SMART Policy Podcast
Podcast by the UT SMART Initiative. Host Jeremy Kourvelas speaks with experts from across the recovery ecosystem - representing healthcare, prevention, law enforcement and more - about local, state and federal drug policy to find out what is and isn't working to make this fight against addiction a little easier.
SMART Policy Podcast
Getting Naloxone on College Campuses and Other Interventions
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You're listening to the Smart Policy Podcast, a production of the University of Tennessee's Institute for Public Service. The data is clear. 18 to 25 is a critical time for substance use and mental health interventions. This is why programs implemented on college campuses have significant impacts.
SPEAKER_02College is a time of transition and experimentation as well as identity development. So you have a lot of things kind of compound to make it a time for complicated mental health.
SPEAKER_00When I talk to students directly who are using cocaine or maybe like buying what they think it's a prescription drug, where we think that the risks are of fentanyl highly being waste, there they're not like linking it though to actually kind of changing behavior often of making sure that they're testing.
SPEAKER_01But that isn't to say that these interventions are easy to launch.
SPEAKER_02You can't have trainings if they think you're gonna encourage drug use, right? So you have to get a lot of people on board before something like that happens in a campus that's also complicated.
SPEAKER_00We had to have conversations with different folks many times over the years to get to where we are.
SPEAKER_01My guests this month are Dr. Jesse Gold, the Chief Wellness Officer for UT System and Associate Professor of Psychiatry at UT Health Science Center, and Megan McKnight, the director of the Center for Well-Bing at UT Chattanooga. In this conversation, we talk about some of the barriers they have faced in launching harm reduction, education, and prevention programs on college campuses, such as concerns over legal liability, debunking myths, addressing stigma, and potentially the most important of all, logistics, such as who pays for what.
SPEAKER_00I mean, that's the battle though, the resources, like who's gonna pay for these things? They do cost money, and campuses are funded differently.
SPEAKER_02I understand where the fear comes from because you're already scared of not doing it right, let alone like some legal repercussion.
SPEAKER_01Finally, we discussed what next steps look like. After all, getting the locks done on college campuses and saving lives is really only step one.
SPEAKER_00But college campuses also then need to be thinking about recovery. If we're engaging in this kind of work on the campuses and are acknowledging that it is a concern among our students, we also need to be thinking about what happens once they receive treatment and are still on our campuses.
SPEAKER_02Hi, I'm Dr. Jesse Gold. I'm the Chief Wellness Officer for the University of Tennessee system, and I'm also an associate professor of psychiatry at the University of Tennessee Health Science Center.
SPEAKER_00Hi, I'm Megan McKnight. I'm the director of the Center for Wellbeing at the University of Tennessee at Chattanooga. And we in our area are for substance use prevention and recovery support services for students.
SPEAKER_01All right. So wellness on college campuses, but it sounds like both uh students and faculty.
SPEAKER_00I mean we do our best.
unknownRight.
SPEAKER_00The conversation around opioids, the epidemic, overdose response is becoming more of a conversation on college campuses, but it's still really not everywhere. We are working within a culture on college campuses where use is more normalized. So we do see students using generally like at higher rates too, sometimes in the general population. But what isn't discussed as much and is still also like the very high is problematic use. So not just students who may be using, you know, like alcohol or cannabis occasionally at a party, you know, on the weekend, but thinking about folks who are doing so either sporadically in particular high-risk ways, or are actually um points to developing um more of a dependence and um higher rates of use. Like so I, a couple different surveys, but the most recent one, National College Health Assessment in the spring of this year, showed um that about 26% of our students had a moderate risk of a substance use disorder. Um, and about 2% were at a high risk for a substance use disorder. Um so that's I mean, that's a pretty large sample of like about 28% of our students total, who, if they were screened, may come back and indicate that they have like a high problematic use.
SPEAKER_01So problematic use and to a lesser extent overdose, but it's still there, is a major problem amongst the student body. What are the substances that you are seeing most commonly used?
SPEAKER_02I mean, I can answer that in some capacity. I think that first I want to also say that like college is a time of transition and experimentation as well as identity development. So you have a lot of things kind of compound to make it a time for complicated mental health. So it's also, you know, I'm a psychiatrist, a time where schizophrenia, bipolar disorder just biologically come out. So we just have it's like a perfect storm for people to have mental health challenges, to be honest. So, you know, people are away from home for the first time, people are living with roommates for the first time, people are around substances a lot for the first time. You know, all of those things lead to like increased sort of temptation, but also stressors. I also think like school-wise, it's a lot more unstructured than high school. So, you know, you have like a final or a couple of papers and things like that. And so it's pretty easy to get behind. I know that's like a hard thing to say, and probably people listening are like, of course, I remember being behind all the time in college, but you know, I think that you can get behind and, you know, do other things for a while. And sometimes that's a social life kind of thing, and you can get like lost in that and then have to kind of catch up. And that can be also a stressor, obviously, because you also want to do good in school. So I think all of those things kind of contribute and also identity development, like what does it mean to make friends and who do you want to be friends with and who are you? And and substances kind of fit within that too, which is like, what does that mean in your life and what role does that play in your life? And if you're a person who's never tried it before, is that something you want to try because other people are using? Um, you know, I think just like all populations, alcohol is the substance of choice. Um, you know, I think it's probably minimized as being as problematic as it can be for people, in the whole general population, not just college students, but alcohol is always the substance of choice. Um, you know, and then I would say, I mean, I see a lot of people with repercussions of marijuana use, even though I think, you know, the general belief because of legalization has been it's harmless in some capacity, where I feel like we missed the message a little bit. And it's not that it's harmless, it just doesn't need to lead to jail time, kind of thing, is where the legalization came in. And I think college students kind of have this belief that they can use it with no consequence. And I've seen psychosis from it um more than I would like. Uh, you know, I'm again being a psychiatrist, sometimes I see a skewed sort of severe end of the stick on that. But um, I have seen a good amount of people come in with psychosis from marijuana use. I have seen a lot of people come in with sort of like lack of motivation, depression, looking symptoms from cannabis use. Um, and then I would say beyond that, you have, I mean, smoking counts in there too. I should also say that. Vaping is also popular on campuses. And then I would say I I've seen kind of like a now a mix of what comes next, which could be prescription drugs and prescription drug misuse, which also includes stimulants. So I brought up the school thing because I do think that um people will stumble into stimulant use, thinking it will help them study or catch up from being behind. And that can be a complicated process of then needing it and becoming dependent on it. Um, and then, you know, opiates fit in the prescription category, but also non-prescription category, depending on which kind of opiate you are using. And then I also would say, I mean, I've seen like the sort of hallucinogen um dabbling with some mushroom kind of situation, and have had patients tell me they're doing it to cure depression, because they heard about that on podcasts and things like that. Um, and they try microdosing. But if you read those studies, it's like so controlled. And the psychotherapy is so controlled. But again, I think you just like they see it on TikTok or they see it in a podcast and they go, well, that's supposed to cure my depression, and I can find that, so I should use that. And then again, you can have long-lasting psychosis from uh mushrooms or or any sort of hallucinogenic substance. Um, Megan might have other opinions about sort of what they're seeing, but that's sort of if I were to like bunch them together, kind of the order of what I've seen in my practice.
SPEAKER_00I think it's interesting is that we are seeing that jump quite a bit higher in like our use data than it had been historically. Um, which that is among other trends, the I think the most noticeable, otherwise, certainly still alcohol, cannabis, um, stimulants that were not prescribed are still up there. But glucinogens must used to be much lower, kind of in our list. And we were thinking about how many of our students using that particular substance. Um and so I have had similar conversations um as Jesse with students who are telling me that they are now using that and relying on you know the studies out there saying that it could help them um with depression, um with anxiety, even like things that they're they're thinking it's gonna support, but they aren't doing it um, of course, in any kind of regulated way within a with a therapist, with you know, folks who are trained um to be administering it, but are definitely using it much more regularly than a student who's telling me before that they might have used it at a festival, you know, like one off, and are um I using I've had students say, you know, weekly, even at this point, which is very different than how I had previously heard students talking about the hallucinogen use.
SPEAKER_01So it seems like there are two broad categories of use uh that I'm detecting here. Uh that on the one hand, you have just the need to relax, wind down, fit in, be cool, what have you. That all kind of is in one can. That's where you see, I'd imagine, a lot of the alcohol and even some of the cannabis use. Although I understand cannabis is kind of in between this and the next category, which is help. Uh be that help for studying in the prescription stimulant kind of way, uh, help to be a higher achiever and things like that. And that's kind of its own special version of that. But in general, help is to get psychological, psychiatric help. Uh and this could be for a number of reasons. I yeah, I think the hallucinogenic the increase in hallucinogens is actually rather interesting. And I mean w it very recently we had the very prominent death of the friends cast member. Uh Matthew Perry. Matthew Perry. Yes, exactly. Thank you. And it was clear that not only was he going to these legalized ketamine clinics where ketamine, though FDA approved as an anesthetic, is used off label legally, but not FDA approved for the treatment of depression. And Jesse, you're right about these these studies. The data is not there for microdosing uh in terms of having a a conclusive therapeutic benefit. I even saw uh a study on Silas Ibin showing that microdosing effectively doesn't work, uh, that it's no different than placebo, that in larger doses, and again, paired with therapy in a very structured, safe environment has had some benefit in some populations. Uh, but yeah, like you said, if you're just taking it and then going about your day and not doing anything to actually address your social determinants of social determinants of health, your friend circle, uh, your job situation, a number of other things, there can be no effect or worsening, perhaps.
SPEAKER_02Yeah, I mean, I think it shows sort of the way that information is conveyed these days, you know. I mean, I think in some ways, like there are studies, and then those studies get translated to like a popular press article or social media and then get translated again to friend groups, and it's like a bad game of telephone. And so what gets lost in that is probably like the actual nuance, right? And so it's not that they have no promise. Like as a psychiatrist, I think in a lot of ways, those medications and that class of medications has more promise than a lot of things we've seen in a long time because we've been pretty stuck without like quick things that could work to help people. But I do think that we, when it's translated, and then people go, Well, I can't access a ketamine clinic because I don't have anybody who does it. I can't afford that. Oh, I could get special K on the street. Like, let's see what that's like. And I think that translation and then that attempt to sort of like deal with something you're trying to cope with, and then thinking that you're doing something evidence-based in some capacity, I think is a is a dangerous translation. Um, you know, and I you use the word help. I mean, I a lot of people use substances for a lot of reasons. I would say that the socializing way is also in a way help, right? Because if you have social anxiety or you don't really fit in, you might be like using substances to sort of like have the be a different person in public than you're able to be without them, right? So it gives you a different personality, it gives you the ability to interact with people when you're shy. It gives you whatever that is. And so there are things like that that also come in with why people use. I think people also don't want to deal with emotions and like big feelings or or stress. And sometimes it can let you forget like grief or you know, sadness or or feeling like overwhelmed by things. And so people use for lots of reasons, and obviously, like their brains also could make them keep using, and then that's a whole nother category of people who then become addicted to what they're using. And so, you know, dabbling can quickly become a problem, and also dabbling is a problem if what they use can kill you right in the first try, too. So I think you know, yeah.
SPEAKER_01You said you said like getting special K on the street or something like that. We've seen instances of ketamine in the street supply being adulterated with xylazine or fentanyl or something else, uh which is which is very unexpected uh to see that because ketamine, as I said, is is legal, but as you just pointed out, access is such an issue. Uh as a quick follow-up to what you said about a bad game of telephone, this this whole situation does remind me of something I I saw TikTok that showed that avocado tea, you know, uh reduced my auntie's blood pressure from 220 over 110 down to perfectly normal. And one, okay, that definitely didn't happen, number one. Uh, but two, uh the only data I could find on that was incorporating avocados regularly into your diet, so in other words, increasing vegetableslash fruit uptake was associated with a statistically significant average reduction in blood pressure, but that's not the same thing as a cup of avocado tea magically erasing severe hypertension. Uh I just wonder if there's a similar thing happening with these substances and communication in general. But Megan, I was wondering, are you seeing this kind of pervasive misinformation on campus? Uh when it comes to what substances can do for people's mental health?
SPEAKER_00Oh, absolutely. Um, I think one of the biggest things that we are battle is still around like cannabis and the conversation, some of which you know, Jesse talked about. Um, but think about um the higher potency cannabis that we're using today, like what's actually available being very different than what I think students think that they're getting. Um, what they whether they're referencing it from things they've seen on TV or movies, or you know, what parents might have used when they were in college or just something, the references, what they think it'll be like is actually it's a very different cannabis. Absolutely. Um, and there's not an understanding among our students of really the potency than like the risks, whether that's you know, psychosis or even like more risk for developing an addiction to cannabis, then we it's different than what we need to think about before. Students are using that too often for sleep, is one of the things I hear a lot. And there is lots of just like misinformation out there about cannabis and sleep. Definitely like think about the long-term impacts. You might say that like it could help somebody in the short term, but they definitely are not aware of they're continuing to use cannabis to sleep, what impacts exist and actually like reducing quality of sleep over time. They aren't able to get into REM sleep, but there's there's actually things that are not gonna be beneficial for them. Um for like fentanyl and the risk in substances, it's interesting because I by and large, our students do know that fentanyl is out there and that it's a concern. And most of them, when I've asked in rooms if folks have like known someone who has overdosed, I mean, like the number of people the hands go up, those spaces is very high. Like they are aware. However, when I talk about the students directly who are using cocaine or maybe like buying any kind of like what they think is a prescription drug, where we think both the risks are of fentanyl like highly being laced there, they're not like linking it though to actually sort of changing behavior often, of making sure that they're testing or of knowing, you know, kind of where they're getting the substances. It it's it that part is interesting to me in what's happening still for them, of not making the connection or having that kind of education still to keep themselves safer if they're going to be using substances that would put them at risk.
SPEAKER_01So to make sure I understand then, they they're aware that fentanyl is contaminating various drug supplies, street supplies, it could be any fake prescription, it could be in the cocaine supply, it could be in pills, but they're not aware that they themselves would then need to test. And when I say we're speaking, of course, in generalities, I'm sure there are kids who do understand this.
SPEAKER_00Oh yeah, and I certainly have some folks that do, but I think by and large, the conversations that I have, um, when we talk about just whether folks know about these things, hi. Whether they they are then actually using substances that could put them at risk, are they taking the steps and changing behavior to try to reduce that you know risk? Oftentimes not. And so I think that that the big things that we're trying to combat and doing more education um around opioid overdose, um, trying to, you know, get fentanyl test strips in front of students is an option, making sure that they're not using alone, they have narcane available, these things and like building in those practices. But I just think that when I start conversations with students, like, oh yeah, like I know these things. But then if I ask swallow-up questions about what they're doing about it as they're then going about using the substances and they know we're higher risk and it just doesn't often connect.
SPEAKER_01So you're talking about implementing harm reduction policies on a college campus. Uh, what does that look like?
SPEAKER_02Yeah, you know, it's complicated because I think whenever you want to change policy or whenever you want to change action, it has lots of different layers to it. So culture is a big component there, right? So, what do people know and understand about the drug, why you would change something like that, why training is necessary. I think you hit a lot of misinformation there too, like Narcan is addictive. Or if we give Narcan, then people will use drugs, right? And I think that that is a gross misunderstanding of harm reduction for a long time. But I think that comes out when you try to implement something on a campus where people are concerned about people using substances anyway, and probably don't all have the same like background understanding of addiction or drugs in general, or you know, all of the medications that we use for harm reduction or the or testing strips, et cetera. So it's a lot of education, honestly, in order to even like start the process of getting people trained and getting people interested or getting people on board, because you can't get people on board with a policy change if they think it's gonna encourage drug use. Like there's just it's a non-starter, right? So I think, and Megan can talk more about how they've been able to do some of that where they are. But you know, I think globally, but also like if we look at our whole system, you're gonna hit different people and different levers of leadership that have misunderstanding. So to implement a policy across a whole campus requires a lot of conversation and education and getting people on the same page before you can even try something, right? So you can't have trainings if they think you're gonna encourage drug use, right? So you have to get a lot of people on board before something like that happens. In a campus, that's also complicated just because there's so many silos and so many different people involved. Right. So getting like a dean's office involved is different than getting housing involved or getting fraternity and sorority life involved or getting athletics involved. Like I would love to tell you that they're all the same family and they hang out every day, but they're like, you know, distant cousins or something, right? Like they are in these like silos where to really do a good job, you have to go to every silo and have those same conversations over and over and over again until all these different people and different levers of a community are on board, especially, you know, across a big system. And so that I think is like a big barrier to even starting it, let alone like then the complicated nature of having to roll something like that out and getting buy-in to even have people show up at trainings that you're having. Or um, you know, you have to partner with local organizations to get like Narcan or fentanyl test trips, right? Because it costs money and they have to be replaced. And so, you know, there are a lot of levers there too, once you actually go to implement things. But I think even like farther steps back, which people might not think about, is like just how complicated it is to try to change the minds of people who don't understand something or have no exposure to it, even if you think it's the right thing to do. Right. Like you can't get people on board if they don't know it. And just because you know it and see it and experience it and talk to people who deal with it doesn't mean that you can change someone's mind like that quickly about it. I mean, I defer to Megan on some of this too, but she can talk about what she's had to do on her campus. But I think that a lot of this is like a global problem. It's not a Tennessee problem, it's a worldwide problem on how we conceptualize substances.
SPEAKER_01Absolutely. I was gonna say, Megan, you've had some successes though. Uh please tell us about that.
SPEAKER_00I have. However, I'm just to you know, just his point, like it has taken us on our campus about six years to get where we are. These are conversations that we started um like back in 2019 and bringing and some of our you know, Tennessee ropes members on campus to do Narcan training.
SPEAKER_01That's the Tennessee uh regional overdose prevention specialists.
SPEAKER_00No, it's just open to the campus community. We couldn't mandate in any way. It wasn't super regular, but we started doing that. And so, but it does take time, like that culture piece. So it was planting seeds and then growing from there as more folks were getting exposed. Um, and certainly as the crisis continued to develop and more funding was coming out, no paid settled money and other things to put more of a spotlight on the work. It helped us grow. But we had to have conversations with different folks many times over the years to get to where we are. Um so it wasn't immediate yeses. It was coming back to the table, you know, kind of every year often of kind of re-engaging certain partners to see um if they, you know, would be open to us doing training with their staff, um, particularly like with our resident advisors, their student workers in our residence halls in particular. You know, that was an ongoing conversation. We were able to train all of them um this fall. So little everyone in housing, including the RAs, resident directors, housing desk assistants, everyone is trained and was able to get in our CAN if they wanted to, which is a big win, but didn't happen overnight. We are also at a point where our general counsel has fully kind of reviewed Tennessee state law and given more explicit permission to UTC employees, include student employees, to administer Narcan without like fear that the university would, you know, come back at them with concern, even though we've had the Good Samaritan law for a while and the covered in a loxone administration. However, there was still fear, you know, on the campus of did the university fully understand that law? Were they going to stand behind them if they were to administer an alloxone?
SPEAKER_01You know, that actually does bring up a good point though, because the law does protect against criminal liability in most circumstances, but it doesn't say anything about academic discipline.
SPEAKER_00That is true.
SPEAKER_01I can understand why there might be some fear there.
SPEAKER_00Yeah, I think that that's fear for our students. I think a lot of, you know, the other stuff we're talking about is kind of fear for staff and faculty of whether or not they could lose their job. But yes, among our students, there's definitely fear of those disciplinary repercussions, though we do have a medical amnesty policy, which many CIPs do, that will protect both the person who is experiencing harm of some kind, um, as well as the person who is responding and getting help for that individual. We try to, when we do education with students, especially around like we're just mentioned, make that a point of conversation and talk with them about that being there. Um, that our priority is saving students' lives. And we don't want things to get in the way of students calling for help, being, you know, being afraid that they're going to get in trouble. And then, you know, potentially having um a tragedy occur. But many students are not aware. When I have conversations about the medical amnesty policy, it's often new information to students. And so there's a lot of work still to do there to decrease that fear.
SPEAKER_01It is a very widespread problem. You mentioned the Good Samaritan law. Despite this, even in the community, let alone college campuses, we see this continued fear of reprisal at the legal level.
SPEAKER_02I mean, the doctors, I mean, like I'm a I'm a doctor, obviously. I mean, we we're taught like we have to do CPR, but then we're also taught we can get sued for CPR, right? So it has never been a really understood law. And if you're a healthcare worker, you kind of go with your oath above all. If you're a faculty member, that's not your oath. Your job isn't to like have to jump in and save somebody. You would hope that they would want to as a human to protect students, like Megan is saying, but it's complicated because our legal system is complicated. But I mean, it's weird to be learning CPR as a doctor and be told like you have to do it, but also if you break someone's ribs, they might get mad, right? Like it's a weird kind of duality to hold to be told both those things and at the same time know that like you'll do it anyway. But like it, it's I don't think our legal system is fully caught up with the idea of like we should be protecting and helping people, you know. But I'm not a lawyer and and I'm sorry to lawyers listening. It's not a judgment call. It's just, I think medicine practices like scared a lot of times because of things like that. And I think that, you know, we're gonna see that in students and faculty even more because they're not doctors, like they don't even know how to use, you know, they got a training, so they're scared to use it in the moment. It's scary. Like I've even done the Heimlich maneuver on a family member, and I'd never done it in med school. It's scary to do that stuff because like if you do it wrong, like not for suing, they also could die, right? Like it's it's it's a scary thing to have that kind of responsibility. And I think I understand where the fear comes from because you're already scared of not doing it right, let alone like some legal repercussion that's like sort of a footnote. But I mean, I I think that compounds all of this misunderstanding that we're talking about to begin with.
SPEAKER_01For sure. Yeah, we're definitely a very litigious culture.
SPEAKER_00Well, that's where it helped, though, to have our legal team kind of to be at the point where we were able to, there was already an awareness. We'd done training, we'd, you know, scaled up levels of leadership who had received training and kind of debunking some concern. So then the legal team being able to review and come in and now say actually to also like even from a legal side, we are you know going to explicitly allow we are in support of staff and faculty doing this. Also, like the number of trainings that I've received like see requests for since that happened has also like, you know, dramastically increased. We're talking about that, just reducing that fear and concern, those barriers for folks to act, to engage with training, to be thinking about this, to even just uh you know, ideally put resources on campuses behind it.
SPEAKER_01Well, speaking of putting resources on campus, uh, let's talk about uh getting the uh one boxes uh uh at UTC. Uh so uh we've covered what the one box is before on this show. Uh it's uh one of these types of first aid kits. It mounts to the wall like an AED, it has uh naloxone in it, uh, but as well as a training video component uh for anybody who doesn't know what they're doing. Um so what's the situation at UTC?
SPEAKER_00So we have purchased 17 one boxes. Um they are about to, I hope like this week, um, be installed in all 11 of our residence halls. They are then going to be um placed in high traffic university buildings. So um, like our university center, our um arena, those sorts of spaces, um library. We, you know, in that process had to have other conversations with building managers to get them on board. And it was actually really, you know, heartening to see that like everyone was really excited, actually, within being reached out and being asked to if they were okay with us moving forward with putting these in their buildings. So that has been helpful. Um, we've also been able to build in systems with our public safety fix, the people who are going around and checking AEDs on a regular basis to sort of build in checks for our one boxes as a part of that.
SPEAKER_01So that's actually a really crucial point. You've built into already existing campus health policy to oversee the restocking and supply of these boxes. Uh that that's actually a really crucial component because yeah, just slapping a box with a dose of naloxone on the wall is one thing, but to ensure that there's always a dose there is something else entirely.
SPEAKER_00Yeah, the intention is um to grow that and have that be available in every building since all of our buildings have AEDs and make it really like standard. But we, you know, through conversations with the campus, decided to prioritize those high traffic student buildings and see what utilization looks like and how often we're restocking and just the questions that folks had to be able to hopefully then like scale it up moving into the next year.
SPEAKER_01This definitely fits in with a broader scope of things. Uh as I said, we've mentioned before how UT Smart has a partnership with Gibson Gibbs, uh, the philanthropic wing of Gibson guitars to get these uh same boxes into music venues. Uh and so we're doing this in the Hamilton County area as well, at areas at high risk of overdose. But this is like you said, the the high traffic buildings being a priority is is definitely a a key piece there. Uh how did the conversation go? I know you said broadly speaking, in terms of harm reduction and education and prevention work, this has been a long uh process. Uh has just this latest phase of it been the latest step in this long conversation, or did this particular conversation go easier or was it harder?
SPEAKER_00It was actually fairly easy, but I think it was but it was coming right on the heels of a lot of momentum on our campus and conversations around um obedioverdose prevention. So an opportunity to kind of tack it on like at a time where there was a lot of focus, and I think that helped. So it was coming off of those conversations this summer with our legal team. It was coming off of the you know, the training for all housing staff, extending to like all of our university center staff, including the student workers in this space. Like there was starting to be more um widespread, like standardized training. And so there were these people who I had to pull in the room, we were talking about one boxes who were more aware. It's like more open to pursuing this, especially when um, you know, I said that we would pay for it from our budget. Um, which is um part of I mean, that's the battle though, the resources, like who's gonna pay for these things? They do cost money and campuses are funded differently. Yeah. Um, and so the opportunity for that is different. So I think it, you know, it was fairly easy, but I don't think it would have been if there hadn't been enough other like conversations already happening.
SPEAKER_01Do you have any advice for other universities and campuses uh considering doing this kind of project?
SPEAKER_00I just I think about it in the context of the work that just been doing and pulling in all of our campuses to look at like standardizing, at least for like the UT system and apparent understanding of doing a pub of rotose training. But with that, it's I think having conversations with people who have done this already. So, like part of that is been to like pull people into that room too who are further along and have done that work with people who from other campuses who may not be as familiar or haven't been able to do it on their campuses and learn from one another. So there are lots of other campuses outside of Tennessee who have done this work. And so being able to lean on colleagues, I think is a great starting place, like learn from them of what they have done and what was useful like um on their campuses to move things along. And then I personally think you just have to start somewhere, do something. I'm not even saying it has to be this if you have to go right to your legal team, you have to go right to housing, like it. I think you just need to start with something, even from something small. So if all you can do right now is bring in external partners who have you know the resources and the time and energy to come in and engage your campus, that's great. You know, like start start there because at least then the conversation is happening and you're able to maybe invite key partners like to the table. Like, hey, this training is happening. You know, have you thought about this? Have you been trained? And start you know, there. We're just at a point, um, not only as a country, but definitely even on college campuses, like what whether it's rates of use or just like general risk for overdose, as high as it is, we can't not be doing anything. So something is better.
SPEAKER_02You know, I started my job in February. I am rolling out understanding what's going on across our system. We have very different schools, we have people doing great work across the system. And my job is not to tell them what to do, but to find areas of concern that we all have and like help us help each other, really. That's how I see my job. Like, this is one of those areas where we all decided that, you know, some people were further along than others, but everyone really wanted to dedicate energy and time and conversation around it. And we formed a working group to do that. Megan's one of the co-leads of that. Um, and so is Shannon Perry from Martin. And, you know, I think what we're really trying to do with that is to help like kind of level set across the system that this is important. And, you know, where those things are are challenging on certain campuses. Maybe we have advice from campuses that have figured it out, or maybe they need support from a system level to do it, or maybe we need to all have goals together. You know, I think in a lot of ways, we're trying to tell the story of what's going on on our campuses and why this matters too. Um, but I think it fits within a lot of the priorities for, you know, uh the grand challenges in our school system, the stuff that you're doing at Smart. Like I think that there's so many of us concerned about this. And then again, you sort of see the siloing of academics and you and you say, well, you know, all these people care about this, but they're not in the same room. How do we get them in the same room? And how do we move forward with all of our collective understanding to push this faster? Because, you know, like Megan said, like, I don't want every school to have to wait six years. You know, people die of this. I don't think any of us want students to die or faculty or staff to die, or a visiting student coming for a football game to die, right? Like there's so many risks that come with this that I think we we're committed to figuring it out and not super slowly and trying to get to a place where across the system, you know, people can feel safe that we're training people that they have access, that they know where to get it, that, you know, maybe some places are starting a little more behind than UTC, but they'll get there and they have plans to get there and they feel supported in getting there. And I think we want to be a school that this is something we're really working on and that we care about and that we recognize is a big issue of our time, and that we have to be dedicating time, capacity, resources, support, my magic wand of my title behind it, um, whatever it is. I think that this is something that we've decided that we really want to work on. And it came very obviously to the surface very quickly in our groups of already meeting that that was something we wanted to commit to. Like we didn't implant it, if that makes sense. Like we didn't say, this is what we're doing. We like had conversations and this bubbled to the surface in all of them, and that became a mutual decision. And that's like what I hope we can be doing in the work that I'm doing is like I'm not telling people what we need, I'm figuring out what we need and helping people get there.
SPEAKER_01Yeah, that makes a lot of sense. And I'm glad you mentioned Shannon. Uh uh, she's a great addition to that team for sure. Uh, we've worked with her before, she's wonderful. There are at the policy level, especially at the state level, there does seem to be a shift in the direction towards increasing access to naloxone in educational settings. Just this last legislative session, they passed a bill that now requires K through 12 schools to keep naloxone on the premises and prohibits the banning of carrying naloxone on campus. Do you think a law oriented at college campuses and universities would be beneficial for reducing the stigma? Is it sort of like takes the burden off of a personal destigmatizing conversation? You know, oh, we don't want to encourage, we don't want to give the idea that drug use happens here and and high enough so on and so forth, the concerns you laid out earlier, versus they can just say, well, it's the law, we have to.
SPEAKER_02Laws always help. I mean, the ways that laws hurt, right? Like, I think that these things have levers and they're in different ways, right? You need the on-campus like education work, on campus conversations and ground support and getting things going. Like that is absolutely necessary, which is why like my job could not ever be useful unless we had the magic that already exists on all of our campuses, right? But you know, we need that. But at the same time, you need policy in line with that to help. You need funding in line with that to help, right? Like all of these levers are important for successful public health rollout. So whatever way policy or law gets involved in a helpful way and not a hindering way is never going to be something where I'm like, oh gosh, because anything you can lay your hat on as something to like motivate is helpful, right? So, like this is a commitment of the state. They're giving these grants, like, yay, right? That helps too. Or this is a commitment of like our school. This is what they're doing. Yeah, right. Like these big sort of grand things, like sometimes seem silly, but really what they do is allow the people who were doing the work to have like more of a blessing to do the work. And that's what law can do in just easing some of the fear and misinformation and concern.
SPEAKER_00I think it can also bring a lot more people to the table who weren't maybe there before on some of the campuses. Um, I think about like when the state put in the law that universities needed to have a prevention, intervention, and postvention policy for suicide. Those were conversations that you know, my campus, I'm sure many others were happening. And there were policies in place, maybe, but they weren't always formalized. And so that had to get people to the table to really have a conversation about what that looks like. How do we formalize it? How do we make it clear? And over then like standardize some ways like our approaches. So I think in that way too, where it will allow people who maybe were already doing the work to hopefully better engage other people who need to be involved in that work.
SPEAKER_01Okay. Any final thoughts?
SPEAKER_02I mean, personally, I'm very hopeful about this. You know, I think that it could feel like a big, big task, and it is a big, big task, but I think there's like a lot of enthusiasm around change and be doing the best, like evidence-based work around it. I feel like very grateful that I get to work with people like Megan and Shannon who like care about this so much because I can't do anything if I don't have people who already get it. Um, but also like Megan's work has been honored by the White House. Like, she's doing amazing stuff in anybody's measure. Like, it's not just my decision that it's good work, it's like the national decision that it's good work, right? And I think we need to honor and support that as much as we need to grow in what we're doing everywhere. And I and I hope that, you know, people listening can both praise where we are and hope we can all do better and have hope that, you know, as an organization, as a school, as a system, we're we're committed to figuring this out together. And it's a really important issue that isn't going away. Um, and is one that we need to spend time and energy and thought and bringing people together around.
SPEAKER_00You know, we're having conversations, a lot of this is around like prevention, you know, like intervention, thinking about the supports that folks need, who might be struggling. Um, but college campuses also the need to be thinking about recovery. If we're engaging in this. Kind of work on the campuses and are acknowledging that it is a concern among our students. We also need to be thinking about what happens once they receive treatment and are still on our campuses and are needing now ongoing like recovery maintenance support. Right. You know, for us is something that has to be a part of it. There is going to be a kind of missing gap of now what do we do with students who are hopefully are getting better, getting access to the resources, are getting help, who are, you know, go maybe go through an overdose and they live and like what's next for them to consider as well.
SPEAKER_01Alright. That's a very, very good point, indeed. Very good points all around. Alright, uh, Dr. Jesse Gold and Megan McKnight, thank you very much for joining me on the Smart Policy Podcast. I very much appreciate it.
SPEAKER_02Thanks for having us. Thanks for having us.
SPEAKER_01For more episodes on in-depth discussions on Tennessee policies related to substance use disorder by a range of local experts. Please subscribe to us wherever you get podcasts and visit our website at smart.tenessee.edu. I'm Jeremy Corvellis. Thank you for listening and see you next month.