Few college students know how to use naloxone, survey shows
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Key takeaways:
- Only 14.2% of college students reported knowing how to administer naloxone.
- Just over 66% felt comfortable calling emergency services during an overdose event.
Less than 15% of surveyed U.S. college students knew how to use naloxone in the event of an overdose, according to results published in JAMA Pediatrics.
Last year, the FDA approved the first over-the-counter naloxone spray as an emergency treatment for opioid overdoses, making it more available, although logistical hurdles like cost and availability remain.
“The increases in fentanyl-involved overdose fatalities among young people guided my research on this issue, particularly exploring possible upstream prevention strategies for adolescents and young adults,” Christina Freibott, MPH, a PhD candidate at the Boston University School of Public Health, told Healio.
“While substance use education — specifically alcohol-related education — is often provided on college campuses, opioid-related education has traditionally been less common,” Freibott said. “Recently, however, more campuses have been adopting opioid overdose prevention and naloxone training programs for their students to address fentanyl-related overdose concerns within this population.”
Freibott and colleagues studied responses from four survey questions added to the 2021-2022 Healthy Minds study, which is randomly administered to adolescents and young adults aged 18 to 25 years attending a higher education institution. The questions were adapted from the Opioid Overdose Knowledge Scale and the Opioid Overdose Attitudes Scale. They asked if respondents knew what naloxone is used for, what the signs of an overdose are, if they knew how to use naloxone in the event of an overdose, and whether they would be concerned about getting into trouble for calling emergency services.
“For this study, we calculated overall response rates to all four questions and compared the responses by demographic characteristics to identify any major differences,” Freibott said.
Out of 7,071 participants in the survey, 30.2% correctly identified naloxone use, and 61.9% correctly identified at least one sign of opioid overdose. Only 14.2% reported knowing how to administer naloxone, but 66.8% felt comfortable calling emergency services during an overdose event.
Knowledge of naloxone use differed by age, race and ethnicity, and gender identity, with participants identifying as “other” race and ethnicity (17.1%) and females (14.7%) being most likely to know how to use naloxone.
“The majority of students indicated they would be comfortable calling for help during an overdose event but less than 15% knew how to use naloxone,” Freibott said. “The results of this study provide a starting point for understanding baseline levels of opioid and naloxone knowledge among college students.”
Two-thirds of all students saying they would be comfortable calling for help during an overdose event was “the most promising finding,” she said.
“This points to the opportunity for more widespread opioid education and naloxone training programs, as college students are already willing to intervene — but need the knowledge and resources to do so,” Freibott said.
Freibott said she and her team will be tracking opioid overdose prevention policies on college campuses, such as “good Samaritan policies,” which encourage students to call for help during a drug- or alcohol-related emergency without fear of disciplinary consequences because this may affect their willingness to intervene.
“Making opioid overdose education and naloxone training more widely available could help increase awareness while potentially destigmatizing conversations around substance use,” Freibott said.
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