SAMHSA (Substance Abuse and Mental Health Administration) statistics show that approximately 11% of college-aged students have used prescription opiates in the past year.  The CDC states that 1 of every 463 of that group will die during that year.  This translates into the probability that in a large state university of 40,000 students, approximately 10 will die in any given year of prescription opiate overdoses.  One would think that statistics of this magnitude would merit  both public outrage and serious attention being paid to this problem by the colleges and universities. 
             In 2007, the National Center on Addiction and Substance Abuse at Columbia University (CASA) issued its comprehensive monograph, titled  “Wasting the Best and the Brightest: Substance Abuse at America’s Colleges and Universities.”  The study found that: “Most colleges and universities have elements of prevention programming on their campuses aimed at addressing student alcohol and other drug use. For the majority of these, the main focus of the programming is informational or educational and deals primarily with alcohol. Far fewer schools have prevention programming to address student prescription drug abuse, illicit drug use and smoking and virtually none has implemented comprehensive measures to address the environmental, social and psychological determinants of student drinking, smoking and other drug use as well as the treatment needs of student substance abusers.” (p. 73) The CASA monograph makes multiple recommendations to school administrators; the final recommendation in the section titled, “Changing the Prevailing Climate” is “Send a clear and powerful message that preventing substance abuse is a key priority for the administration by allocating sufficient funds to the effort and ensuring that prevention, intervention and treatment programs are coordinated and conducted by trained professionals with knowledge and expertise in the area.” (p. 114) A key recommendation to trustees and alumni was: “Insist that schools address the culture of substance abuse in a comprehensive way and track progress in preventing and reducing the problem.” (p. 116)
            As part of the White House 2011 Prescription Drug Abuse Prevention Plan, the Office of National Drug Control Policy (ONDCP) has labeled college and university students as one of four special populations deserving more focused effort in this area.  The ONDCP has invited the participation of the universities as partners in dealing with this problem.
               It is not clear to us the extent to which the unversities have really made themselves partners in this effort.  While universities and colleges are an unfortunate breeding ground for substance abuse, it is our impression that for public relations reasons universities do not wish to acknowledge the extent of the problem.   Parents will not want to send their children to universities where substance abuse is seen as a problem. 
           In addition to dealing with parents, universities need to pay attention to the students and their desires.  Universities long ago relinquished their role of acting in loco parentis.  Thus, alcohol and substance use have been seen as aspects of individual student choice and part of youthful lifestyle experimentation.  Students resent heavy-handed university efforts to control these aspects of their lives.  Presumably this contributes to the unwilligness of many universities to cooperate with the DEA in its effort to partner with them regarding patterns of sales of substances in the university. 
           Parents contribute to this problem through their blindness to the extent of subtance abuse among their children, so that they do not ask about the extent of substance abuse at universities and colleges to which their high school students are applying. 
           Universities, parents, and students all contribute to the problem through the assumption that substance use is part of a lifestyle, and through their failure to realize that significant numbers of students are vulnerable to addiction. Thus a conspiracy of silence prevents a fully cooperative effort among parents, universities, and government to deal with the epidemic of prescription drug abuse and the deaths resulting from it.