In Oregon, a bill that would require schools to provide education on the dangers of fentanyl is headed to the governor’s desk. The state is one of the first to consider expanding drug prevention education in this way, in response to student deaths from the powerful synthetic opioid.
The bill, which passed the state house and senate with bipartisan support, would require several state agencies—the Oregon Health Authority, State Board of Education, and Alcohol and Drug Policy Commission—to develop curriculum supplements that school districts must use.
The materials would cover the potential risks involved in fentanyl use and the use of other synthetic opioids, and highlight laws in Oregon that provide legal immunity for people who seek treatment.
At least three other states—Illinois, Texas, and California—are considering similar legislation.
Teen drug use has been on the decline for the past few years—it hit a new low in 2021, according to federal data. But teen deaths from overdoses increased in 2020 and 2021. And overall population deaths from fentanyl, specifically, have risen since 2016, with a sharp increase during the pandemic.
Over the past few years, some districts have started to stock naloxone, a drug that can temporarily stop symptoms of an overdose. In the Los Angeles Unified School District, which made the decision to train staff on naloxone use last year, Superintendent Alberto Carvalho cited concerns about fentanyl exposure specifically.
Fentanyl is more potent than other opioids like heroin and oxycodone, meaning smaller amounts can cause a lethal overdose. Some drug dealers also mix substances, making it possible that a teenager who thought they were taking a different drug could be exposed to fentanyl unknowingly.
The Oregon legislation aims to confront this problem, requiring curriculum to include information about counterfeit drugs.
This kind of information is key to prevention efforts, said Linda Mendonca, the president of the National Association of School Nurses. “Lots of schools have begun to talk about the risks and provide awareness that fentanyl is real, and it’s out there,” she said.
Still, it’s important that curricula or programs states develop go further than just providing facts about the drug, said Holly Alperin, a clinical associate professor in the College of Health and Human Services at the University of New Hampshire.
“We need to be really careful that we’re not implementing health education that’s solely focused on knowledge acquisition, or just solely sharing the ills of fentanyl,” said Alperin, who is also the chair of the Society of Health and Physical Educators’ Health Education Council.
“Historically, we’ve gone so far in the direction of bringing in lots of information in the hopes that it’s going to change behavior. ... But in actuality, that’s not how behavior change plays out.”
Challenges involved in drug prevention and awareness
Research on school-based drug and alcohol prevention efforts has identified some common features among successful programs.
The most effective lessons generally include interaction between teachers and students, in which teens can practice refusing drugs and develop a game plan for avoiding use. Social influence is also powerful: strong strategies include—reinforcing the message that most teens don’t use drugs, and having peer leaders facilitate instruction, are also strong strategies.
The goal is to build the skills that can support students to make safer choices, said Alperin. “No matter what the health topic is, we really need to back it out, and place an emphasis on, ‘What do we need young people to do?’ and then teach them how to do these things.”
While most states address drug prevention in schools—either requiring schools to provide education, or state agencies to make curriculum available—fewer mandate that opioids, specifically, are covered.
A few states have added requirements or guidance in recent years. Between 2017 and 2019, Maryland, Michigan, Texas, and Virginia included opioid addiction in health education standards or asked the state to develop instructional materials, according to the Education Commission of the States, a research clearinghouse.
Still, experts say that even when good programs are available, it can be hard for districts to find the time and money to stick with them.
In testimony for the Oregon bill, proponents said that the chance that other drugs could be mixed with fentanyl requires targeted instruction—students may not know that certain pills might be contaminated.
“Often, teens are seeking out what they think are real pharmaceutical pills to deal with anxiety or other mental health struggles. Others are looking to have ‘some fun.’ They are not seeking out fentanyl,” wrote representatives from the Beaverton school district in Oregon, in a letter of support for the bill.
The Beaverton schools developed a fentanyl awareness program, used in the district, that’s also available to school systems throughout the state.