In the summer of 2020, Monica Vera-Schubert spoke to NPR about her long struggle to get health insurance for her son Bobby’s addiction treatment. They had recently succeeded, he got sober, and Vera-Schubert, a single mother, expressed her immense gratitude.
“My son is alive; I am grateful for every moment I have with him,” she said.
In the years that followed, Bobby became a dedicated student and was accepted into his dream university, UCLA. He sometimes worked alongside his mother, a pharmacist, as an activist, giving talks and warning others about the dangers of prescription drug abuse.
“I always tell him: ‘Bobby, I am so proud of you,'” Vera-Schubert said at the time. Bobby replied: “Mom, I am so proud of You.”
That was four years ago.
This spring, Vera-Schubert came forward again and said Bobby had relapsed. On April 12, a roommate found him slumped over his desk in his dorm, apparently from an overdose of counterfeit Xanax pills laced with fentanyl. Bobby Schubert was 29.
Deadly trend
The Schuberts’ tragedy highlights the importance of a stronger public health response to overdoses, including on campus. According to data provided to NPR by the CDC, the overdose death rate among young adults ages 18 to 24 increased 34% between 2018 and 2022. The trend is largely due to cheap and powerful opioids like fentanyl, which are found in a variety of street drugs and counterfeit pills that resemble treatments for anxiety or ADHD.
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In short, casual or even accidental drug use is now much riskier and results in the deaths of larger numbers of people – many of whom may not even know they are taking opioids. Yet health advocates say too few colleges have concrete plans for overdose prevention on campus – whether through mandatory overdose education, widespread distribution of overdose reversal medications or chemical drug test strips that check for the presence of fentanyl.
Wrapped in shame
A key reason for this inaction is the lack of data, says Christina Freibott, a researcher at Boston University. “There is no dedicated data collection on campus,” she says. “You are not always aware of the cause of a student’s death. Whether it was an overdose or something else.” Doctor-patient confidentiality often protects this information, she says. And even when students are resuscitated after an overdose, for example, they are unlikely to report the incident to school authorities.
Overdoses are surrounded by mystery and shame, says Monica Vera-Schubert. On that devastating night, as she stood outside her son’s dormitory and lamented over his body, she felt excluded; no one from UCLA, the police or the coroner spoke to her or consoled her. “My son died there in the university dormitory, and no one wants to say anything.”
Mette Lampcov for NPR / visual reporting for NPR Science
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Visual reporting for NPR Science
A few weeks later, when Vera-Schubert reconstructed the last moments of Bobby’s life using a chronology, her grief turned to agony when she realized that one thing could have changed everything: “Was there Narcan in the dorm where my son is? No.”
Narcan – a brand name of the drug naloxone – can completely reverse an opioid overdose when administered quickly, often as a nasal spray. California’s Campus Opioid Safety Act went into effect last year and requires most state and community colleges to offer tuition and free naloxone to their students. UCLA officials say the school is in compliance.
Mette Lampcov for NPR / visual reporting for NPR Science
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Visual reporting for NPR Science
Yet, according to Monica Vera-Schubert, in the ten minutes it took paramedics to arrive after Bobby was found, no one near him had access to naloxone. She was later told there was none in the building.
“For ten minutes, maybe longer, my son just lay there. There was no Narcan,” says Schubert. “My son just lay there. Would he still be here? Maybe.”
Blinders on?
Naloxone itself is inexpensive and harmless; it has no effect on people who do not overdose. However, some college administrators worry that the highly visible presence of naloxone on campus could damage their image: What will future parents think? Will it seem like an endorsement of drug use?
“Of course, you first think it’s a problem when you have to put a student in a body bag,” says Susan Murphy, who held that position when she was associate dean of the pharmacy school at the University of Charleston in West Virginia. That loss and others prompted her to leave the university five years ago to run the West Virginia Drug Intervention Institute, which provides overdose education and distributes kits with training videos to schools and bus systems.
She says many college administrators remain willfully blind despite the increasing risks. “The lack of reporting data allows people to keep putting blinders on,” she says.
Murphy says some colleges understand the urgency of the issue – including all the colleges in her home state of West Virginia. “We’ve had some really brave college presidents who said, ‘I don’t care what the perception is, this has to happen,'” she says.
The most proactive schools develop their own solutions. Some, for example, use their own pharmacy students to other students to detect overdoses and administer naloxone. Others — including Virginia Tech, the University of Georgia, and colleges and universities across West Virginia — hang boxes of free naloxone and instructional videos alongside first aid kits and fire extinguishers in places like libraries and dorms. Some even distribute fentanyl test strips so students can test their drugs before they take them.
That includes institutions like UCLA. Representatives there declined to be interviewed but said in an emailed statement that they are providing free naloxone and fentanyl testing kits at more than 20 locations on campus, including in residence halls. They said they plan to expand the availability of those kits later this month, before classes resume.
That wasn’t enough to have naloxone within reach when Bobby Schubert needed it.
His mother says she met with school officials the month after his death and told them she hadn’t found any naloxone anywhere on campus, including in her son’s old dorm. “My son might still be alive if something had changed,” Vera-Schubert told them.
On the road to recovery and ready to help
Proximity to naloxone is crucial, says Preston Quigley, whose high school years were marked by drug use and several dangerously close encounters with an opioid overdose.
“It’s like drowning, but you don’t know it,” Quigley says of the feeling of an overdose. Quigley is now 26, has been sober for three years and is studying social work at West Virginia University. He has had friends who needed naloxone to resuscitate them. “If Narcan wasn’t available, we would shake them, slap them, do whatever we could to keep the person awake,” he says.
Quigley, who is active in his college’s support group, says fentanyl has only made drug use more frightening in the years since he quit: A student could take a pill from a friend, thinking it was a study aid for the night, and then die. “That’s the difference, in my opinion, and that’s a big danger for the college population,” he says.
“The students know it”
But it takes too long to expect schools themselves to embrace and implement overdose prevention, says Theo Krzywicki, a former paramedic in long-term rehabilitation who founded a group called End Overdose. The group works directly with students, bypassing school administrators to distribute naloxone and provide training. So far, it has 28 groups, and there’s a backlog of students at 75 other schools wanting to start new groups.
“I think that explains how big the problem is: the students know,” says Krzywicki about the large number of new applicants. “That’s why we focus on working with the students, because the students are usually more motivated to make a change than the campuses.”
He says too few public health efforts take into account the realities facing young people; the old “Just Say No” anti-drug campaigns are useless, especially given that fentanyl lurks invisibly in so many places. Education, he says, is most effective when it comes from peers who understand.
“If you have a person who understands the community and culture and can provide the information at a level that people not only understand but embrace — and that’s the most important part — you can really make great progress,” Krzywicki says.
Trauma also for the witnesses
Peer-to-peer training can also be an important source of emotional support for bystanders – including students who have attempted to resuscitate unconscious roommates or friends.
“People are very aware that this is a huge problem that threatens our generation,” says Madeleine Ward, who lost a middle school friend to an overdose. She says the experience leaves terrible scars. “I think I was very, very aware that fentanyl in particular was a very big problem and something I needed to be careful about, for myself and my friends.”
But during her first year at UCLA, Ward says, everyone around her seemed completely unprepared. “When I got to college, I was very scared because I felt like not many people knew what Narcan was or that many people were afraid of taking medication laced with fentanyl.”
So Ward started an End Overdose group at her school, distributing naloxone and teaching fellow students to recognize the signs of an overdose. “After every single training we did, so many people were really deeply affected by overdoses and overdose losses.” (Ward happened to live on the same campus as Bobby Schubert, but did not know him and was unaware of his death.)
Ward, who graduated in May, says things are slowly changing on campus. In one of her last lectures, a professor asked for the hand of those carrying naloxone to be raised. In a lecture hall of 200 students, about 50 raised their hands, Ward says, “which was a big deal for me because I didn’t know anyone carrying Narcan my freshman year.” That, she says, means everyone is safer.
Photography by Mette Lampcov. Photo editing by Katie Hayes Luke.
Copyright: NPR
