Examining quality of life by recovery status among college students with a history of substance use

Quality of Life (QoL) is a vital measure for individuals with chronic health concerns, including those with a history of substance use. Limited research, however, focuses on QoL among college students with a history of substance use, while comparing those in recovery to those not in recovery. This study aims to address this gap.

We analyzed secondary data from the American College Health Association National College Health Assessment (ACHA-NCHA) III (Fall 2019–Fall 2022) to evaluate QoL across physical, psychological, social, and environmental domains. Using adapted questions from the WHOQOL-BREF framework, we constructed domain-specific and overall QoL scores. Multivariate linear regression was used to assess the association between recovery status and QoL, adjusting for demographic and lifestyle factors.

Among 249,849 students, 2.2% (n = 5473) self-identified as in recovery. Students in recovery reported significantly lower QoL across all domains compared to those not in recovery, with the greatest difference in the psychological domain (mean difference: − 4.43, 95% CI [− 4.79, − 4.07]) and the smallest in the environmental domain (− 1.31, 95% CI [− 1.54, − 1.09]). Stratified analyses revealed that younger students, females, non-binary individuals, and NH Asian/Native Hawaiian Pacific Islander students exhibited the largest QoL disparities.

College students in recovery face notable challenges in their QoL, especially in psychological and social domains. These findings highlight the need for targeted interventions, stigma reduction, and tailored support systems on college campuses to improve recovery outcomes and overall well-being.