College student attitudes and perceptions toward opioid overdose and harm reduction at a large, public university

<h2>Abstract</h2><h3>Background</h3> The number of college-aged students using illicit drugs has increased, alongside cases of polysubstance use and the addition of illegally manufactured fentanyl into other substances. Harm reduction strategies have been implemented to reduce overdose encounters. Literature has focused on college students' knowledge of these topics; however, evidence is lacking regarding student attitudes toward opioid overdose risk and harm reduction tools and their perceptions and knowledge regarding access to those tools. <h3>Objective</h3> This study aimed to assess (1) student attitudes regarding opioid overdose and harm reduction and (2) perception and knowledge of access to these services at a public university. <h3>Methods</h3> This survey was conducted by an on-campus pharmacy at a large university in the southern United States. A 32-item survey was developed in Qualtrics and distributed using Listservs and e-mail groups and by posting flyers around campus. Those 18+ years and students enrolled at the university were included. The survey included 3 sections: (1) perceptions and attitudes, (2) supplemental questions, and (3) demographics. The survey remained open for 30 days. Results were analyzed using descriptive statistics. <h3>Results</h3> A total of 196 surveys were included. Most respondents were unlikely or very unlikely to obtain naloxone for themselves (n = 113, 58%); however, almost three-quarters (n = 136, 70%) indicated that they were very likely or likely to recommend obtaining naloxone to a friend. Of 174 comments provided, 64 (38%) mentioned a lack of knowledge of resources and 26 (18%) cited stigma as a barrier. Most respondents (n = 141, 72%) were unaware that naloxone is available free of charge from on-campus pharmacies. <h3>Conclusion</h3> Many college-aged students agreed that there is a risk of overdose on campus, a lack of knowledge about harm reduction tools, and a need to increase access to these tools. Students' attitudes toward the need for harm reduction tools highlight a need for expanded education in this population.