Harm Reduction:
Managing One's Use of Psychoactive Substances
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Marijuana, along with alcohol, nicotine, and caffeine, are among the most widely used drugs of choice by collegiate students in the U.S. Although U.S. policy regarding drugs is driven by a definition of drugs as being illicit substances and its overarching objective when establishing public policy regarding such drugs is interdiction, all four of these substances, plus prescription medications and many over-the-counter compounds (OTC) available without prescription include psychoactive compounds.

These four common drugs of use for college students should be viewed with equity when discussing substance use with contemporary collegians, especially if a Student Affairs professional is discussing the results of the substance use assessment with an individual student. This is meant to suggest that students need to be asked about their use of these legal substances and their declaration of "in moderation" when acknowledging use, of whichever substances are reported, be discussed from a "harm reduction" point of view. Although few readers will likely have a problem with talking about "low risk" use of caffeine, some, I suspect, will question doing this with alcohol and many will likely question the appropriateness of doing so with marijuana and tobacco…let alone other real drugs. Keep in mind, however, that when doing this I use my definition of low risk and not the client's, and I have yet to find a reasonable definition of "no risk" for any of these substances. In short, the consumption of any psychoactive substance—but especially these four psychoactive substances—all include risk, be that health, legal, social, vocational, personal (a.k.a., impaired judgment) or whatever.

Now, when talking about the management of psychoactive substances, there are certain guidelines, or as an old friend of mine who first introduced me to these guidelines almost 30 years ago called them, "rules for psychoactive management" (Weitzel, 1981) that need to be heeded. These include:

1. When there is an opportunity or inclination to consume a psychoactive, especially in order to feel good or get high, consider zero consumption. As a matter of fact there are clear indications when no use is responsible use, e.g., alcohol and driving, Central Nervous System depressant substances and operating machinery, e.g., antihistamines, or tobacco when being treated for asthma.
2. When a decision to consume has been made, consume as LITTLE as necessary, rather than AS MUCH as possible.
3. Discuss the sought after effects of the substance being used with another
4. Research the side effects and discuss with others
5. Include, among those with whom you discuss these effects, non-consumers of the substance you are considering using.
(NOTE: These suggestions were first presented by William Weitzel at workshop at the PA "Governor's Council" Drug & Alcohol Conference, Oct. 28, 1981)

We need to be careful in our rush to "do the right thing" that we do not close the door on the one place that students can turn to get objective information, us. If we are perceived as "narcs" or the "campus DEA," as students wish to discuss the dangers of drugs, we will only have mandated conversations with closed mouthed students. Student Affairs professionals and faculty ARE the appropriate individuals on campus with whom students should be discussing issues of drug use, and this means open and frank discussions.

Of course, as professionals working in higher education, we should not advocate the use of any drug, licit or illicit, for any reason. Rather, we should recognize that many students do use drugs, especially the "big four" mentioned above, frequently with minimal risk. Does this mean we should say, "Hey, if it feels good and you're not hurting anyone, go for it?” absolutely not. If anything we should be inviting students to review the first rule mentioned above" and the risks associated with ANY psychoactive use in order to make objective decision based on accurate facts. A likely motto for the effective Student Affairs professional in higher education may well be, "Good decisions begin with accurate information."

It is entirely possible that there is a continuum for marijuana use just as there is for alcohol, caffeine, or other drug use. This continuum runs from "no risk," i.e. abstinence, to "guaranteed risk," i.e., dependence. I believe it is part of our responsibility to invite students to consider this fact and to make decisions accordingly. Students have come to expect our professional reaction to a discussion of psychoactive use to only include the "no risk" end of the continuum. If we act as they expect we all but guarantee failure in affecting the decisions our students/clients are making as regards drug use as we argue with each other from across the resulting abyss.

When inviting students to look at "the big picture," which includes the risk end of the continuum, we may well be confronted, sometimes quite bluntly, with a student’s perception that we are being subjective and trying to tell them how to live their lives. Be this as it may, there are students who have decided to continue to smoke pot - drink caffeine/alcohol, smoke tobacco, use OTC compounds contrary to directions, etc. - even after our conversations. What is interesting, however, is that they frequently do so, but on a level of significant reduction in frequency and quantity from that presented when seeking counsel or feedback from a professional familiar with the rules outlined above. Is this a no-risk decision? Again, this is absolutely not true. But is it a more proactive approach to engaging contemporary collegians in a discussion about the choices they make? You decide.

To close as I began, often we are the source of accurate information and to deliver that information requires that we recognize that sometimes to deliver "all" of the information necessitates that we include "some" of the information that, in and of itself, we do not condone.

What do you think?