As opioid-involved deaths climb across the country, university administrators are tasked with developing comprehensive plans for keeping their campuses safe.
At the upcoming Rx Drug Abuse & Heroin Summit, Allison Smith, PhD, senior program administrator for the Louisiana Board of Regents, and Cecelia Spitznas, PhD, senior policy analyst for ONDCP, will discuss improving overdose prevention efforts and naloxone availability on college campuses.
Ahead of that presentation, Smith spoke with Addiction Professional about the specific groups within college populations at the greatest risk for opioid overdose, crafting policy around naloxone administration on campus, and keys for getting buy-in from university leaders across the state.
Editor’s note: This interview has been edited for length and clarity.
Certain groups within the overall college population are at an increased risk of opioid overdose. Who are these groups, and why is their risk heightened?
Specifically with opioids, it tends to be more of an issue with Greek life—sororities and fraternities—or even some of our athletic students. That’s a key group some people miss. Those students are more routinely prescribed high doses of medications. With athletes who are rehabbing injuries to quickly get back on the field, there’s an opportunity for misuse there. [We must be] sure that when we are educating the general campus, we are also including athletics in that discussion as well.
We utilize Generation Rx through the Ohio State University. They focus on safe medication practices and modeling safe patient behaviors. They’ve partnered nationally with about six or seven fraternities and sororities to put that program in all of their chapters across the nation. We know there is a shield of liability those students have when they have on-campus housing as opposed to traditional residence halls on campuses. Students in Greek life tend to have a higher misuse rate across the board.
Are there other substances that disproportionately affect certain groups within college campus populations?
Opioids follow the trends we’ve already seen with alcohol use and stimulant use as well. … Fraternities, sororities, when talk about high-profile negative consequences that have happened, students more often than not are attached to some sort of hazing initiative that has substance use involved. But alcohol and stimulant use are traditionally the other big things that we see on campus.
Your Rx Summit session description mentions that some college administrators are refusing requests for naloxone access on campus. Why is that? Is it a funding issue? Philosophical?
Our campuses are open to receiving naloxone. The Board of Regents oversees all public institutions of higher education in the state of Louisiana. We have the power to lay out policy for those institutions to comply with. But we have 10 private institutions in Louisiana in the Louisiana Association of Independent Colleges & Universities (LAICU). We don’t have policymaking authority for them, but they are able to opt in. We have four public higher education systems. A representative from each system and LAICU came to the table with our office to develop the policy. What we covered was a refusal to administer. We know there is some stigma around naloxone use and things of that sort. In crafting a policy, we were very clear that the person can refuse to administer it, but they have to be trained. That may be where some miscommunication comes in. We make sure that they’re trained, but we express that if you do not feel comfortable or capable administering naloxone, you’re still required to call 9-1-1 or emergency assistance. You can be trained, but if you still don’t feel capable in that moment, there is no option to do nothing. You still are required to call emergency medical services.
What has been the biggest key for you in getting buy-in from college administrators who may have been less receptive previously?
I think the way our conversation has gone in Louisiana is that higher education is a part of the state’s overall health goals. We’re not a separate entity doing a one-off thing. We’re a part of the state of Louisiana Department of Health’s overall goals for health and wellness. It’s aligned with our state’s goals. Also, just having the very real conversation that as a society, as substance use goes on college campuses, we were behind the 8 ball on alcohol use. We were behind on stimulant use on college campuses. We cannot afford to let a third substance rise to the level of the first two. We can include marijuana and cannabis use. We’re behind the 8 ball on those things. We can’t afford to add another substance to play catch-up on.
We’re in a unique position to do some great prevention work so that the numbers on our college campuses never rise to the levels we see in our general population. … We are in a position to do really good primary education to keep our college students safe and also teach them how to model safe medication practices to those around them.