Twenty-year-old student and housing resident advisor Michaela Brewer was no stranger to the idea of an opioid overdose when East Tennessee State University decided to put Narcan in its residence halls.
Brewer was 19 years old when one of her close friends and co-workers overdosed on opioids and died. She said he was only in his 30s. On probation for marijuana use, he resorted to partner drugs to get high. Specifically, he took heroin and drugs laced with fentanyl.
“It was honestly really weird because all the tell-tale signs that you think of when you hear the word drug addict, wasn’t him at all,” Brewer said. “I didn’t know until someone told me. I felt really bad for him because obviously that’s terrible that he feels like he has to do that, or he had to do that to manage the everyday life.”
Because Brewer’s co-worker had isolated himself beforehand, no one was present to try and save him. Brewer wishes she could have. Now that all ETSU residential halls have Narcan, Brewer is able to save the life of a student who overdoses on opioids.
Generation Rx, a group of students from the ETSU Gatton School of Pharmacy, trained 66 residential housing staff on how to spot an overdose and administer Narcan on Aug. 14.
Narcan nasal spray, a brand name version of naloxone, is an overdose reversal drug for opioids. It blocks the effects of opioids by pushing them off the opioid receptors in the central nervous system. Naloxone does not have any effect on a person with no opioids in their system. According to Generation Rx student leader Dawnna Metcalfe, Narcan kicks into effect 30 to 45 seconds after administration and immediately sends the person into withdrawal.
Generation Rx is an initiative under the American Pharmacy Association that focuses on the safe use of prescription medications. The group travels to high schools and colleges to teach about prescription stimulant abuse. Director of Student Counseling Services at Emory and Henry College Todd Stanley said that ETSU’s Generation Rx traveled to Virginia to train roughly 50 of their students how to administer naloxone during a revive training on April 16.
“Naloxone can save someone’s life,” said Generation Rx student leader Abby Lopp. “You never know who is misusing opioids, or who has a prescription for opioids. You have no way of knowing that. So, you don’t know, if you come up upon someone who is unconscious; you don’t know if they’ve had a heart attack or if they have low blood sugar or if they overdosed. So, just having naloxone there prepares someone in the case of emergency.” Metcalfe said getting Narcan on campus was a big win because there were challenges along the way.
The Center for Prescription Drug Abuse Prevention and Treatment, a center for excellence at ETSU, began research on the availability of Narcan in the local community in 2014. The center’s operations director, Angela Hagaman, proposed the idea of putting Narcan on campus in 2017 while organizing a campus prescription drop-off with the Gatton College of Pharmacy.
The first attempt to get Narcan in residence halls and academic buildings on campus failed. When Hagaman reached out to student affairs, they said it was not necessary because the police arrive quickly enough that it is not needed. However, Hagaman said after hearing author Sam Quinones advocate for the use of Narcan at a summit during a presentation sponsored by Ballad Health, ETSU President Brian Noland said Narcan should be on campus.
“There was a lot of resistance to it because there is a lot of stigma around the opioid epidemic, around the use of naloxone,” Metcalfe said. “People think that naloxone is for people who are addicted to opioids, and that is not the case at all. Any-one can overdose. Addiction does not discriminate against people, so it took a long time to break those barriers down even within our own college.
"Other universities in the Appalachian region, like Appalachian State University and West Carolina University, do not have naloxone in their residence halls.
Pam Buchanan, the director of Student Health Services at Western Carolina University, said their campus EMS and police are the only groups with access to naloxone on campus at Appalachian State University.
Wellness and Prevention Services Director Alex Howard said only campus police have access to it. Howard said debates about the use of Narcan have hindered attempts to put it in their residence halls.
Generation Rx’s next goal is to eventually train all students and staff at ETSU on how to administer Narcan. For Lopp, these trainings have implications that travel beyond campus.
“It’s like a bigger picture than just campus,” Lopp said. “So, the people we train on campus; we train them, and we give them naloxone, and then they go home.
They go back to their home-towns, and you don’t know the things that they see there. So, it’s not just about being on campus, it’s about affecting a greater population.”
Brewer was working back home when her co-worker over-dosed.
When Generation Rx trained Brewer and the rest of the housing staff, they did not know what the resident advisors might have seen or experienced at home; what Brewer had experienced at home.
Familiar with the effects of the opioid crisis, Brewer is glad the residence halls now have Narcan.“ I think it’s really important, especially because the opioid abuse is terrible in Tennessee,” Brewer said. “Especially knowing someone that I was close to who passed away, who we could have saved his life had we known. That would have been really great if he could still be here today.”
Now, with Narcan at their disposal, Brewer and the other ETSU housing resident advisors can be prepared if a student overdoses in their residence hall. For the university, having Narcan on campus means protecting their students. For Brewer, having Narcan on campus means saving a life.
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