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Resiliency: Substance Use and Harm Reduction

This LibGuide provides materials about substance use. disorder (SUD) and harm reduction.

Navigating this LibGuide

This LibGuide features materials related to substance use. Please see below for instructions on how to navigate this guide:

  • To the left, you will find your main menu, which includes two sections: ProQuest Materials and NC Live Materials
  • Located on their subject page, you will find many materials about each topic. Each item will have a link that will take you to NC Live or ProQuest.
  • To access the ProQuest Materials, you can either:
    • Type in the e-ISBN in the search bar on your university library's webpage
    • Click the title to follow the link directly to the ProQuest Webpage for this item. Use your university single sign on credentials to access the materials.
  • To Access the NC Live Materials:
    • Go directly to the NC Live website and enter the information on the search bar
    • Click the title to follow the link directly to the NC Live Webpage for this item. NC Live will ask you the name of your institution through a drop-down menu. Scroll through the menu until you locate the name of your library. Select the name of your library to to log into NC Live. 

The Substance Abuse and Mental Health Services Administration (SAMHSA) (2024) states that substance use disorder (SUD) occurs when the recurrent use of alcohol and or drugs causes significant impairment. These impairments include physical health problems, disability, and failure to meet major responsibilities in activities of daily living (i.e. work, school, or home). The most severe form of SUD is addiction (National Institute of Mental Health, 2024). Additionally, individuals can be diagnosed with co-occurring mental disorders.

According to NIMH (2024), several forms of behavioral therapies have been proven to be effective in treating adults with SUDs and co-occurring mental disorders, including:

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Assertive Community Treatment (ACT)
  • Therapeutic Communities (TC)
  • Contingency Management (CM)

Behavioral therapies for children and adolescents include:

  • Brief Strategic Family Therapy (BSFT)
  • Multidimensional Family Therapy (MFT)
  • Multisystemic Therapy (MST)


National Institute of Mental Health. (2024). Substance use and co-occurring mental disorders.

Substance Abuse and Mental Health Administration. (2024). Mental health and substance use disorders.

According to Prevention with Purpose: A Strategic Planning Guide for Preventing Drug Misuse Among College Students:

  • 73% of students attend four-year residential colleges and universities full-time
  • 75% of college students report consuming alcohol at least once while in high school
  • College students cite four main reasons that college campuses provide a rich environment for drug experimentation:
    • ease of drug availability
    • lack of parental influence
    • normalization of drug use among peers
    • low perceived risk of harm from drug use
  • Research-supported risk factors for alcohol and drug misuse in college include:
    • Individual factors - financial stress, higher levels of overall stress, history of depression, sensation-seeking behaviors, and current use of alcohol, tobacco, or cannabis
    • Interpersonal factors (family and peer supports) - family history of depression, perceived marijuana use by peers, family environment, perceived peer alcohol use
    • Community factors - campus culture/normalization of substances, lack of parental supervision, increased availability of substances, living arrangements (on- or off-campus)
  • Research-supported protective factors against alcohol and drug misuse include:
    • Individual factors: negative attitude toward alcohol and religious commitment
    • Interpersonal factors (family and peer supports) - parental monitoring, no family history of alcohol misuse
    • Community factors - involvement in service-based extracurricular activities, on-campus alcohol-free events and programming, and living in substance-free housing
  • Groups of Students at higher risk of substance use
    • Athletes
    • Fraternities and Sororities
    • LGBTQIA+ Students
    • Students with certain mental health conditions (i.e. depression, anxiety, and panic disorders)


Campus Drug Prevention. (2024). Prevention with purpose: A strategic planning guide for preventing drug misuse among college students.

The Substance Abuse and Mental Health Services Administration (2023) defines harm reduction as a practical and transformative approach that incorporates community driven public health strategies to empower people who use drugs (PUWD) and their families with the choice to live healthier, self-directed, and purpose-filled lives.

Harm reduction is an approach with six pillars, 12 principles, and six core practice areas that centers around the lived and living experience of PWUD, especially those in underserved communities (SAMHSA, 2023). It is part of the continuum of care and a comprehensive strategy that includes prevention, treatment, recovery, and health promotion (SAMHSA, 2023). 

Prevention seeks to stop problems before they start, including: preventing exposure to substances (or screening and intervening with early misuse), reducing risk factors, and strengthening protective factors (SAMHSA, 2023). It also sees to halt the progression of substance use to substance use disorder (SUD) along with any harms associated with substance use (SAMHSA, 2023). 

Six Pillars of Harm Reduction (SAMHSA, 2023)
Harm Reduction... lead by people who use drugs (PWUD) and with lived experience of drug use.
...embraces the inherent value of people.
...commits to deep community engagement and community building.
...promotes equity, rights, and reparative justice.
...offers most accessible and non coercive support.
...focuses on any positive change, as defined by the person.
Principles of Harm Reduction (SAMHSA, 2023)
Respect autonomy
Practice acceptance and hospitality
Provide support
Connect with Community
Provide many pathways to well-being across the continuum of care
Value practice-based evidence and on-the-ground experience
Cultivate relationships
Assist, not direct
Promote safety
Engage first
Prioritize listening
Work toward systems change
Six Core Practice Areas
1. Safer practices
2. Safer settings
3. Safer access to healthcare
4. Safer transitions to care
5. Sustainable workforce and field
6. Sustainable infrastructure


Substance Abuse and Mental Health Services Administration. (2023). Harm reduction framework.

Looking for more information on your campus?

Use the search terms below:

  • Substance use disorder
  • Harm Reduction
  • Substance use AND college students
  • Substance use treatments
  • models for substance use treatment