Colleges Embrace Streetwise Tactics to Prevent Substance-Abuse Deaths

When Reed College students obtain an illicit drug, a campus group will lend them a chemical testing kit designed to detect dangerous adulterants in whatever they are about to consume. The private college, while strictly banning illegal drug use, nonetheless tolerates student-to-student distribution of the kits as a way to reduce the likelihood of students inadvertently poisoning themselves. “Anything students are going to do to help keep themselves safer, and reduce harm, is a good thing,” says Kevin T. Myers, a Reed spokesman.

When Dickinson College hosts major concerts in its auditorium, students who feel ill from consuming alcohol or illicit drugs can head to a designated area to drink water and rest while watched by sober students and emergency medical technicians. The campus chapter of Students for Sensible Drug Policy first got administrative approval to operate such an area in November 2014, when the university had booked an electronic-dance-music act that the campus group expected to attract users of drugs associated with the dance-club scene and known to cause dehydration and overheating.

Elsewhere, both the dormitory resident advisers at the University of Texas at Austin and the campus police of the University of Central Florida are being trained to administer Naloxone, a medication that revives people who have overdosed on heroin or some other opioid. Sue Riseling, executive director of the International Association of Campus Law Enforcement Administrators, says the number of large public colleges equipping their police forces with Naloxone has increased substantially in the past three years, and she expects its use by campus police forces to soon become fairly mainstream.

Throughout the nation, colleges have been embracing practices that focus on safeguarding, rather than punishing, students who abuse alcohol or illicit drugs, often at the suggestion of students themselves. Such institutions stress that their intent is not to be permissive, and that their rules against underage drinking and illicit-drug possession remain in effect. Nevertheless, faced with the persistent risk of alcohol-related student deaths, a national upsurge in opioid overdoses, and nationwide spates of medical emergencies among consumers of “club drugs,” the colleges have been showing a willingness to suspend enforcement of their rules if necessary to keep students from being harmed.

The shift is most evident in the proliferation of medical-amnesty or Good Samaritan policies, which offer immunity or leniency to students found to have violated rules governing substance abuse in the course of seeking medical help for themselves or for a peer. Of more than 70 private and public colleges recently surveyed by Students for Sensible Drug Policy, a national advocacy group, just over half had some form of amnesty policy in place. Although most of the policies mention only medical emergencies related to alcohol, a growing number cover drug-related emergencies as well.

“All campuses are different, and we have to recognize that there is no one-size-fits all solution” to preventing harm from substance abuse, says John McLaughlin, managing director of the higher-education practice of Arthur J. Gallagher & Company, a risk-management and insurance firm that advises more than 800 colleges and universities. But when the goal of reducing harm bumps up against colleges’ desire to enforce rules barring the use of alcohol or illicit drugs, he says, “I am always going to side in favor of the protection of students’ lives.”

Cultural Shift

Colleges’ turn to harm-reduction strategies comes at a time when Americans’ attitudes toward illicit drugs have become more liberal, as evident by recent passage of state measures legalizing the recreational use of marijuana.

Also helping drive the shift may be a belief that colleges can inadvertently harm students by overemphasizing anti-drug enforcement. At the University of Massachusetts at Amherst, for example, a student’s 2013 death by heroin overdose was blamed partly on the actions of the campus police force, which had caught him selling drugs. It placed him in a confidential informant program rather than in addiction treatment. The university last year ended the informant program in response to an investigative panel’s conclusion that those students pressured to become confidential informants had escaped administrative pressure to get help. In announcing the decision, Kumble R. Subbaswamy, the campus’s chancellor, called the informant program “fundamentally inconsistent with our core values” such as trust and compassion, and said he was ending it as part of a “philosophical shift” to “emphasize prevention, intervention and rehabilitation along with enforcement.”

More broadly, says Mr. McLaughlin, “We are seeing too many alcohol-related deaths where students are afraid to come in — or their friends are afraid to bring them in — for treatment because of fear of disciplinary action.”

“Forward-looking administrators will recognize they can keep their students safer through harm reduction than through ineffective punishment,” argues Betty Aldworth, executive director of Students for Sensible Drug Policy, whose campus chapters have been playing a role in advising some colleges’ harm-reduction efforts.

Risk Assessments

Despite the rising popularity of harm-reduction strategies, considerable disagreement exists over which are appropriate or actually enable dangerous behavior.

In the wake of a highly publicized 2015 incident in which 11 people at Wesleyan University were hospitalized for drug overdoses, an investigative panel there actually concluded that the Connecticut private college had not been enforcing its drug policy strictly enough. It said the college needed to take steps to remove students’ “perception that they won’t get caught and face serious judicial and/or legal consequences” for illegal drugs, making clear that the sale or distribution of such substances will result in dismissal. It called for a review of the amnesty policy in place at Wesleyan to ensure that it had been resulting in more calls for medical assistance. Based on that review, the university decided to leave its amnesty policy intact.

Among organizations known for a tough anti-drug stance, the National Center on Addiction and Substance Abuse discourages any harm-reduction approach that could be perceived as condoning underage drinking or illicit drug use. It opposes kits that test drugs for adulterants as promoting a false sense of safety, and says colleges concerned that they cannot prevent substance abuse at campus events should not host them.

Nevertheless, the center supports Good Samaritan policies. Samuel Ball, its president, said in an email that a college’s response to a student with an alcohol or drug problem “should be primarily focused on promoting safety and health,” with disciplinary processes used primarily to ensure students get evaluated and treated.

On the other side of the debate, Scott Burris, a professor of law and public health at Temple University and a co-founder of the Prescription Drug Abuse Policy System, a federally financed database of state laws regarding prescription drug abuse, says harm reduction “is not about encouraging” drug use but “meeting people where they are at, and making sure whatever they do causes the least possible harm.”

Confronting Reality

Students at Reed, in Portland, Ore., can check the chemical composition of illicit drugs by sending an email to an account maintained by the campus chapter of Students for Sensible Drug Policy. An automatic reply tells them the location and combination of a locker on campus holding a testing kit, which can check small samples for the presence of the drug and common adulterants. The campus group has found that it can trust students to borrow the kits for a few hours and then bring them back, says Logan M. Tibbetts, a junior and one of its leaders.

The kits, which first came into widespread use in the late 1990s and are produced by organizations such as DanceSafe and the Bunk Police, test for an assortment of drugs, including cocaine. Their chief users, however, are people seeking to take 3,4-Methylenedioxymethamphetamine, or MDMA, generally known as Ecstasy in pill form or Molly as a powder. MDMA is itself dangerous, especially if taken in excessive amounts, but what is sold as MDMA is often some riskier and cheaper substance, such as methamphetamine. A recent national survey by the University of Michigan’s Institute for Social Research found that just over 4 percent of college students reported using MDMA last year.

Although several colleges are said by campus SSDP chapters to permit student-to-student distribution of the testing kits, Reed, a liberal-arts college with about 1,400 students, stands out in its willingness to openly discuss doing so. Mr. Myers, its spokesman, says its tolerance of the kits should not be interpreted as tolerance of illicit drug use, citing more than 150 disciplinary referrals for drug law-violations there annually in recent years. Rather, he said, the college allows the kits as part of an arsenal of strategies to keep students safe, including the distribution of cards reminding students of its medical amnesty policy and outlining the symptoms of overdose.

“We recognize the realities of the situation,” Mr. Myers says. “We have a policy and we enforce that policy, but we want our students to be healthy and safe.”

Other colleges have explicitly rejected the drug-checking kits. Yale University’s administration last spring denied a request by the university’s SSDP chapter to direct campus police to withhold enforcement of a Connecticut ban on the kits for the duration of a daylong concert. The Wesleyan panel formed in the wake of its 2015 overdose incident determined that research on the kits’ effectiveness has been inconclusive and that the university cannot itself provide the kits without risking federal funds. (The Drug Free Schools and Communities Act of 1989 requires colleges to take steps to prevent the use, possession, or sale of illegal drugs.)

Bracing for Trouble

Much less controversial than the testing kits is colleges’ distribution of Naloxone, which comes in injectable or spray form and can immediately revive someone on the verge of death from an opioid overdose.

The University of Central Florida’s office of student health services last year trained about 70 campus police officers to administer Naloxone, and now requires them to carry it during their shifts. Thomas Hall, the university’s director of student services dealing with substance abuse, says heroin “hasn’t been a major issue” there yet, but, with the drug’s popularity in central Florida, “it is realistic to believe it will pose a threat to our community.” Naloxone also can be used to revive people who have overdosed on prescription opioids, which are far more likely than heroin to be abused by college students.

Decisions about whether to adopt such harm-reduction practices “need to be made by senior administrators who can balance the benefits and potential liabilities,” says Ann H. Franke, who advises colleges on risk management as president of Wise Results LLC. Although some harm-reduction policies can expose colleges to legal risks, she says, common sense should lead an institution “to prefer defending itself from a lawsuit from someone who is alive versus a lawsuit from the estate of someone who is dead.”

Peter Schmidt writes about affirmative action, academic labor, and issues related to academic freedom. Contact him at peter.schmidt@chronicle.com.

Correction (9/20/2016, 6:07 p.m.): This article originally implied incorrectly that the National Center on Addiction and Substance Abuse was affiliated with Columbia University. This year the center changed its name, from CASAColumbia, to reflect that it is now an independent organization. The article has been updated to reflect this correction.