At the University of California, Berkeley, six locations across campus offer students free fentanyl test strips and naloxone. Harm reduction coordinators host drop-in office hours on most weekdays. Students spanning the recovery spectrum can attend weekly support meetings that include 12-step programs, but also non-12-step mutual aid and harm reduction groups.
Harm reduction and recovery support haven’t always been priorities on campus. The student-led group that runs these programs, Recovery at Cal, was largely dormant until 2021, when a passionate group of students fought to bring it back to life.
“We identified three pillars … of what the program would require to be substantial and supported meaningfully,” co-founder Johnny Smith, who graduated from Berkeley in 2024, told Filter. “Those three things were having full-time staffing, some sort of recurring institutional funding and a fixed, dedicated private space.”
Drawing on Berkeley’s success, student advocates continue to urge the highest levels of university leadership to implement these pillars across all 10 University of California campuses.
California’s flagship universities aren’t the only schools reckoning with growing demand for harm reduction and recovery programs. Across the United States, colleges have steadily implemented opioid overdose trainings, naloxone distribution programs and other initiatives aimed at helping students navigate an uncertain drug supply.
Across a broad range of institutions, the pathway for implementing strong programming was strikingly similar.
A new study published in the American Journal of Health Education interviewed 25 university leaders to understand how colleges build support for this programming and what makes their initiatives successful. It reports that advocacy by students and staff, thoughtful collaborations with community partners and state policies mandating that colleges provide overdose prevention resources have driven the rapid expansion of campus harm reduction efforts.
“A growing number of schools are implementing overdose prevention policies or expanding access to naloxone on their campus,” study co-author Christina Freibott, of Boston University, told Filter. “Either there’s state policies requiring them to do so, or there’s advocacy … from the student level or the community level to have these resources available.”
The researchers selected their sample of 25 schools to maximize representation, interviewing upper-level student health staff from public and private universities with enrollment ranging from less than 3,000 to over 20,000 students. They also included community colleges and specialized schools, such as an arts college.
Even across such a broad range of institutions, the “pathway” for implementing strong programming, as Freibott calls it, was strikingly similar.
“A lot of schools have really creative and impactful collaborations with community-based organizations … That was the next step before implementing a more in-house program.”
Like at Berkeley, student advocacy was often the first step. Once students identified a need and rallied to fill it, universities tended to bring in external partners such as community organizations, to distribute resources or host training sessions.
“A lot of schools have really creative and impactful collaborations with community-based organizations that provide overdose prevention training or have access to naloxone that they can distribute throughout the school,” Freibott explained. “That was the next step before implementing a more in-house program, or something that [the universities] took ownership of themselves.”
For many schools, the biggest challenge to establishing these initial partnerships was convincing students and staff, particularly those in control of the budget, that such resources are necessary on campus.
“[T]here’s a perception that college students are sort of immune or not a population of major concern for opioid overdose,” Freibott said. “A lot of administrators that I spoke to were tasked with shifting the narrative.”
In an attempt to increase awareness, schools often reframed opioid overdose as “poisoning.” That’s language that many harm reductionists argue promotes punitive narratives about drug use or assigns blame unjustly.
Freibott acknowledged the problems of this approach, though she added that when “poisoning” language mirrors how many universities already talk to their students about the risks of alcohol, it “often helped just sort of flip a switch in people’s brains.”
Recent legislation, however, has decreased reliance on such tactics in some places. More state policies than previously require that publicly-funded higher education institutions provide naloxone access and overdose education to students and staff.
“It sort of removes the need to garner that internal support,” Freibott said. “Schools are finding it very helpful as a way to sort of reference, ‘Well, we’re doing this because the state requires it.’”
It’s still not enough. While most states now allow schools and staff to carry and administer naloxone, only a minority mandate it—though in 2024 alone, at least a dozen passed laws to increase access in settings including higher education.
“It’s so critical that it’s a student-led initiative that welcomes institutional support … that really makes up the most effective dynamic.”
The extent of these policies also varies. While Florida requires that universities maintain a supply of naloxone in all residence halls, for example, California’s Campus Opioid Safety Act mandates that university students also receive “educational and prevention information.” Maryland is another state that mandates both stocking naloxone on campus and providing students with overdose prevention education.
Advocates hope that the adoption of more state-level policies will help protect campus harm reduction, amid the Trump Administration’s systematic defunding of both higher education and harm reduction programs.
“[This study] happened before some of that federal shift happened, so it’s not yet known how that may affect the state-level policies, but I do know that a growing number of states are implementing these policies,” Freibott said.
Even as state policies push more universities to establish overdose-related programming, student support remains essential to their success. Reflecting on the impact of Recovery at Cal, Smith urged universities to embrace a bottom-up approach, deploying their institutional staff and funding in service of student-driven programming.
“It’s so critical that it’s a student-led initiative that welcomes institutional support,” he said. “It’s that sort of synergy that really makes up the most effective dynamic.”
Photograph (cropped) of UC Berkeley campus by Mizzlbrd via Wikimedia Commons/Creative Commons 2.0
