The UC Berkeley chapter of End Overdose at Sproul Plaza in Berkeley on Jan. 23, 2024. The organization passes out free fentanyl test strips to students, and gives other organizations training on Narcan usage. (Photo: Juliana Yamada/CalMatters)
This article was published to CalMatters on Feb. 22, 2024.
When Mel McKernan moved in with her new roommate Braedon Ellis, they bonded quickly. Every night she would stay up until 1 a.m. just waiting for Ellis to get back from her job so they could watch TV together. McKernan, 19, was a second-year student at Seattle University. Ellis was 20 and working as a Domino’s delivery driver.
“She genuinely was the light of my life,” recalled McKernan, who has since transferred to UC Berkeley. “She had this beautiful purple hair. I felt like that was just an aura that she carried around with her.”
McKernan thought she had made a friend for life. The two young women lived with two other roommates in a beautiful waterfront house in Kenmore, Washington. But behind the walls, a darkness lurked. Their other roommates were addicted to fentanyl, an extremely potent synthetic opioid.
McKernan had braced herself for the possibility of losing a roommate. But she never expected it to be Ellis. Their magnetic connection severed when Ellis overdosed from a combination of drugs that included fentanyl.
“It completely changed my view on opioids,” McKernan said. “Because I was like, this could hit anyone. It can hit literally anyone.”
Braedon Ellis. Photo courtesy of Dionne Waltz
Fentanyl is now the leading cause of drug-related deaths nationwide. After a new wave of deadly overdoses among Californians 15 to 24 started to rise in 2019, lawmakers turned to California’s public colleges and universities to offer life-saving resources to its students.
The Campus Opioid Safety Act, which took effect Jan. 1, 2023, required campus health centers at most public colleges and universities to offer students free Narcan, a nasal spray that can reverse an opioid overdose. Some colleges and universities have since armed students with Narcan, but not all have followed suit.
The rise of fentanyl deaths
Today, when someone in the United States dies of a drug-related overdose, it’s usually linked to fentanyl. That’s a change from 20 years ago, when prescription opioids like OxyContin were the leading killer, according to Theo Krzywicki, founder and CEO of End Overdose, a national nonprofit based in Los Angeles aimed at eliminating drug-related overdose deaths, especially among teens and young adults.
“Fentanyl is a very different drug than OxyContin,” Krzywicki said. “The way people use it has changed.” Because fentanyl delivers a stronger and shorter-lived high than other opioids, people often use more of it, he said, and build up a tolerance to it quickly.
For years, the opioid epidemic hit middle-aged Californians harder, but the new wave brought on a rise in death rates for teens and young adults. By 2021, teens 15 to 19 were five times as likely to die from an opioid overdose compared to 2019. For 20- to 24-year-olds, they were over three times as likely. Rates for adults between 25 and 75 years old, meanwhile, roughly doubled in the same time frame.
Recently, opioid-related fatalities among the state’s young people have started to reverse. While death rates for adults 25 and over continue to rise, rates have declined for people under 25. Since 2021, per-capita rates for opioid-related overdose deaths dropped by over a third for Californians 15 to 19 and 20 to 24.
Rising awareness could be what’s driving the recent decline, according to a statement from the Los Angeles County Department of Public Health. College-aged students increasingly use social media to spread information about the risks of fentanyl and where to find life-saving resources such as Narcan. Young people also tend to have stronger support systems and are less likely to use drugs alone, according to the statement.
Lawmakers require colleges to combat the crisis
Melissa Hurtado, a Democratic Central Valley state senator, introduced the Campus Opioid Safety Act, or SB 367, in February of 2021. She said she chose to target college campuses after hearing story after story of young people overdosing in her district.
“It was just such a serious threat,” Hurtado said. “And it still is.”
State Sen. Melissa Hurtado speaks at a press conference on Oct. 14, 2022. Photo by Larry Valenzuela, CalMatters/CatchLight Local
This January, another law, AB 461, went into effect that added fentanyl test strips to the requirements. The small paper strips can be used by drug users to check if their supply contains fentanyl. Counterfeit prescription pills, made to look like OxyContin or Adderall, often contain fentanyl, according to the U.S. Drug Enforcement Administration.
The act requires campus health centers at California State University campuses and community colleges to order free Narcan through a state program called the Naloxone Distribution Project. Schools also must educate their students about preventing overdoses, and let them know where they can find opioid overdose reversal medication. The law “requests” the University of California system to do the same, stopping short of a requirement because of the system’s constitutional autonomy.
At least 100 public colleges in California have Narcan somewhere on campus, according to data from the state distribution project that included a list of all applications from colleges and universities. Although not required by law, some private universities like Stanford also offer Narcan to students.
Every UC and Cal State has ordered Narcan from the state distribution project in the last two years, with the exception of CSU Maritime Academy. However, CSU Maritime said in an email statement that Narcan is available through their student health center.
Fourteen of California’s 72 physical community college districts were not represented in the data, but Narcan could still be on those campuses. Victor Valley College, in San Bernardino County, ordered Narcan through its police department, so the request was categorized as law enforcement. DeAnza College in Santa Clara County received its supply of Narcan from the county health department, according to college spokesperson Marisa Spatafore.
Cal State Bakersfield gets the word out
Hurtado represents much of Kern County, one of the deadliest counties for opioid-related overdoses among young people. In 2022, 15- to 19-year-olds in Kern County fatally overdosed on opioids at a rate three times higher than the statewide rate for the same age group, according to the California Department of Public Health. For 20- to 24-year-olds, the rate was twice as high.
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