June 18, 2019
Opioid overdose from the use and misuse of illicit and prescription opioids is a major public health problem in the United States. In 2016 alone, 4,070 young people ages 15 to 24 years died from an opioid related overdose (AACAP News: January/February 2019. Volume 50, Issue 1). Drug overdose deaths involving any opioid―prescription opioids (including methadone), synthetic opioids, and heroin―rose from 18,515 deaths in 2007 to 47,600 deaths in 2017 (https://www.drugabuse.gov/related-topics/trendsstatistics/overdose-death-rates)
Unfortunately, college campuses are not immune to this epidemic. The potentially fatal consequences of opiate overdose due to misuse or non medical illicit use of prescription opioid medications, including the possibility of concomitant misuse of alcohol, is a major concern for college communities, administrators and campus health care providers. The Jed Foundation (JED) encourages colleges to create a formalized pathway of response to overdose in all campus substance use intervention/prevention efforts.
One important harm reduction strategy for prevention of opiate overdose deaths is the use of naloxone. This is an FDA approved medication that can avert death when administered in a timely manner and works by binding to opioid receptors in the brain, reversing or blocking the effects of other opioids. Naloxone can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications. Naloxone is available in three forms, is extremely safe and can be an appropriate response for all opioid events including overdose with fentanyl, carfentanil and other opioid analogs and can be administered after minimal training. Though it varies from state to state, most colleges can engage peers and trained members of the college community to provide auto-injector and nasal spray formulations of naloxone to someone who has overdosed. States are working to eliminate barriers to naloxone use by providing immunity to bystanders who administer naloxone during an overdose.
JED promotes a comprehensive and holistic approach to prevention of drug misuse and its consequences. In addition to campus-wide education on the dangers of opiate use, diversion and danger of combining opiates with other drugs and/or alcohol, and offering treatment services aimed at substance abuse issues, JED strongly endorses implementing campus-wide programming and protocols specifically aimed at identifying and preventing drug overdose. Ideally, naloxone would be widely and easily accessible across campus (health and mental health centers, residence halls, academic buildings, athletic buildings, common areas, etc) – information about access to naloxone should be clearly and prominently displayed. Also, and as permitted by local law, it would be ideal to aim for educating and training all members of the campus community to recognize an overdose and initiate a response including the administration of naloxone. Participants in this type of training might be first responders, campus security, health/mental health staff, faculty, administration and staff, those who work in student areas such as transportation and dining staff, those at high risk for overdose, known opioid users/misusers, residential life staff, and volunteer students.