Rarely a week goes by when I don’t receive a frantic text or call from a desperate parent whose college-age kid is in an emergency room being treated for a drug-related problem.

Young adults ages 18 to 25 make up 11.1% of the more than 7.7 million drug-related annual emergency room visits in the United States, and they have the highest rate of cannabis-related ER visits, according to a 2023 report by the Substance Abuse and Mental Health Services Administration, or SAMHSA.

I’m a family physician and college health expert, and parents often lean on me to help them figure out what to do when their child is in crisis, which gives me a third title: medical myth buster.

Before you send your teens off to college, it’s worth exploring the myths and realities around college drug use to get a better view of what parents can do to keep their young adult children safer in this new cultural climate.

Here are some of the most dangerous myths I hear, and my advice to combat them.

Myth No. 1: I don’t need to talk to my children about drugs because they are “good” kids.  

False. It’s mind-boggling to parents that their smart, successful, law-abiding teen would suddenly start using drugs. Parents can’t imagine why their responsible child would trust a seedy stranger offering them pills or weed.

In my experience, even if your children are straight-A students, Eagle Scouts or their high school’s volunteer of the year, they may still try drugs. That’s why you may get a call about them experiencing a drug overdose, hallucinations, paranoia, depression or a drug- or alcohol-related car crash.

Myth No 2: My kid knows to stay away from seedy drug dealers.

False. Most college drug dealers don’t look like whatever you imagine scary criminals look like. They actually look like typical undergrads because they often are. So, erase the image of a heroin exchange in a dark alley and replace that with a concerned friend in a dorm.

Here’s how it can start. Let’s say your child hasn’t slept in several days because they are studying so hard for chemistry. A friend might offer some pills so they get some rest and ace that test tomorrow.

What if they can’t stay awake but need to finish that term paper that’s due tomorrow morning? They may try a friend’s “study aid” pill — often an attention deficit hyperactivity disorder, or ADHD, stimulant available by prescription.

Is their social anxiety causing a near panic attack before they head out to a party? They may try a (THC-laced) gummy candy to feel fine. (Tetrahydrocannabinol, or THC, is the primary psychoactive substance in cannabis.)

Could there be anything more innocent looking than an animal-shaped gummy? Not only are the edible THC products deliberately packaged in juvenile, brightly colored graphics, but the edibles look like childhood gummies, brownies, chocolate bars, chips and more.

These THC edibles circumvent the “bad” things we’ve warned our kids about such as smoking, inhaling or pill taking. Even kids who would never light a cigarette or joint may be tempted to try a bite of candy.

Myth No. 3: We experimented with weed in our college days and turned out fine, so our kids will, too.

Maybe false. College kids aren’t just experimenting anymore. Cannabis use has become very common across college campuses, whether it is legal in your kid’s state or not. In a 2022 study of more than 14,000 students enrolled in 19 Texas colleges (where recreational cannabis is still illegal), nearly 40% of students had used cannabis and more than 26% had used it on their college campus, according to a 2023 study.

Furthermore, today’s weed is stronger than what you may have used. The THC of the 1980s and earlier was not considered addictive because there was no identifiable withdrawal syndrome, according to addiction psychiatrist Dr. Elizabeth Stuyt.

The concentration of THC has spiked from less than 1.5% in 1980 to 3.96% in 1995 to an average of 16.14% in 2022, as noted by the National Institute of Drug Abuse based on cannabis samples seized by the US Drug Enforcement Administration.

The marijuana flower produced in Colorado now has an average of 19.2% THC per gram; concentrate products such as hash or oils average 67.8% per gram; and vaporizer cartridges average 79.7% THC per gram, according to the 2020 Colorado Market Size and Demand Update report.

Today’s weed is indeed addictive for at least 1 in 6 teens and 1 in 10 adults, according to SAMHSA. While the overall odds may be with you, there is no way to predict whether you will be one of the 16.7% of teens or the 10% of adults who become addicted.

Myth No 4: Only hard-core partyers use drugs in college.

False. Outside of the party drug culture, I see more college students self-medicating. Students are looking for a way either to stay alert and focused or to calm down their brain’s anxiety to study, sleep and socialize more effectively. They are not looking for a buzz — they are trying to reach a functional norm.

Meanwhile, while nearly everyone is aware of the fentanyl crisis, few college students see significant risk in accepting or buying what they believe is a prescription pill of Xanax or Adderall. The drug dealers likely perceive minimal risk because they are often selling products that they are using themselves.

Myth No. 5: My child is not a drug dealer.

Maybe false. I have been fascinated that many students who are selling drugs do not consider themselves drug dealers. They are usually shocked and offended when I use those words and talk about the serious legal consequences of selling prescription medications. There is clearly a disconnect in their mind between their actions and people selling nonprescription illegal drugs.

Some students sell a portion of their own appropriately prescribed ADHD stimulants or other medications, and those pills are often shared or resold. This practice likely adds to the misconception that other pills offered by peers are also safe, legally manufactured and prescribed pills.

Fact: Parents can prepare their children for the reality of drugs and college life.

True. First, be sure you add Narcan spray, an opioid antagonist that can immediately reverse fentanyl overdose, to your student’s college first aid kit. Narcan is available without a prescription, though you will likely need to ask for it from a pharmacist because most stores are keeping it “behind the counter” to avoid shoplifting of the product, which sells for roughly $44 for two units.

Talk your teen through Narcan’s directions, but it is simple to use: The spray is a single-dose unit that you spray with one squirt into the victim’s nose after laying them on their back. If the struggling-to-breathe or unconscious victim does not have fentanyl or any other opioid in their system, Narcan will not cause any harm. Make sure your teen knows to always call 911 and stay with the victim if they administer Narcan; a second dose may be required.

Second, actively encourage your student to seek medical help if they complain about an inability to focus or concentrate on their studying, if they can’t sleep, or if they feel panicked with social or test anxiety. Counseling and legitimately prescribed medications can do so much to help these issues, and this is a large part of what college health services treat.

Reassure them not to wait till they are at crisis levels to seek help, whether it is for a physical illness, injury, stress, anxiety or depression. Especially with mental health issues, students will try everything to self-help and self-medicate, and