Alcohol & Other Drug Resources

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.

Strategies to Consider to Lower Your Risk

• Don't Drink. Not everyone drinks, so don't feel like you're missing out.
• Know the Size of a Standard Drink.
  • Beer: 12oz at 5% alcohol
  • Hard Seltzer: 12oz at 5% alcohol
  • Wine: 5oz at 12% alcohol
  • Liquor: 1.5oz at 40% (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, three drinks max 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 Drink. 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.

Strategies to Consider 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.

Delta-8

• Delta-8, or delta-8 tetrahydrocannabinol (THC), is a naturally occurring cannabinoid found in the cannabis plant. Similar to its more well-known counterpart, delta-9 THC, delta-8 is a psychoactive compound that can produce mild euphoria and relaxation when consumed. However, delta-8 is typically present in much lower concentrations in the cannabis plant. It is gaining popularity as a standalone product and is often extracted and concentrated to be used in various products such as edibles, vape cartridges, oils, and tinctures. It's important to note that regardless of its legal status, possessing Delta-8 on campus property is strictly prohibited, and individuals caught in violation may face consequences. While delta-8 may have some potential benefits, it is important to be aware of its potential risks.
• There are no federal or state regulations governing the production of Delta-8, leading to a lack of safety evaluations and research on its effects.
• Delta-8 is commonly produced synthetically using industrial chemicals.
• The potency and chemical composition of Delta-8 products from the same brand can vary significantly between purchases.
• Marketing guidelines for Delta-8 products are challenging to regulate, leading to ambiguous labeling such as "hemp" or "CBD."
• Studies have shown that Delta-8 and other hemp products bought from smoke shops may contain heavy metals and inaccurate dosing information.

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.

• Vaping cessation resource: This is Quitting. Text DITCHJUUL to 88709.
• NC Quitline: 1-800-QUIT-NOW 
• Quit at Duke: 919-613-7848
• Duke Health Smoking Cessation Program
• Tobacco-Free Duke 
• Student Health: 919-681-9355 and choose option 1. 
• Employee Health: 919-684-3136 and choose option 1.   

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

• Disposing of Medication Video

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.

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.

Fentanyl

• Fentanyl, a potent synthetic opioid 30-50 times stronger than heroin, is primarily prescribed for medical pain management. However, the most concerning issue with fentanyl today is its widespread mixing with other drugs like cocaine, heroin, methamphetamine, and MDMA (ecstasy). Additionally, illicit dealers are producing fake pills, often called "fentapills," that resemble genuine prescription medications but contain dangerous amounts of fentanyl.
• Learn more about fentanyl and fentapills at songforcharlie.org
• Fentanyl overdose poses a severe and life-threatening danger. As an extremely potent synthetic opioid, fentanyl is far more powerful than other opioids like morphine and heroin. Its high potency means that even a small amount can lead to a dangerous overdose. Individuals who consume drugs laced with fentanyl, often without their knowledge, are at an increased risk. Fentanyl can depress the respiratory system, leading to slowed or stopped breathing, which can be fatal. Recognizing the signs of fentanyl overdose, such as pinpoint pupils, slowed heart rate, and unconsciousness, and seeking immediate medical attention is crucial to prevent a tragic outcome. Public awareness, education, and access to naloxone (an opioid overdose-reversal medication) are essential in combating the growing threat of fentanyl-related overdoses.

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.

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.