In the fentanyl era, ‘Just Say No’ must become ‘Just Say Know’

Adolescent overdose deaths hit a new high this year, nearly tripling from 2019 to 2021, according to the Centers for Disease Control and Prevention. News outlets have been inundated with stories of high school students overdosing in school bathrooms. As panicked and unprepared educators find themselves newly on the frontlines of this nationwide crisis, the Biden administration has officially called upon schools to intensify drug prevention efforts. 

The suggested measures in the White House letter include naloxone distribution and preventive educational programs. While the government’s explicit support of drug prevention in schools is a crucial step, the resources offered to educators by way of preparation are unfortunately wholly unsuited to the magnitude of the current crisis, a relic of a pre-fentanyl era.

As an educational consultant, I work with diverse school districts on drug prevention and education strategies. My commitment to finding real solutions started in high school — I survived my own struggles with drug use and misuse, but lost several close friends to overdoses. I’ve witnessed the ineffective pendulum swings of school-based responses to adolescent drug use. We went from “Just Say No” to “Just Say Nothing,” and none of it worked. We need a new approach — what experts call “Just Say Know.” And it needs to happen now.

Harm reduction, an evidence-based approach that aims to reduce the negative consequences associated with substance use, is regarded as an overdose prevention best practice by governmental and public health agencies alike. Yet none of the educator resources suggested in this letter to schools contain overdose prevention strategies. Instead, they focus on outdated “life skill training” programs, which are unfortunately both irrelevant to and inadequate for the scale of our current crisis.

Educators would be better off using materials like Safety First, an evidence-based high school curriculum (to which I contributed) that incorporates harm-reduction strategies and is available for free from Stanford’s REACH Lab. Yale’s Play2PREVENT Lab creates evidence-based programs that incorporate lifesaving overdose prevention information for students into an engaging video game format.

But simply having the right resources out there is not enough. To facilitate distribution and implementation of these lessons, the Department of Education needs to invest in the creation of an accessible digital platform targeted at schools and educators across the U.S., similar to what has been produced in other countries. Such a platform would provide access to the above resources along with directions for organizing naloxone trainings, easy-to-read FAQs and myth-busters, and examples of fentanyl and overdose prevention implementation across a diverse cross-section of school districts, whether rural or urban, conservative or progressive.

Similar platforms already exist to educate parents about fentanyl. I recently worked with California’s Department of Health Services and Song For Charlie to create The New Drug Talk website, whose straightforward structure of “what to know,” “what to say,” and “what to do” could easily be adapted for schools and educators.

The Biden administration’s goals of ending the overdose epidemic and protecting students from fentanyl will only become a reality if we equip schools with tools that match the reality of our current situation. 

Schools need up-to-date, actionable resources that speak to the realities of the epidemic. If teachers, coaches and counselors are to become the new champions of student health in the age of fentanyl, they will need accessible, evidence-based implementation strategies. If we really want to address this crisis, it is time to move from good intentions to effective action.

Rhana Hashemi is a PhD student in Social Psychology at Stanford University and a Bay Area–based drug educator. She founded Know Drugs, an educational organization dedicated to harm-reduction education and preventing drug overdoses among youth.