Not Your Average Back-to-School List: How to Protect Children and Teens As They Return to School

By Kevin, Roy, Chief Public Policy Officer, Shatterproof

Pens, binders, graphing calculator: Check, check, check.

What's less likely to appear on school supply lists, however, are health-related items for teens and young adults that can help them in the face of the drug epidemic.

Use of the powerful synthetic opioid fentanyl is now the leading cause of death for Americans ages 18 to 49, according to the Centers for Disease Control and Prevention (CDC) and a recent analysis from The Washington Post. The deaths caused by fentanyl are higher than those caused by car accidents, suicides and gun violence.

The recreational drug landscape has changed drastically with the introduction of many synthetic drugs and it has become difficult to know how to educate and prepare youth. Pills and powders are being distributed in hometowns and suburban neighborhoods across America. This is occurring in affluent and middle-class communities as it is in lower socioeconomic neighborhoods.

As a result, deaths involving fentanyl are on the rise in the U.S., spiking 182% in recent years according to the CDC. At least 1,800 teens died from 2019 to 2021 due to a fentanyl overdose. In fact, an average of 22 teens die in the U.S. each week from drug-related fatalities, a death toll driven by fentanyl use, according to the New England Journal of Medicine. These drug-related teen deaths equate to losing a high school classroom full of students each week.

Shatterproof, a national nonprofit organization dedicated to transforming addiction treatment, has information and resources specifically designed to help navigate conversations between parents, caregivers and youth.

Shatterproof has compiled these tips to help equip yourself and your children about the dangers of illicit drug use, what tools are available, where and how to access them, and how to use them: 

1. Promote Good Mental Health

Before a problem ever arises, teach your kids about the safe, tried-and-true ways to manage their mental health, stress life skills and build resiliency. The U.S. Surgeon General’s 2021 report recommends habits and routines that support and protect youth mental health. They include:

• Take care of your body and mind. Stick to a schedule, eat well, stay physically active, get quality sleep, stay hydrated, and spend time outside. Avoid substances that can ultimately make you feel tired, down or depressed, such as alcohol, marijuana, vaping, and/or tobacco.
• Learn and practice techniques to manage stress and other difficult emotions. Try to recognize situations that may be emotionally challenging for you and come up with strategies to manage those emotions.
• Invest in healthy relationships. Social connection is a powerful buffer to stress and a source of wellbeing. But too often in our fast-paced lives, quality time with people gets crowded out. Make space in your life for the people you love. Spend time with others regularly and get involved in group activities, such as recreation and outdoor activities, after-school programs, and mentorship programs.
• Ask for help. Find trusted adults, friends, or family members to talk to about stressful situations. If you are struggling to manage negative emotions, reach out to a school nurse or counselor, a teacher, a parent or caregiver, a coach, a faith leader, or someone else you look up to and trust.

2. Know the Risks 
It’s a process to educate your children about the real dangers of experimenting with drugs, and it should start when they are young. Kids need to understand that drugs are harmful to their health and can result in death. A study in Pediatrics showed that abstinence for high school seniors improved five-fold over nearly 40 years. Unfortunately, for those who do choose to use drugs, the risks of doing so are greater than ever.

• Fentanyl is 50 times stronger than heroin and 100 times stronger than morphine. Just two milligrams of fentanyl, the equivalent of 10 to 15 grains of table salt, is considered a lethal dose. A one-time experiment with this drug can result in death.
• Illicitly manufactured fentanyl is being disguised to resemble prescription medications like depressants, ADHD medication and opioids, according to the CDC.
• Fentanyl is often mixed with other drugs, so a buyer may think they are purchasing something else, like a sleeping pill or caffeine pill, and end up having a fentanyl overdose.
• The Drug Enforcement Administration (DEA) Laboratory discovered that, of the fentanyl-laced fake prescription pills analyzed in 2023, 70% now contain a potentially lethal dose of fentanyl.
• Death is not the only risk from illicit drug use. Research shows that individuals exposed to cannabis in adolescence are two to four times more likely to develop a schizophrenia related disorder. Another recent study found even casual marijuana use was "significantly associated" with adverse psychosocial issues among adolescents.

Educate your children about these risks and ensure they do not have access to obtain these substances online or through any other unreliable source. Encourage them to adopt a healthy game plan for their life. Here are several resources for doing so:

• “Fentanyl – Get the Facts” – Shatterproof created this four-part video series to educate viewers about who is at risk and how to safeguard themselves and loved ones.
• “Real Deal on Fentanyl” – Shatterproof served as an issue advisor on this national Ad Council campaign to address America’s overdose crisis, helping young Americans understand the danger and prevalence of fentanyl, which includes lesson plans for middle and high school youth. The campaign also shows drug dealers stepping in as teachers – or “substitute dealers” – to educate students about the fentanyl crisis through the lens of their everyday class subjects, such as chemistry.
• Fact Sheet on Cannabis – Developed by the Yale School of Medicine with the Connecticut Department of Mental Health and Addiction Services, the fact sheet outlines the risks of psychosis from cannabis.

3. Understand How to Spot and Treat Overdose 
Despite knowing the risks, some will still use drugs. This means that we need education on how to save lives. Opioid overdose reversal medications, such as Naloxone (brand name, Narcan) and nalmefene, are easy-to-use medications that can reverse an opioid overdose in minutes. On pharmacy shelves, you might see Narcan or RiVive. With a prescription, additional options are available, like Kloxxado, Zimhi and OPVEE.

These medications block the deadly effects of opioids, like fentanyl, in the body. These life-saving medications should be onsite on school campuses.

How to Obtain Overdose Reversal Medications

• Narcan is available without a prescription in all 50 states. Check a retail pharmacy shelf or ask a pharmacist how to get Narcan.
• Look for resources from your local health department; use the map at  HarmReduction.org; check community-based programs, based on your state; or select your location on the Next Distro website. A pharmacist or a community health organization can help you understand what is available in your location.

Shatterproof has a Narcan training video available on its website. Before administering, the CDC recommends calling 911 immediately. Try to keep the person awake and breathing and lay the person on their side to prevent choking.

How to Spot an Overdose 
Understanding the common signs associated with different types of drug-related fatalities and taking immediate action can mean the difference between life and death.

• Shatterproof outlines how to spot an overdose on its website, along with the various actions to take in the event of an overdose depending on the substance consumed.
• If your child is experiencing distress, people around them must be able to recognize the signs of an overdose — especially unresponsiveness, slow or erratic breathing, and blue lips and fingertips — and call 911 and administer Narcan.

Encourage your children to surround themselves with trustworthy people who understand that Good Samaritan laws offer protection in most states, should something go wrong. Good Samaritan laws create legal protections for people who call for help in the event of an overdose to encourage and protect bystanders who may otherwise not be willing to call for fear of being arrested for drug-related crimes.

If your child or their friend is living with addiction, it may also be necessary to educate them about access to other tools to prevent death, including fentanyl test strips. These small strips of paper can detect the presence of fentanyl in different kinds of drugs and drug forms, like pills, powders, and injectable substances, according to the CDC. While a useful tool to prevent accidental drug-related fatalities, not all fentanyl test strips can be trusted. It is important to purchase fentanyl strips from health departments, community organizations or other trusted sources.

4. Tips to Keep Your Kids Safe at Home 
It’s important for adults to keep prescriptions drugs secure. Nearly half of prescription drug misuse begins with a family member or loved one, not an illicit drug source. Additionally, remove high-alcohol-content mouthwashes and inhalants such as aerosol cans, paints and glues.

It can be terrifying when your child is using drugs. When they use heroin, fentanyl or other prescription opioids, however, the fear is even greater because they pose a much higher risk of a fatal overdose. While you work on connecting your child with treatment, there are things you can do to help diminish the risk for an overdose:

• Have a safety plan. While not endorsing the use of substances, it’s important to accept your child may experiment and focus on reducing harmful consequences. Discuss a safety plan with your child as a precautionary measure to help reduce the opportunity of an accidental overdose. Additionally, let your child know that you care and you want to stay involved in their life in a positive way.
• Educate your child about the risks of overdosing. If your child has been abstinent from using opioids for any period of time, regardless of the reason, they will then be at a greater risk of overdosing if they return to the substance. A change in tolerance can happen as a result of detoxing, completing a treatment program, being in jail or prison, prematurely discontinuing certain forms of medication-assisted treatment, or simply choosing not to use substances. As a result, your child’s “usual” dose could turn life-threatening. It’s important to have ongoing conversations about the risks associated with lowered tolerance as part of the overall safety plan.
• Wave the red flags related to combining opioids with other substances. People who use opioids often do so in combination with other substances such as stimulants (e.g., cocaine, meth) and depressants (e.g., benzodiazepines, alcohol, sleep medications), placing them at greater risk of death. In combination, these substances can tax the heart and the respiratory system, greatly compromising your child’s health. It is imperative to educate your child about these dangers.

Know that drug use happens in every community no matter a person’s demographics, background or political affiliation. Don’t dismiss your child’s drug use as a rite of passage, a phase or recreational use. Addiction doesn’t discriminate. It is crucial to raise awareness and educate children, parents and educators about the real risks of fentanyl-laced pills and how to stay safe while we work toward a future where no one has to lose their life to a preventable drug-related fatality.

For more information, visit shatterproof.org