Rebecca Tan | Longreads | August 2019 | 13 minutes (3,006 words)

I. “A death sentence”

On May 16, 2016, scores of adoring parents gathered at Franklin Field on the University of Pennsylvania’s campus, beaming as 2,225 undergraduates threw their mortarboards into the air, colorful graduation cords swinging from their necks. Paul Clarke, a 22-year-old with brown hair and pale skin, was meant to be on that field. He was meant to have his name emblazoned in black under the list of economics majors, his portrait sitting snugly in the yearbook among the rest of the class of 2016. Instead, the young man was seven miles away, alone, in a dimly lit house littered with half-burned joints, beer cans, and hidden bags of opioids.

In the months following that bright Monday, as Clarke’s classmates settled into high-paying jobs in New York City and San Francisco, he overdosed on heroin three times.

When he was admitted to Penn in 2012, Clarke was a precocious, first-generation, low-income 18-year-old plucked from Kensington, Philadelphia — a neighborhood where heroin is sold often and openly in public — and ushered into the ivy-cloaked buildings of a storied campus. Despite a history of drug use in high school, Clarke stumbled along for his first three years there. He slipped into intense bouts of drug use during his summer breaks, but would always return to school in August, earning a near-perfect GPA. Between joining a fraternity and picking up a binge-drinking habit, he managed to make the dean’s list twice. Then, over the course of Clarke’s senior year, undiagnosed mental health problems sent him spiraling into addiction. As the summer turned into fall of that year, he switched his beers out for painkillers, stopped attending classes, and started crying himself to sleep.

Soon, Clarke was placed on academic probation, kicked out of his fraternity house, and forced to move back home to Kensington — a decision Penn officials said was based entirely on his poor academic performance that semester. He had failed two of his courses and had either failed or taken an incomplete in another, which according to university policy, meant he had to be “dropped from the rolls” and required to take time away from school. As he struggled to keep his spot at Penn, he found little in the way of support.

His friends and family spent months protesting his suspension, arguing that sending the 23-year-old back to Kensington was not only going to worsen his addiction, but could very likely kill him. In one of multiple emails sent to five of the university’s top administrators, Clarke’s half brother John Foley wrote, “I’m not convinced Paul will survive this time away.” In another, he stated plainly: “For Paul, a year away is a death sentence.” Aside from some contact with administrators focused on student wellness, who claimed to have no control over the situation, Foley’s emails went almost entirely unanswered.

The story of how an Ivy League student goes from the dean’s list to overdosing half a dozen times before his 25th birthday exposes a question at the heart of how universities respond when students face addiction: Allow them to stay on campus or send them away? Clarke’s efforts to claw his way back into school, to graduate, and just to survive, are a stark reminder of the stakes for students like him.

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From the day he arrived at Penn, Clarke stood out from his peers. (Disclaimer: I went to Penn as well, and was enrolled at the same time as Clarke, although we never crossed paths socially or academically.) A 2017 study by the Equality of Opportunity Project found that 71 percent of Penn students come from the top 20 percent of the income scale, the second highest figure in the Ivy League. Outside the confines of what students call the “Penn bubble,” 26 percent of Philadelphia residents, including Clarke’s family, live below the poverty line.

But Kensington, the neighborhood where Clarke grew up, isn’t just poor. In October 2018, the New York Times Magazine ran a feature on the area by Jennifer Percy, dubbing it the “Walmart of heroin.” Alongside a photograph of drug users shooting up underneath the Kensington Avenue underpass, the magazine describes the area as “the largest open-air narcotics market for heroin on the East Coast.”

In his admissions essay to Penn, Clarke wrote about the moment he learned that his home was different: “I found my mom’s coke straw after a tip from a friend who was asked to buy her a 20-bag,” he wrote. “I found out how my dad really died. I found out my house was always cockroach-filled and disgusting. I found out none of the things going on in my house were normal.”

When he arrived as a freshman in the fall of 2012, Clarke lacked some of the skills his classmates took for granted. He didn’t know he could email professors if he had problems, for example, and he found it hard to maintain eye contact with anyone, said a former girlfriend of his, Lody Friedman. In addition, Friedman said, Clarke’s “post-traumatic stress was very, bleedingly obvious.”

“And I’m not surprised,” she continued. “He experienced acute trauma his entire life.”

Clarke was 14 when he first took drugs. It was the summer; he stole a bag of marijuana from his stepfather and smoked it in his bedroom. Later that year, he asked one of his stepfather’s buddies for cocaine, but mistakenly got a bag of heroin. By the time he was in high school, Clarke was sampling from an extensive menu of substances. When he turned 15, he started taking Xanax, and at 16, picked up Klonopin. His preferred cocktail was a combination of cocaine and benzodiazepines.

“This behemoth of an institution brought him in like, ‘Look who we found from Kensington.’ But when he encountered the problems that they probably could have predicted, they sent him back.”

The summer after his freshman year of college, Clarke overdosed at his grandmother’s house in Port Richmond, a neighborhood bordering Kensington. When Foley, who lives in Washington, D.C., contacted Penn about the incident, Student Intervention Services, the department in charge of crisis situations, assured him that there would be a dedicated administrator monitoring Clarke in the coming semesters. This worked for a couple of months, until Clarke stopped responding to administrators and they stopped reaching out.

Two years later, Clarke found himself battling a major depressive episode more or less alone. Foley, who watched from afar, believes this was when the university failed his younger brother.

“This behemoth of an institution brought him in like, ‘Look who we found from Kensington.’ But when he encountered the problems that they probably could have predicted, they sent him back,” he said.

Friedman, who is now a teacher in Boston, feels similarly: “Students are expected to advocate for themselves, which is fine for those coming from affluent families, but it’s not fine for someone who has raised himself. If you knew Paul and understood his background, it’s pretty fucking obvious why he wouldn’t respond.”

II. To Reset or Derail?

It’s common practice at colleges and universities to encourage students struggling with severe addiction to take time off from their studies. At first blush, this policy seems reasonable: College campuses, rife with substance-fueled social events, can often be hostile to recovery. But this policy rests on some assumptions that, with students like Clarke, don’t apply.

At Penn, administrators are eager to emphasize that students struggling with their academics or health are urged to take a leave of absence in order to “reset.”

“We’ve tried to destigmatize the idea that a leave is failure,” said Rob Nelson, the former executive director for education and academic planning at the university. “The actual idea is that something is going wrong and you need to take time off. … Any kind of separation from the university usually has the effect of helping students succeed.”

For Clarke, this wasn’t the case. Sending him back to Kensington, by his own account, exacerbated his problems with addiction not just because his environment offered a steady stream of drugs, but because sending him away robbed him of one of the most important anchors in his life: being a Penn student.

Clarke spent four months at a recovery house in Collingswood, New Jersey, while participating  in a now-defunct recovery program called Life of Purpose in nearby Cherry Hill. There, trained mentors guided residents through recovery with the aim of transitioning them back to school. Similar collegiate recovery programs have existed since the 1970s, though they remained relatively unknown within higher education until about five years ago. According to the Hechinger Report, there were only several dozen collegiate recovery programs in 2013; today, there are around 200.

At Penn, the central resource for students struggling with addiction is the Office of Alcohol and Other Drugs, housed under the office of the vice provost for university life. The office’s director, Noelle Melartin, said in an email that they offer a program called First Step, “a brief intervention for students whose alcohol or substance use is at a lower level of severity.” Students like Clarke, with more severe cases of addiction, are referred to “appropriate outside services,” she wrote.

By the time it became clear to Penn that Clarke was struggling with addiction, he had already overdosed once and secured a steady supply of drugs from Kensington.

At elite universities, collegiate recovery programs can sometimes be seen as bad PR, experts say. James Winnefeld, a cochair of the nonprofit SAFE Project lost his college-age son to fentanyl-laden heroin in 2017. He told the Hechinger Report, “[Universities] don’t want parents walking around campus seeing posters that imply there is any kind of a substance abuse problem on campus.”

And yet, substance use among college-age Americans is clearly an issue. Figures from the Kaiser Family Foundation show that in 2017, more than 4,760 people ages 0 to 24 died from opioid overdose. According to a 2017 report from the Centers for Disease Control, the number of drug overdose deaths of people ages 18 to 25 increased 411 percent from 1995 to 2015 — the greatest increase of any age group.

Despite this, a 2018 report found that fewer than 5 percent of universities in the United States have in-house recovery programs. Penn, in other words, is not the exception but the rule.

In December 2018, the Ruderman Family Foundation, a philanthropic organization focused on disability inclusion, released a report that concluded that Ivy League institutions are effectively using leaves of absence to push students off campus in order to avoid legal liability and bad press.  Read more…