More than 2,000 people died of drug and alcohol overdoses in Maryland last year — a record number that is part of the nation’s opioid-abuse crisis.
As part of their response, Maryland legislators have passed a law requiring that students be educated four times — twice in elementary school, once in high school and once at the college level for incoming full-time students — on the dangers of opioids, including heroin. The law applies to all higher education institutions that accept state money — and so includes private colleges as well — and requires naloxone (which can be used in cases of overdoses) to be stocked by campus police and public safety officers.
Preventative education for new students is nothing new for higher ed, as colleges often offer or require student participation in programs aimed to prevent drug and alcohol abuse or sexual assault.
At the same time, despite the widespread use of training and seminars, alcohol abuse and sexual assault — which often go hand in hand — remain major problems in higher education. Will training to prevent opioid addiction be any different?
“This is going to require a variety of different responses and a variety of different channels to solve,” said Tammy Wincup, chief operating officer of EverFi, which is prescription-drug safety and addiction-prevention programming for some Maryland colleges. EverFi is the same company behind the online alcohol education program AlcoholEdu, which many colleges use to educate incoming students.
“What we should be held to — what we should all be held to — is, ‘Are we moving in the right direction?’” Wincup said, recognizing that prevention education at the college level, on its own, probably isn’t enough to stem the tide of addiction and overdoses. While issues stemming from alcohol use and sexual assault are still priorities on campus, she said, EverFi, along with support for its programs from the state and federal governments, has helped make a positive impact at colleges.
AlcoholEdu uses computer-based interactive modules focusing on prevention and education around problematic drinking behaviors, and a study from the National Institutes of Health found it was useful for short-term results, although “effects did not persist in the spring semester.”
In the Centers for Disease Control and Prevention’s section on “Promising State Strategies” to combat opioid abuse, education programs aren’t listed. Instead, the list has bullet points dedicated to prescription drug monitoring programs and databases; regulations on clinics, doctors and Medicaid; increasing access to treatment; and expanding access to naloxone. To be fair, Maryland has also instituted measures beyond education to fight opioid misuse, including steps outlined in the CDC’s recommendations, and the bill introducing the education component at colleges does expand access to naloxone.
Data Sorely Needed
The classes at Maryland colleges might provide more data for the CDC to use in its study of opioid abuse, although existing data suggest that the opioid education programs at the college level could be effective, if done right.
“There isn’t much evidence about the effectiveness of educational programs among college students, but in terms of programs for adolescent populations, effective programs are those that go beyond traditional messaging and also promote positive youth development and skills,” Courtney Lenard, a CDC spokeswoman, said via email.
Citing a 2013 study on prevention programs aimed at prescription drug misuse, she said that, over all, there are positive effects from education and prevention programs, though the data regarding opioids are limited.
“Interventions have shown longitudinal effects on a range of other substance misuse and problem behaviors and have evidence supporting economic benefits,” Lenard said. “Although these results are extremely promising, the sample sizes were small — there was an overall low rate of prescription opioid misuse — and it is yet unclear how such findings might generalize to populations broader than those studied.”
In a press briefing last month, Health and Human Services Secretary Tom Price named education as a priority in fighting opioid abuse.
“The problem is very complicated, and currently we’re on the losing side of this war,” he said. “We know that this involves public health, the medical community, health-care delivery system, law enforcement, education, local and statewide elected officials, devastated families, and those in treatment and recovery.”
EverFi is confident it is up to the task.
“As an education organization, we have been, over the last decade, focused on how you use multiple delivery sites to stress preventative education,” Wincup said. “Our sweet spot has always been, how do we couple topic areas [such as alcohol use and abuse] with [arming] young people with formative knowledge?”
The opioid epidemic has often centered on rural, working-class populations. On the surface, at least, it seems as though the college-going population might not be the most pressing demographic on which to focus anti-heroin resources.
Indeed, deaths from heroin and opioid overdoses are concentrated in populations older than the typical four-year college student, according to CDC data — but that doesn’t mean that abuse and misuse aren’t relevant topics for colleges. And even with the data skewing one way, opioid abuse has been well documented on college campuses, leading some to examine treatment options for addicted students. In addition, health officials need to think about nontraditional college students.
“When we talk about college students, we have to not fall into the trap of thinking of strictly traditional-aged college students who are 18 to 22, on four-year residential campuses,” said Rob Buelow, vice president of prevention education at EverFi. “That simply doesn’t reflect the majority of students who are attending two-year and technical colleges.”
“We have to be thinking of the role those students play within those communities that might be more rural and working class,” he said. “I think having a policy lever to address this across higher ed as an institution that is serving so many nontraditional-aged students as well is really important.”
At the same time, it’s important to be realistic about rates of abuse and misuse among college students when EverFi is making its programming, said Kimberley Timpf, senior director of prevention education.
“The majority of students are not abusing or misusing prescription drugs,” Timpf said. “As part of a community … we hope that [students] will stand up, will recognize, will step in if you see a friend who is struggling.”
Regardless of demographic trends, however, a risk remains — no matter what.
“It’s important to note that no demographic group has gone untouched with the opioid crisis,” Lenard said.