The “Big Five” as outlined in Recovery Ally Training*:
Withdrawal Symptoms
Attention Deficit Hyperactivity Disorder (ADHD) affects approximately 8% of college students in the United States.1 The most effective medication for ADHD is a class of medicine called “stimulants” including: Ritalin, Adderall, Vyvanse, and Focalin. These types of medicines work well for students with ADHD, but misuse has become a health and safety concern among college students.
“Rule-setting” to Limit Use
Negative consequences of substance use can lead an individual to give themselves arbitrary “rules” as a means to reduce or stop their use. Examples might include only drinking or using on weekends, switching from hard liquor to beer or wine, or only using substances when they have completed all of their class assignments, etc. If the individual regularly breaks or changes their own “rules”, it may indicate that their substance use is getting out of their control.
Sacrificing Activities
When an individual gives up pursuits they previously enjoyed in order to obtain, use, or recover from the effects of a substance, it could be a sign that their use has become unmanageable and needs to be addressed.
Role Fulfillment Failure
This means that an individual’s substance use is interfering with their ability to meet major responsibilities at school, work, or home. Missing classes or assignments, neglecting extracurricular commitments, or repeatedly missing work may be signs that a student is in need of additional support.
Craving or Compulsion to Use Substances
When a person finds that they cannot change their patterns of substance use—even when they want to—it is likely that their use has become unmanageable. Someone experiencing serious cravings may not understand why they can’t “just stop” despite the negative effects of continued use. It is important to know that these compulsions are powerful, and that individuals in this situation are not actively choosing to keep using substances.
*Recovery Ally Training is a one-hour educational presentation offered by the UAB Collegiate Recovery Community to provide faculty, staff, and students with the tools to understand substance use disorders, connect to campus resources, and engage in compassionate and helpful dialogues with peers about substance use and recovery. For more information, email