Substance abuse is a major mental-health issue that can disrupt the lives of college students. A complex set of factors can lead to or exacerbate abuse or addictions. While it isn't the case 100 percent of the time, depression can co-occur and contribute to the development of a problem.

Chris Carr, a clinical sports psychologist for in Indianapolis, has worked first-hand with student-athletes who have succumbed to a dependency dilemma. Since 1992, Carr has worked in the athletics departments at Washington State University, Arizona State University, Ohio State University and Purdue University to provide treatment for mental-health issues.

"The issue with eating disorders isn't just the physical-health risks," Carr said. "If you're treating patients only from the perspective of 'We're going to weigh you and monitor your nutrition' and you're not dealing with the counseling-related issues, then you're not providing appropriate care.''

There are several measures to prevent substance abuse from spiraling out of control. Student-athletes are subject to random drug tests administered by the NCAA, and many schools (74 percent according to the 2003 Drug Education and Testing Survey) also have their own testing programs.

Schools also can use the CAGE test, which stands for "cut down," "annoyed," "guilty" and "eye opener" and poses the following questions:

• Have you ever felt you should cut down on your drinking?

• Have you ever been annoyed by criticism of your drinking?

• Have you ever felt bad or guilty about your drinking?

• Have you ever had a drink the first thing in the morning to steady your nerves or get rid of a hangover (eye opener)?

Two or three affirmative answers indicate a high probability that a person may have an alcohol-abuse problem. Four positive answers indicate alcoholism.

"Students who suffer from anxiety and depression are at greater risk to develop alcohol and other drug problems,'' said William DeJong, the director of the Center for College Health and Safety in Newton, Massachusetts. "Part of the thinking here is those problems in some instances can result in students self-medicating. Those problems also can result in behavior that can put them in high-risk situation where they will be more likely to start experimenting with alcohol and drugs.''

Treatments in such cases vary, but one method is called Brief Alcohol Screening and Intervention for College Students (BASICS). The program is a two-part interview process between the student and a counselor. The first meeting is an interview and assessment session. The second session is when a student has come back within a few weeks of keeping track of his or her drinking frequency and setting.

"The University of Washington studied this BASICS program, and they were able to show significant reduction in high-risk use, which held over time,'' said Laurie Davidson, the associate director of the Center for College Health and Safety. "A second good reason to start with a technique like this is that if the student really does show sign of dependence and needs more than a couple of sessions, you've really made a good connection with a student. You haven't been confrontational."

The NCAA has also taken steps to provide institutions with programs designed to help with treatment and prevention of mental-health issues. The NCAA Health and Safety Speakers Grant assists campuses to bring experts to campus to speak to groups of athletes and other students about health and safety issues.

The NCAA also provides funding for the Athletic Prevention Programming and Leadership Education (APPLE) Confer-ences, during which "prevention teams" made up of student-athletes, athletics administrators, athletic trainers and campus wellness staff are trained to improve their campus alcohol and other drug-abuse education programs and policies.

Also, CHOICES grants provide funding to successful applicants to implement a campus-wide alcohol-education program that integrates student-athletes or athletics into the campus prevention effort.

TEAM-work

The NCAA is a member of the TEAM Coalition (Techniques for Effective Alcohol Management), whose mission is to promote responsible alcohol consumption on game day through training and media messages, to ensure fan safety by reducing alcohol-related instances both in facilities and on surrounding roadways. For more information, go to www.teamcoalition.org.