The opioid crisis is taking the lives of around 115 Americans each day—and is taking over the lives of millions of others. Although the problem is more common in rural than urban areas, the fact that doctors have in recent years over-prescribed opioid painkillers means that anyone can be at risk for abusing these powerful drugs. Now that we’re aware of the opioid epidemic, fewer prescriptions are being written—but opioid addiction and abuse is still a massive public health emergency. As parents who send their children off to college each year wonder: has the opioid crisis reached college campuses?

Drug Use on Campus

Unfortunately, students often misuse prescription and recreational drugs. College and university campuses have always dealt with drug use among students, but with the opioid epidemic in full swing, there is even more cause for concern. Prescription amphetamine-based drug Adderall, which some students use to focus and study for long periods of time, was used among college students at a rate of 9.9% in 2016, while non-college young adults used the drug at a lower rate of 6.2%. Opioid misuse on campuses is harder to pinpoint, but about 7% of 870 students surveyed in 2016 said they had abused opioids.

Why are Students Using Painkillers?

Many people who become addicted to opioids start off by using prescription drugs for a medical condition. Some of these students like the relaxation they get from using opioids, and continue to use them—with some even selling extra pills to their peers. Though some students start abusing opioids after using them medically, others start taking them for a range of reasons. Some use them to relieve some of the pressure to perform well at school or for social reasons, like fighting off the effects of a hangover or during parties.

Although opioids are one of the drugs of greatest concern on campuses around the country, other painkillers are often used as well. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are common over-the-counter painkillers. While appropriate when used sparingly for pain, these drugs can have dangerous side effects when used improperly. Over 25 billion doses of acetaminophen are sold each year, and hundreds of deaths are linked to the improper use of NSAIDs.

Painkillers and College Athletics

Although any college student could start abusing painkillers, student athletes are among the most at risk. Although 8 million students are athletes in high school, only 3.3% of male and 3.7% of female basketball players will play at the NCAA level. Still fewer become professional athletes. That’s a lot of pressure to do well and to stay healthy for games. After an injury, most athletes are anxious to get back to the field or court, and begin taking prescribed opioids and other painkillers. As a result, many student athletes become dependent on painkillers.

A Normal Way of Life

Because opioids have been overprescribed for years, many students have grown up believing that using pills for pain of any kind isn’t a big deal. Unfortunately, we don’t do a good job culturally of educating young people about what these drugs can do to the body. Combine that with the high pressure of college academics, a competitive environment, peer pressure, and less supervision than students are used to, and it’s not surprising that drug abuse becomes a normal way of life for many students. Eventually, drug use can take over students’ lives, and they may turn to the black market or illicit drugs like heroin.

Changing the Conversation

When we discuss the opioid epidemic, it’s often framed as a problem that only affects people in rural areas, but that’s simply not the case. Changing the conversation and realizing everyone is affected by this crisis—even young people on college campuses—is the first step.

Some universities are beginning to take steps to help students overcome addiction by offering sober housing. Treating the problem is only one part of the equation, however. It’s important to educate students on the effects of drugs, the consequences, and discuss positive alternatives to opioids, like natural medicine, exercise, and taking the necessary time away from physical activity to heal from injuries.

Painkillers play an important role in our modern healthcare system, but they need to be treated with extreme caution. Reducing our dependence on them is essential, but so is making sure that everyone—including students—has access to support and treatment to help them leave opioids behind if they get out of control.