'It's literally just about keeping people alive’: Harm reduction advocates push for access to Narcan on campus
University to launch a ‘community-based health initiative’ around Narcan on campus, officials say
Editor’s note: This article contains references to substance abuse and overdoses. Please see the bottom of this story for resources.
It’s an unseasonably cold day in October, and Thomas Cortez is standing in front of a crowd in the School of International Service atrium. Cortez, a second-year graduate student in SIS, is training people on how to use Narcan, a nasal spray used to reverse an opioid overdose.
“Do you want to get Narcan trained?” Cortez calls out as people walk past him. A few shake their heads and keep walking, but most take him up on his offer. The training takes less than five minutes, and participants leave armed with Narcan, fentanyl testing strips and knowledge that could potentially save a life.
Cortez is among a growing number of people who believe making Narcan more accessible, especially on college campuses, is crucial. As the executive advisor on the SIS Graduate Student Council, he spearheaded an Oct. 18 Narcan training in partnership with the DC Department of Behavioral Health to help achieve this goal.
In 2020, 94 percent of fatal opioid overdoses in the district involved fentanyl or a fentanyl analog, according to the DC Department of Behavioral Health. This is compared to 22 percent of cases in the first quarter of 2015. From 2016 to 2020, there was a 129 percent increase in opioid deaths for 20- to 29-year-olds in the district.
“[The opioid epidemic] is exploding here in the United States, especially here in the district, is just something where I feel like it's important to start having this normalized on college campuses and start having this conversation more normalized,” Cortez said.
Others in the AU community share this sentiment. Abigail Goldner Morris, who graduated from AU in May 2022, works as a housing program coordinator for HIPS, a harm reduction organization. During their time at AU, Morris, HIPS and the Health Promotion and Advocacy Center put on several training sessions on how to use Narcan for students who were interested.
Morris, who is a Department of Health certified Narcan trainer, says AU should be doing more to make Narcan accessible to students, starting with training resident assistants and housing desk receptionists on how to use it.
“I think that a good analogy, especially on a college campus, is condoms and STDs. Most students on AU’s campus, I think know where they can get condoms but maybe don’t know where they can get tested. But because they know where they can get condoms, a lot of them would probably be able to figure it out … it’s a good framework of how Narcan could be used on campus, just in having it there as the entry point for folks to try to be safer, because AU students are using drugs,”
In the course of their work, Morris learned about additional nonfatal overdoses in the AU community. After hearing that, Morris emailed the University in Nov. 2021 to discuss adding the one-and-a-half-hour Narcan training for RAs and DRs to the training they already receive on other topics. Morris was told via email by Housing and Director of Residence Life Lisa Freeman that discussions about Narcan were currently being had “with senior leaders on campus,” and because the semester was almost over, “a decision on what direction we may take will not occur until next semester.” Freeman said she would be back in touch in the spring semester.
Morris responded again, stressing the urgency and importance of training RAs and DRs to carry Narcan with them, and volunteered to do the training themself. Morris said despite how easy it would be to train people, they felt like AU didn’t understand the urgency of the issue, even after knowing someone had an overdose in a dorm.
“Having a decent chunk of students, especially students who are student leaders, like RAs and desk receptionists to an extent … having that knowledge will be so, so, so life-saving in so many situations,” Morris said.
Morris said the training typically takes an hour and a half, and after that, RAs and DRs would be able to distribute Narcan to anyone who might ask for it. Just like Cortez’s training, RAs and DRs would then be able to give people the knowledge to train their residents in less than five minutes and then give them the Narcan to take with them.
“The goal of that training is basically so everyone who is trained can give like a two or three-minute little blurb about like what Narcan is and how to use it,” Morris said.
The Eagle reached out to the University to schedule an interview with Housing and Freeman and Assistant Vice President of Campus Life Traci Calandrillo. The University was not able to make either of them available for an interview with The Eagle in time for publication.
“The University is launching a community-based health initiative around Naloxone on campus and will brief members of the student media on Friday. Additional stakeholder engagement is also underway,” Elizabeth Deal, assistant vice president for community and internal communications, wrote in an email to The Eagle. “Our approach is based on a commitment to the health and safety of our community, along with managing the legal and regulatory elements of Narcan provision under DC statutes.”
In the district and beyond
Making Narcan accessible on college campuses isn’t a new concept. At Bridgewater State University in Massachusetts, “Opioid Overdose Kits” were added to defibrillator boxes on campus in 2017. At the University of Wisconsin-Milwaukee, Narcan is available in the lobbies of dorms and other buildings like the library.
A barrier harm reduction advocates like Morris often face in their work is the stigma associated with drug use — entities like universities may be reluctant to make things like Narcan or fentanyl testing strips available because by doing so they may believe it promotes drug use.
The problem, Morris said, is that drug use will happen regardless.
“It's not a morality issue. It's literally just about keeping people alive, like this is like the bare minimum,” Morris said.
D.C.’s standing order for Narcan allows pharmacists to dispense it to anyone without a prescription. Narcan does not cost anything to obtain, is available to pick up at pharmacies and clinics in every ward in D.C. and be delivered to any D.C. address. Additionally, there is no requirement to show an ID to obtain it. In 47 states and the district, “Good Samaritan Laws” protect those who may have administered Narcan to someone experiencing an overdose from legal liability.
Cortez said one way to make harm reduction more normalized on college campuses is to incorporate it into programming for freshmen, the same way that all first-year students are required to participate in Empower AU or take AUx.
“Starting off there and saying, ‘this is what Narcan is,’” he said. “A lot of these topics, people don't ever talk about before they get to college. So just, one, normalizing it and normalizing the conversation at first, and then two, actually providing those resources.”
Morris said the prevalence of substance abuse on college campuses, especially at AU, has become normalized and not making Narcan available on AU’s campus ignores the reality of substance use on college campuses.
“Pretending that AU students don't use drugs is living in denial and, simply, how you kill AU students because you're not gonna give them the resources they need,” Morris said.
‘Way beyond American University’s campus’
Amanda Choutka, a senior professorial lecturer in the Department of Literature, said access to Narcan on college campuses is another tool in the toolbox for harm reduction.
Choutka has Narcan in a drawer in her office, but not because she thinks a student might overdose in the middle of class or during office hours. Instead, she said if a student were to come to her and express concerns about a peer she could pass it on to them, as well as for students who may be out in D.C. and run across someone who may be experiencing an overdose.
“In reality, we’re on a college campus, and as much as it may make people uncomfortable to think about students using certain substances, using opioids on campus, I have to assume that it's happening,” she said.
D.C. has the third-highest mortality rate in the country for opioid-related deaths, according to the Howard University Hospital. Harm reduction advocates like Morris and Cortez agree making Narcan accessible to AU students can have a positive ripple effect in the community.
“I also don't believe it’s something where they should be assuming that this is solely for college campuses. So a lot of our students, they don't party on campus. They go out into D.C. and they go out into clubs and they find other areas where they can go out and have a good time,” Cortez said. “Just having this on them out there, this is something that can help someone way beyond American University's campus.”
HIPS’ 24-hour hotline can be reached at 1 (800) 676-4477. To find out where you can receive free Narcan kits in D.C., text "LiveLongDC" to 888-811.
To seek help or access information about accidental overdoses or harm reduction resources near you, visit the National Harm Reduction Coalition’s resource page. If you are experiencing grief or trauma following the death of a loved one, visit the Grief Recovery After a Substance Passing resource page. The Substance Abuse and Mental Health Services Administration National Helpline can be reached at 1-800-662-HELP(4357) for individuals and families facing mental or substance abuse disorders.