Stop the Campus Opioid Epidemic — Before It Becomes One

The opioid crisis continues to make headlines for devastating the lives, families, and futures of millions of Americans, most recently with news that 72,000 people died of drug overdoses in the United States in 2017.

While middle-aged Americans have been most affected by opioid addiction, young adults, many of whom start to experiment with drugs and alcohol as teenagers, are also at risk. They must not be overlooked, and it’s up to colleges and universities across the country to protect a generation of young adults from the destructive effects of this public-health catastrophe.

In 2016, about two-thirds of drug-overdose deaths — more than 42,200 — were linked to opioids, including prescription painkillers, heroin, and synthetic opioids such as fentanyl, which is 80 times more potent than morphine and is now responsible for the majority of overdose deaths in the U.S. That means on average, 116 Americans die every day from an opioid overdose.

Drug-overdose deaths at colleges are rare, but this doesn’t mean campuses are insulated from the problem. According to the Centers for Disease Control and Prevention, from 2015 to 2016 such deaths among young people aged 15 to 24 increased 28 percent, and deaths involving synthetic opioids other than methadone doubled.

While research on opioid use among college students is still relatively new, recent data suggest that use has risen significantly over the past two decades. From 1993 to 2005, the use of prescription opioids (for example, Percocet, Vicodin, and OxyContin) increased by 343 percent among college students. At one in every four colleges, at least 10 percent of the students had used prescription opioids. Opioid-related insurance claims for treatment of college-age patients at Blue Cross Blue Shield have also doubled since 2010.

Several factors contribute to the growing use of opioids among young people; perhaps chief among them is easy access to the drugs. In a 2015 survey by the Hazelden Betty Ford Institute for Recovery Advocacy and the Christie Foundation, of 1,200 college-aged youth, 16 percent reported having used painkillers not prescribed for them, and more than 34 percent said these medications were easy to acquire.

Rising rates of substance use among college students have also led to increased sexual risk behaviors. A 2014 study shows that college students who misused prescription drugs reported significantly more sexual partners and unprotected sex acts during the past three months, increasing their risk of acquiring HIV and other sexually transmitted infections.

The need for expanded access to overdose-prevention and drug-treatment strategies for this young, and often vulnerable, population is glaringly obvious. The Hazelden Betty Ford Institute study found that over 37 percent of the college students surveyed would not know where to go for help in the event of an opioid overdose.

The promising news is that steps are being taken to stop the potential spread of the opioid crisis on campuses nationwide.

For example, some states are ramping up education initiatives, especially for students, health professionals, and university administrators. In Maryland, legislators have passed a law requiring that students be educated four times about the dangers of opioids, including heroin — twice in elementary school, once in high school, and, for incoming full-time students, once at the college level. The law applies to all higher-education institutions that accept state funding, including private colleges. Certainly, more drug-prevention education is needed during this phase of young peoples’ lives, but the Maryland law represents an important start.

Colleges are also expanding counseling services and treatment of opioid addiction on campus. For example, the New Jersey Division of Mental Health and Addiction Services allocated $5 million to state colleges to provide and expand on-campus recovery programs, including substance-free living environments for students in recovery and services aimed at preventing addiction. Rutgers University, the College of New Jersey, Rowan University, and Montclair State University, among others, have either expanded upon existing recovery-housing options or launched new addiction-recovery programs.

In 2016, the American College Health Association released guidelines for college health providers to deepen their understanding of the issues surrounding opioid prescribing, review ways to maximize safety and reduce the potential for abuse, and identify possible avenues to assist addicted students with rehabilitation, recovery, and return to the college environment.

Strengthening college response plans is all well and good, but more needs to be done. Students require broader availability of medication-assisted treatment tailored to their specific needs. To prevent fatal overdoses, colleges should increase access to naloxone, a drug used to reverse an opioid overdose. The University of Texas at Austin, the University of Wisconsin, and Bridgewater State University, among others, supply campus police officers and health centers with the drug. But since most opiate overdoses occur outside a health setting, naloxone kits should be distributed more widely on campuses so that they can be easily used by roommates or friends.

A U.S. surgeon general’s national advisory in April urged Americans to carry and learn to administer naloxone.

An integrated strategy should also include increased efforts to destigmatize addiction and change the public perception that a person battling substance abuse has a character flaw or lacks willpower. Addiction should be treated like a chronic disease. Adopting the mind-set that it is an illness that can be successfully treated but that can relapse, as is the case for diabetes, could help reframe the opioid problem for parents, educators, and students, as well as help direct recovery and prevention funds onto campuses.

Additionally, more research is needed to document the scope of opioid use among college students. The establishment of a national database of opioid use on campuses would aid in the study of this population group. An online resource hub for use by college students, administrators, educators, and health professionals should also be established. It could highlight the latest statistics, research, policies, and evidence-based best practices to combat opioid use. The Foundation for AIDS Research has established a national opioid database to help a broad range of stakeholders combat this public health problem.

Clearly, increased funding, enhanced education, early detection, and expanded access to treatment services and recovery programs are needed to safeguard the health of today’s college students, as well as those in the years to come. And just as clearly, now is the time to act.

Rear Adm. Susan Blumenthal, retired, is the senior policy and medical adviser at amfAR, the Foundation for AIDS Research, in Washington, D.C., and a clinical professor in the medical schools at both Tufts and Georgetown Universities. David Xiang is a junior at Harvard University. He has been a health-policy intern at New America and a senior editor of the Harvard Health Policy Review.