Campus Safety In the Overdose Crisis

College campuses are a launch point for independence — and for many students, a time when substance use begins or escalates. With a drug supply increasingly contaminated with fentanyl, that experimentation carries heightened risk: one pill can kill. Although overdose deaths have fallen markedly, they remain the leading cause of death for Americans ages 18–44. A staggering 40% of Americans know someone who has died of a drug overdose. With more than 20 million young adults enrolled in higher education in the United States, colleges must treat overdose prevention as a campus‑wide safety imperative.

Our team recently published findings from a study showing promising progress in campus overdose prevention. My colleagues and I interviewed 25 higher education leaders who told us that implementing campus-based overdose prevention programs accelerated in states with policies requiring schools to provide naloxone (which can reverse an opioid overdose) to their students, faculty, and staff. Higher education leaders said these policies removed administrative uncertainty, unlocked funding and donated supplies, and accelerated campus rollout.

A Massachusetts bill under review in the current legislative session provides a timely example of how states may use policy to prevent overdose deaths. By directing institutions to make naloxone accessible, these policies go beyond encouraging best practices. Instead, they normalize overdose prevention as an institutional responsibility and reduce perceived legal and logistical barriers to implementation.

Colleges must treat overdose prevention as a campus‑wide safety imperative.

Not surprisingly, naloxone policies for colleges and universities can vary substantially between states. Some only require campuses to have naloxone available; others go further and mandate overdose education and training for the entire campus community. The same goes for substance use education for students, which colleges approach in many different ways. To understand these trends, we reviewed 46 studies exploring how schools protect students against opioid-related harms (e.g., misuse, dependence, overdose).

We found that naloxone training and peer‑led distribution are feasible and effective at increasing student knowledge and confidence that they know how to respond to an overdose. While we found limited evidence on how campus-based overdose prevention programs are implemented, the higher education leaders we interviewed described a common pathway: starting with collaboration with external community partners, then internal capacity building, and finally rolling out “in‑house” overdose prevention programs.

Our findings point to a clear, practical agenda for research and policy that can be accelerated with state action. First, we need studies that show whether state laws requiring naloxone on campuses are having their intended effect. Researchers should explore whether mandates increase naloxone on campus, boost training, prevent overdose deaths, and ultimately protect students’ health and futures. Second, we must look at how these laws are implemented. Are mandates equally effective at getting naloxone into smaller, low‑resource schools as they are in larger, well‑funded ones? Do they encourage one‑time trainings or sustained programs run by students and staff, and do they lead to permanent access points like naloxone boxes in residence halls?

State laws do more than send a message—they can catalyze lifesaving action on campus.

Effective campus overdose prevention also requires student health centers to routinely screen and refer students to evidence‑based treatment and recovery support services. Recent research on Collegiate Recovery Programs—which offer tailored support services to college students in recovery—found that more than a third offer overdose education and naloxone training to the student population. This highlights a potential avenue to connect important substance use resources for all students, regardless of whether or not they are in recovery. This combination of readily accessible naloxone plus timely referral to treatment and recovery services provides a life‑saving emergency response for students at immediate risk. It also creates a clear pathway to sustained recovery and academic success for the campus community as a whole.

State laws do more than send a message—they can catalyze lifesaving action on campus. If policymakers enact clear mandates tied to education, training, and funding, campuses will face fewer barriers when implementing and sustaining overdose prevention programs. As Massachusetts and other states explore these policies, researchers must partner with states and colleges to evaluate outcomes, refine best practices, and ensure enacted laws translate into equitable, durable programs that save student lives.