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Inside Higher Education
Opioid Epidemic
Largely Skips Campuses
By Grace Bird
May 7, 2018
While the opioid epidemic continues to ravage American communities --
opioid-related fatalities tripled from 2000 to 2015 -- colleges largely
have been spared by the crisis so far.
The opioid epidemic is often called the "equal opportunity" crisis,
because the abuse of prescription opioids historically has hit white
people harder than minority groups. (However, opioid-related overdose
mortality rates are increasing at a faster rate among black people than
white people.) But the epidemic does discriminate in terms of
education, as it disproportionately affects poorer, more rural and less
educated communities.
Individuals with less education are more likely to develop an addiction
to opioids, recent research has found. This is for a few reasons:
people with low education levels have fewer job opportunities, leaving
them more vulnerable to depression and addiction; they usually work in
areas with higher risks of workplace injuries, making opioid painkiller
use more likely; and they have fewer resources to combat drug
addiction, like money for rehabilitation.
College students are by no means exempt from the epidemic. The American
College Health Association was concerned enough to release a set of
guidelines in 2016 to universities on prevention and treatment
strategies for opioid misuse.
Jessica Higgs, director of health services at Bradley University, who
chaired the task force that produced the recommendations, said while
rates of opioid use on campuses are lower than in the general
population, cases can be difficult to identify. “We do believe that
there is probably more abuse on campus than we are aware of.”
According to the association, a small but significant number of
students are misusing opioids. Between 7 and 12 percent of college
students reported using opioids for nonmedical reasons, according to
the 2016 guidelines report, while 2 to 3 percent reported moving from
using prescription opioids to heroin. The college health group's
recommendations on opioid-misuse prevention including a push for
college prescribers to give opioids very sparingly, and only if the
benefits outweigh the risks. They also encouraged colleges to train
employees to treat overdoses and distribute naloxone, the opioid
overdose reversal drug.
“Colleges definitely have an obligation to address the opioid epidemic
as it manifests on their campuses,” said Beth DeRicco, director of
higher education outreach at Caron Treatment Centers. “While a small
percentage of students misuse pain relievers, the danger of opioids and
the way in which use has risen makes it an incredible concern.”
Following the release of the guidelines, a flurry of colleges
introduced opioid-related policies. Many distributed naloxone to campus
police and health centers. Some colleges offered training sessions for
students and employees on opioid use.
For example, the University of Wisconsin Madison forged an agreement
with a nearby Walgreens that enabled students to purchase naloxone from
the pharmacy, and the university has also hired two new substance abuse
counselors in recent years. However, opioid misuse at the flagship
university is exceptionally rare, said Angela Janis, director of
psychiatry and co-director of mental health services at Madison.
According to a 2016 university survey, 55 students, or 0.8 percent of
the campus population, reported having a substance-use disorder. Of
that group of 55 students, 76 percent had an alcohol-related disorder,
while only 5.4 percent had issues with opioid misuse.
Community Colleges React
Community colleges also are grappling with the opioid crisis.
A handful of students at Asheville-Buncombe Technical Community College
in North Carolina died of opioid overdoses in the past year. In
response, Asheville-Buncombe announced in August several measures to
improve prevention and treatment. The college gave campus officers
naloxone, changed the locks on single-stall restroom doors and offered
staff training on signs of opioid use.
Anne Arundel Community College in Maryland's governing board last month
passed an opioid addiction and prevention policy. The change followed a
law passed last year in Maryland that requires elementary, secondary
and postsecondary students to be educated on the dangers of opioids,
including heroin. The policy mandated that campus police receive
training to recognize and treat an overdose, give incoming full-time
students in-person training on opioid use, submit an annual report to
the Maryland Higher Education Commission documenting each time naloxone
was administered, and include instruction on opioid-use disorder in the
physician assistant program.
No cases of opioid misuse or overdoses had been reported at Anne
Arundel, Tiffany Boykin, dean of student engagement, said. However,
Anne Arundel County has been devastated by the crisis. Between January
and mid-March, 37 people in the county died of drug overdoses, compared
to 27 people in the same period the year prior.
"It may not be a student who is actively engaged in practicing. They
may have a parent or spouse or a friend who is affected," Boykin said.
"The majority of our students are working professionals. When they're
trying to cope with a family member or a loved one who is affected,
it's very difficult for them to be successful."
Colleges Distribute ‘Life-Saving’ Drug
Nowadays, few dispute the effectiveness of naloxone, a drug that
reverses the effects of an opioid overdose and can save the affected
person's life.
“There aren’t a ton of side effects. If you gave it to someone who
wasn’t having an overdose, you wouldn’t make them terribly sick,”
Higgs, of Bradley University, said. “The benefits do pretty
significantly outweigh the risks.”
The U.S. surgeon general released a rare national advisory last month
urging all Americans to carry and learn to administer naloxone. (The
last time the surgeon general's office issued a warning of this kind
was a 2005 call for women to avoid alcohol while pregnant.) “We know
that 77 percent of opioid overdose deaths occur outside of a medical
setting and more than half occur at home,” the surgeon general tweeted
last month.
While naloxone was approved by the U.S. Food and Drug Administration in
1971, and a nasal-spray version, Narcan, was approved in 2015, many
states have only legalized its over-the-counter purchase in the past
few years.
A flurry of universities have recently followed suit, giving campus
police officers and health centers supplies of the drug.
For example, the University of Tennessee Knoxville’s police department
stocks naloxone, but it is only carried by patrol supervisors,
according to Mike Richardson, a spokesman for the campus police force.
He said no officers have administered naloxone to date.
Bridgewater State University in Massachusetts introduced a
public-access naloxone program in September, installing the drug in 50
defibrillator boxes in campus buildings, including all 11 residence
halls. And Ohio University has given naloxone to campus police officers
while distributing the drug to several college community programs. This
month, the university plans to start stocking naloxone in its free
medical clinic.
But DeRicco said that while it is important to distribute naloxone on
campuses, treatment can't stop there. "We need to give students access
to support, recovery. A comprehensive approach is so important."
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