbeing of all members. Prior to the workshop an anonymous survey is completed by members of the group to provide personalized feedback and to guide the conversation with aggregate data specific to your group.

If you would like to schedule this workshop for your group, email duwell@studentaffairs.duke.edu.

Supporting the Entire Duke Community

When does drinking for fun or other drug use turn into a concern? It’s not always easy to see when substance use has crossed the line from moderate or social use to misuse or abuse. And it can be hard to talk to your friend about your concerns for their drug use habits. Being a friend or partner of a person with an substance use problem can be difficult for you and negatively affect your relationship.  You are not alone.

Tips for talking with your friend:

  • Express to your friend when they are sober about how their substance use makes you feel. You may be met with excuses, denial, or anger but what does matter is that you express your love and concern with specific examples of behavior that has worried you.
  • Making empty threats or preaching does not show your support for them.
  • Don’t feel guilty or responsible for their behavior. It is not your fault.
  • Keep in mind that change cannot be forced. It takes time for someone to seek help and develop new coping skills to overcome problem drinking. Being patient is important.
  • Remain involved in the recovery process but don’t assume their responsibilities. Taking over their responsibilities protects them from the consequences of their behavior.

Ask yourself these questions:

  • Do I worry about how much my friend uses substances?
  • Am I embarrassed or hurt by my friend’s behavior after they uses substances?
  • Do I make excuses for this behavior to our friends or others?
  • Are you afraid to upset your friend for fear it will cause them to use substances?
  • Does substance use seem to be more important than other things?
  • Has the personal safety of myself, partner, or other friends been threatened when they uses substances?

If you have answered YES to any of these questions, consider seeking support from any of these resources:

If you are concerned about a student's health or behavior, and your concern is not considered an emergency, please complete a DukeReach report or call 919-681-2455.

We welcome those in our community who are in recovery or allies to recovery.

 

Recovery Support Group at Duke University

Struggling with addiction? Seeking support for your recovery journey? Join our weekly seminar meetings where students discuss issues they face as they pursue recovery at Duke.

The Recovery Support Group at Duke University provides a caring and supportive environment for students working towards recovery from addictions. We communicate a message of hope, link students with recovery-related services and persons in recovery, and facilitate the development of healthy and sustainable habits of mind, body, and spirit.

What is recovery?

Recovery is a lifestyle and long-term journey towards freedom from addiction and substance use through abstinence. However, while remaining abstinent from substance use is important, is only one aspect of long-term recovery. For many of us, the brightest part of our long-term recovery lies in finding a new way of living that seeks to break old habits, understand ourselves better, and even enrich our spiritual lives. It is in these aspects that we find freedom from the obsessions and painful cycles of our past.

The details of each person’s journey on the road of recovery can look different. Some may use 12-step or SMART programs as a foundation for their recovery while others may set a goal with a therapist, medical professional, or spiritual mentor. For some, their recovery may include MAT, or medically-assisted treatment, using substances like methadone or suboxone administered by licensed professionals to help them abstain and remain sober.

No matter what each individual’s road looks like, the Recovery Support Group is united in our common bond of seeking freedom from addiction, physically, mentally, and spiritually.

Fall 2021 Recovery Support Group Meetings

  • Every Tuesday at 12:00pm - 12:45pm; Virtually via Zoom
  • Every Thursday at 11:00am - 11:45am; Room 144 of the Student Wellness Center
  • Every Friday at 4:00pm-5:00pm; Room 144 of the Student Wellness Center

 

Additional Resources

  • DukeReach: DukeReach provides case management services to students in recovery or returning from a leave of absence for ongoing coordination of care and referrals to resources on and around campus. For more information contact DukeReach at 919-681-2455

  • AA Meetings: Alcoholics Anonymous® is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism.  For Durham-based AA meetings, click here.

  • Al-Anon: Al-Anon provides friends and relatives of those with a substance use disorder an opportunity to gather together to share their experience, strength, and hope in order to solve their common problems.

  • NA Meetings: Narcotics Anonymous  provides help from peers and offers an ongoing support network for substance abusers who wish to pursue and maintain a drug-free lifestyle. the name, Narcotics Anonymous, is not meant to imply a focus on any particular drug; NA’s approach makes no distinction between drugs including alcohol. For Durham-based NA meetings, click here.

  • Duke Marine Lab - Recovery Resources: For students taking classes at the Marine Lab in Beaufort, NC and looking for support, click here for resources.

 

We recognize that parents and families are the first line of defense against many unhealthy decisions that students make.

It is important to have open and honest conversations with your student about their personal well-being.  Specifically, having non-judgmental discussions about alcohol and other drug use helps educate and guide them towards decisions that keep them happier and healthier while they are at Duke.

Click here for information on how to get the conversation started.