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The search for solutions for managing campus overdose risk

ARI SHAPIRO, HOST:

The deadly threat of drug overdoses continues to grow for young people as cheap and powerful opioids like fentanyl infiltrate more drugs. That's changing the culture of drug use on some college campuses, where students are demanding solutions. NPR's Yuki Noguchi reports.

YUKI NOGUCHI, BYLINE: Preston Quigley's high school years passed in a blur of drug use that included dangerous brushes with opioid overdose.

PRESTON QUIGLEY: I definitely had some close calls. And it's kind of like drowning, but you don't know it. I just got extremely lucky.

NOGUCHI: Friends sometimes needed naloxone, the overdose reversal drug also known as Narcan, to revive them. If that wasn't available, he'd shake or slap the person to keep them breathing. Quigley is now 26, three years sober and active in the recovery community at West Virginia University, where he's earning a degree in social work. He says drug use has only gotten riskier. Fentanyl can come mixed into drugs like cocaine or in fake pills that look like Ritalin or Adderall. A student might take one thinking it's a late-night study aid, then wind up dead.

QUIGLEY: That, for me, is where the difference, I think, lies and where a lot of the danger lies for the college population.

NOGUCHI: In 2022, the overdose death rate for 18 to 24-year-olds had spiked by 34% over just five years. Yet no one tracks student overdoses on campus or even fatalities. Medical privacy shields that information. Christina Freibott, a public health researcher at Boston University, says many schools also stay mum, worried that outreach might hurt their reputation.

CHRISTINA FREIBOTT: People don't necessarily want their campus to be viewed as a problematic hot spot for this.

NOGUCHI: So colleges' response to overdose prevention has been mixed. Some proactive schools are investing. Some use their own pharmacy school students, for example, to train other students to recognize overdose and administer naloxone. Others, including Virginia Tech, University of Georgia and colleges across West Virginia hang boxes containing free noloxone and how-to videos in places like libraries and dorms, alongside first aid kits and fire extinguishers. Freibott says some schools even distribute fentanyl test strips so students can test their drugs before using them.

FREIBOTT: One thing that I wish is that colleges were aware of what other colleges were doing. And if there was like a resource that showed all of the different approaches that all these schools are taking to this, it would normalize the efforts that are going on.

NOGUCHI: Theo Krzywicki is a former paramedic and firefighter in long-term recovery himself. He founded a group called End Overdose to train young people to use naloxone. His group works directly with students, bypassing school administrations to work on campus. So far, it has 28 college chapters, with students at 75 others looking to start new ones.

THEO KRZYWICKI: I think that answers how big of a problem it is. The students know. The students know. That's why we focus on working with the students because the students are more motivated to make change typically than the campuses.

NOGUCHI: He says anti-drug messaging has largely overlooked the realities of life most young adults face. It's their peers, he says, who have greatest credibility.

KRZYWICKI: When you have one person that understands the community and the culture and provide the information in a level that people not only understand, but are willing to receive, that's the biggest part. You can really make a lot of progress.

NOGUCHI: Peer-led training also provides support for bystanders, students who've tried to revive unresponsive roommates or friends. Madeleine Ward, who lost a middle school friend to overdose, says that experience leaves terrifying scars.

MADELEINE WARD: I feel like I was very, very aware of the fact that fentanyl in particular is a very big, like, issue and something that I kind of needed to look out for for myself and for my friends.

NOGUCHI: Yet, Ward's freshman year at UCLA, she says everyone seemed unprepared.

WARD: When I got to college, it was very scary because I didn't feel like that many people knew, like, what Narcan was or that many people were scared about taking drugs that were laced with fentanyl.

NOGUCHI: So Ward cofounded an End Overdose chapter, handing out naloxone and teaching others to recognize signs of overdose.

WARD: After every single training, we have so many people who've been really deeply impacted by overdose and overdose loss.

NOGUCHI: Ward, who graduated in May, says things are changing. During one of her last classes, a professor mentioned Narcan.

WARD: She asked everyone who was carrying Narcan to raise their hand. And it was probably like a 200-person lecture hall, and I think like 50 people raised their hand, which was huge to me because I didn't know a single person who carried Narcan freshman year.

NOGUCHI: Which she says means everyone's much safer. Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.