Universities continue to grapple with the opioid epidemic

Students come to universities for an education. But with the opioid crisis continuing to kill thousands of people across the country every year, campuses are focusing attention and resources on the reality that some students may also engage in substance use, knowingly or not, that puts their life at risk.

That reality was made plain after the fentanyl overdose death last January of first-year University of Victoria student, Sidney McIntyre-Starko. The 18-year-old suffered a cardiac arrest in her dorm room and died five days later, according to her family.

At Carleton University a commitment has been made, in partnership with Algonquin College, to educate everyone on its campus about the risks of opioid use and the strategies available to prevent overdoses and poisonings. There are 19 boxes, soon to be 26, with naloxone nasal spray in prominent places throughout the Ottawa university’s property, 10 of them in student residences. There are training courses for staff, faculty and students on recognizing the signs of someone in trouble and how to administer naloxone, including reassurances that, even if a person isn’t overdosing, the spray won’t do any harm. Carleton insists on having spray available because so many people are intimidated by the idea of giving anyone an injection. The institution has been prioritizing harm reduction on campus for several years and has evolved from preventing alcohol overconsumption to now awareness of other substances.

Carleton also operates a comprehensive website which includes legal information letting people know they are protected by Ontario’s Good Samaritan Act if they try to help someone overdosing. Campus security get standardized training in how to handle drug situations as does a volunteer student first-responder team. There are “party-safe fairs” and social media messages and group conversations about different kinds of substance-use problems people can experience, especially unknowingly taking something potentially fatal – a more common situation among students than cases of regular substance users running into trouble.

And, the university has a dedicated manager of student conduct and harm reduction whose mission is to get as many students on campus as possible to listen — even a little bit — through what the university calls its Umbrella Project harm reduction strategy. It emphasizes a realistic and wide-ranging approach to young people.

“Our approach with students is not an abstinence-based approach,” said manager Dillon Bradley. “We have multiple touchpoints and layers of availability. We want folks to live the life they’ve decided to live but minimize the risks.”

Carleton’s efforts have been boosted by the province of Ontario’s recent decision to make naloxone nasal spray easily available. A memo was reportedly issued by the provincial government to postsecondary institutions in July on the importance of developing effective safety measures for opioid risk, following more rigorous requirements implemented in British Columbia. B.C. brought in province-wide guidelines for its 25 postsecondary institutions after Ms. McIntyre-Starko’s death. Her family alleged that campus security were slow to respond and didn’t administer naloxone until at least 10 minutes after they were called.

In spite of national concern over the issue and the B.C. and Ontario governments’ measures, a scan of 10 institutions contacted by University Affairs suggests there’s a wide range of responses from colleges and universities outside of B.C.

Two universities described their policies in brief summaries. The University of Toronto stated that, “[i]n the case of medical emergencies, members of our community are encouraged to call 911 to receive help from municipal emergency response services. Campus Safety officers are trained and equipped with naloxone kits in case they are first on the scene.” In Montreal, given Concordia University’s downtown location, on-campus agents there are equipped with and trained to use naloxone. “Health Services also stocks some naloxone but have told me they have not had to use it yet,” wrote communications officer Vannina Maestracci.

Other institutions elsewhere in the country indicated that they had developed a variety of new strategies in recent years.

The University of Winnipeg started getting more proactive last year when it outfitted its campus security personnel with naloxone kits and training. That “wasn’t in response to any particular incident,” said Caleb Zimmerman, the university’s executive director of marketing and communications. “With opioids continuing to be a serious public health concern throughout Canada, naloxone kit availability and training was clearly becoming very important. With our location at the heart of Winnipeg’s downtown, we felt it was important to be equipped to help anyone on or near our campus who requires the administration of naloxone.”

Besides providing naloxone kits and training to anyone on campus who wants them, U of Winnipeg also has detailed policies on counselling and referrals to treatment for students, emphasizing that there is no judgment and the university takes a harm-reduction approach.

The University of Alberta has taken similar measures. There are also naloxone kits in student residences and all of the university’s residence life staff – students and professionals — are required to pass a first aid course. In addition, the university supports a unique student-led initiative called the FentaNil Project that aims to reduce harm from the overdose crisis on and off campus, said Michael Brown, a media strategist with the external vice-president’s office.

Efforts have been ongoing since 2017 at York University when it started equipping its community safety staff with naloxone and training all staff, including residence dons, in opioid and fentanyl issues. The university also provides online tutorials and links to resources related to substance use and mental health issues. It uses a harm reduction approach and its health education and promotion team raises student awareness through materials available at student workshops and other events.

There are no national statistics on drug poisoning or overdose deaths at Canadian postsecondary institutions and none of the institutions that responded to queries for this article had a reported death on campus. But general statistics show that younger people are at risk, even though the hardest-hit group is people in their 30s and 40s. A journal article showed that opioid deaths among people aged 15 to 24 rose nearly 370 per cent between 2013 and 2021, from 2.6 to 12.2 per 100,000 population. This amounted to 1,021 deaths over that period.

Statistics released in May from the BC Coroners Service documented 126 deaths of people under 19 from 2019 to 2023, or about 25 a year, while there were almost 1,500 among people aged 19 to 29, about 300 a year. According to research published in Health promotion and chronic disease prevention in Canada : research, policy and practice, B.C. has the highest rate of opioid deaths per capita among all the Canadian provinces; Alberta is the next highest.

The issue is likely to keep getting more attention in the postsecondary world as student substance use habits shift. Although Carleton still puts out messages about being careful in advance of events that typically see high alcohol consumption, such as football games, Halloween, and St. Patrick’s Day, the reality is that alcohol use is generally not the problem it used to be among postsecondary students.

“When I look back five or 10 years, alcohol was the big concern then,” said Mr. Bradley. “We’ve really pivoted since then in what we talk about. Now it’s substance use more broadly.” And with the postsecondary years being a common time for young people to sample many new experiences, concern is highest for students who aren’t regular drug users but who are only very occasional users or first-timers.

“The larger audience we have is the ones most at risk of unknowingly using,” said Mr. Bradley, the same ones most likely to run into trouble. And, he adds, it can’t be just the universities and colleges doing the work to prevent that. “This level of education really needs to begin at the high-school level. If there was more non-judgmental education in high-school, they would be better prepared when they come to our doors.”