Why college students use alcohol and drugs? Now I want participation. I want a few answers and then we continue. Yes. I think it has to do with increased stress levels. I actually had a comment, I guess, because at the beginning of this course, we talked about how over the past few years, stress levels in college students are constantly increasing, therefore I would imagine the alcohol and drug abuse would also be increasing in the same sense. That's exactly what is happening. I forgot your name. Emily. Emily said that one of the reason is stress. The assumption is that because we now have an epidemic of stress, then the level of alcohol and drug consumption is going up. Anybody else wants to add? Yes. I think there's a big social aspect to drinking. I personally don't, but I know a lot of my friends who drink to socialize. Without drinking, sometimes they're not as sociable. Yeah. That's actually one of the reasons. The social aspect, peer pressure. Yes, you. I mentioned that there is more of a lack of supervision because before you come to college, depending on where you live, whether you're living at home, you're being more monitored by your parents. They're more authoritarian. Excellent. Then when they come to college, they're more on their own. Very good. Lack of supervision. Yes. It's a new environment. Everything is new. You are all free. There are no parents. Except for me. I lived with my parents the first two years of college. That's not fair. Let's talk about the answers. Number 1 is coping with stress. You're absolutely right. This is a very stressful time in your life. It's a transition. When you are stressed, what do we do? We reach for a quick fix. We are not going to say, "Oh, I'm stressed, I'm going to start exercising tomorrow. I'm going to join this group and that group or I'm going to hike." Usually, we look for a quick fix. Coping with stress is one of them. Course load. Course load adds to that stress. This is something that I'm really, really hoping that we can fix. We constantly talk about the level of stress among our students on this campus, but I think stress alleviation needs to start right here, with the professors. I witnessed that two of my students who had the flu went to the emergency room and they tested positive for the flu virus. They were told that they were contagious. "Here is the antiviral prescription and you need to stay home for four days." These two students, in two different classes, missed the midterm. They missed the midterm. They had a note, emergency department note, yet the professor or the faculty who was teaching the course did not accept that as a valid excuse. Have you guys ever experienced anything like that, or is this just these two students? This is a severe case because they had the emergency department, they had the flu, but this can happen. So you are under stress thinking that, "Oh my God, look at my course load. Look at how much I have to study, and If I get sick, God forbid I'm sick, I can't even make it up. I can't even make up the exam." This is why I said that some of this stress alleviation needs to start here, at the faculty, and at the university level. This is one of the excuses. How about being curious? We just want to know how it feels. This reason, I have witnessed many students who got in trouble for that. I witnessed a student who almost died because this student used an illicit drug, one of the drugs of abuse that we are going to talk about, and he happened to have a genetic polymorphism, or a genetic predisposition, that predisposed him to have a much CVA reaction. After just one dose, he went into coma. He was taken to the emergency department. Luckily he's fine. But he could have been gone if he had not made it to the emergency department soon enough. These are real issues. When you have the curiosity and you just want to see, "How is it going to make me feel?" just remember that this curiosity can really result in very, very bad outcomes. How about peer pressure? You go to parties, you know that you're 18 or 19 and you can drink, but there's peer pressure. I can guarantee you that you experienced some of that. That was a fraternity party. If you don't drink, you are not cool. You really need to have a lot of self-confidence and self-esteem to say that, "You know what? Even if you're 21, I'm not interested or I had one beer, I'm not interested in the second one." These are the top four reasons that you see in the literature, but we can add more to them like the ones that you brought up. These are some of the reasons. These are the most commonly abused drugs on college campuses. I can guarantee you that when I put the names up, you agree with me and you say that, "Yes, these are the five most commonly abused drugs." Alcohol. Why alcohol is one of the most abused drugs? Why? What is so special about alcohol? Access. As you said, you may come from a family and the family was very strict, they never allow you to drink, so no drinking. Maybe that's what their parents think because I have seen high school kids intoxicated in hospitals with alcohol. But maybe you come from one of those families and then all of a sudden you are here, you live in a dorm. Where do you think we find the most amount of alcohol? In dorms. On college campuses is mostly in dorms and then it's fraternity parties. Alcohol is one of them. How about marijuana? We already talked about that. I'm going to share some other information about marijuana. Ecstasy. When I was doing my residency at UCSF, we used to see people in the emergency department who had reactions to this street drug and I have the names; MDMA, Molly, party drug. There are many other names for that. This is a drug that a lot of people use because they're just curious to see how they feel because you feel pretty interesting after taking this. It's the euphoria, it's the happiness, the self-confidence goes up, all the colors become more vivid, but it has the potential for abuse. I talked to one of my students who had taken, we refer to it as Molly, and he said that he felt so good that he almost wanted to use it at least once or twice a week. This is how addictive this could be. Another commonly abused drug. Yes, and then we've had an increase in emergency room visit by 1,200. Guys, this is not 12 percent or even 200 percent, it's 1,200 because now, it's a club drug. If you go to music festivals, if you go to concerts, this is a drug that people use, of course, not us, other people. I was shocked to see cocaine on this list. The rate of cocaine use on college campuses had increased by about three percent over the past decade. That's pretty bad because cocaine is highly addictive. Seventy percent of cocaine addicts started using cocaine in college and the reason that I was shocked is that I know cocaine is not cheap. It is not a cheap drug of abuse, but we see an increase in its use on college campuses and 25 percent of people who try cocaine become addicts and they have other issues, including on a global scale, damaging their lives. Cocaine is a highly addictive drug. You may look at this list and say, "Okay, great, I'm an occasional alcohol drinker. I'm not a marijuana addict. I don't use prescription drugs. I only use Adderall during finals. So that's okay. I don't use Molly. Definitely, I'm not a cocaine user." But I would like to add more to this list. I'm going to add one more thing and you're going to see that in a few slides.