In November, the Oregon Health Authority began offering all middle and high schools in the state free kits containing naloxone, a medication used to reverse overdoses from opioids, including fentanyl. Fake prescription pills laced with fentanyl have been linked to accidental overdose deaths among multiple teens in Oregon. Amid this backdrop, a new investigative series from The Lund Report, University of Oregon’s Catalyst Journalism Project and OPB takes a look at what drug prevention messaging looks like in Oregon’s school districts. The investigation revealed that what students are being taught varies widely, and that many school districts don’t use programs backed by evidence that they are effective at delaying or preventing substance use.
Emily Green is the managing editor of The Lund Report and the lead reporter on the series. She and Amelia Templeton, OPB’s health reporter, join us to talk about what they heard from district officials, educators and high school students around addiction prevention education in Oregon.
The following transcript was created by a computer and edited by a volunteer:
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. [Youth] 12 to 17 years olds in Oregon use cannabis, cigarettes and illicit drugs at higher rates than the national average. And as fentanyl has hit the west coast, overdose death rates for teens here have climbed quickly over the last five years. State law says schools have a role to play in this. It requires that districts have comprehensive substance use prevention plans in place, but no one had taken a statewide look to find out what schools are actually teaching until now. Emily Green is a managing editor at The Lund Report. She’s been talking to teachers, students and experts to find out what districts are doing to try to prevent or delay substance use. She joins us now, along with OPB’s health reporter, Amelia Templeton - one of her partners on this project. Emily and Amelia, welcome back.
Amelia Templeton / Emily Green: Thank you so much.
Miller: Amelia, first. I just want to start with some of the data. What does it show about substance use disorder among young people in Oregon?
Templeton: I think there’s three data sets that are helpful. There’s the Oregon Student Health Survey and then there’s a National Survey on Drug Use and Health, and finally overdose data from the CDC. So to take the state survey data first, about 11% or 12% of high school juniors report vaping or using cannabis in the past month, about 7% report binge drinking and about 1% reported misusing prescription opioids in the past month. A caveat to all of this, the students that we interviewed told us they think that survey is under-counting use, because students don’t really like to share their drug use with adults.
From the National Survey, we know that 12 to 17 year olds in Oregon are using cannabis cigarettes and illicit drugs at rates that are higher than the national average, and also use rates go up significantly after high school for the 19 to 24 year old age group.
And then finally, and most concerning as fentanyl has become a part of the drug supply in Oregon over the past five years, the risk of overdoses for young people has gone up fivefold. And in the last year that we have the full data for, in just the 15 to 19 year old age group, there were at least 26 overdose deaths.
Miller: Emily, what did you hear about this from a teacher you talked to - a science teacher named Zach Lazar in South Eugene High School?
Green: Zach Lazar has been teaching science at South Eugene High School for about six years, and he said that he’s noticed that since kids came back to school following the pandemic, it seems that a greater number of them seem to be struggling than before. And he said it makes him sad to see how easy it is for kids to go down the wrong path. And he said in just the past two years, he’s lost three of his students to drug related deaths.
Miller: You focus, as I mentioned in my intro, on the role that Oregon’s almost 200 school districts play in this. What are they required to do under state law?
Green: Under Oregon State law, schools are required to have a “comprehensive substance use prevention plan” in place, and they’re supposed to update it every year, based on the most recent research. Right now, Oregon kids are facing an increasingly dangerous drug supply and a range of unparalleled external pressures that are leading to higher rates of anxiety and depression. So we wanted to know - what are schools doing to adapt? What are they doing to help prevent and delay drug use in this new reality? Are they living up to the letter of the law? And given the gravity of the situation, are they using evidence-based programs that are likely to actually work?
Well, we quickly learned that the Oregon Department of Education doesn’t keep tabs on what specific programs are in use. So we partnered with the University of Oregon’s Catalyst Journalism Project to survey districts across the state, asking them what they teach for substance use prevention. And that was no small task. We couldn’t have done it without the help of Elizabeth Yost, a student journalist with the project, who spent a lot of time over the last six months repeatedly reaching out to districts to gather this data.
Miller: Well, how likely is it that districts are using evidence-backed substance use prevention curricula?
Green: Districts have a lot to choose from, and pretty much every curriculum out there makes the claim that it’s evidence-based, but evidence-based can mean a lot of different things. What’s important is figuring out what is the strength of the evidence. And that’s a huge question and it’s not one that we were trying to evaluate on our own. There are four different clearinghouses - two of them are run by the federal government and two are independent - that look at these programs and identify the ones that meet some minimum standards of efficacy. We consulted with these clearinghouses to see what they said about the programs that are in use in Oregon. And it turns out that most districts, 60%, aren’t using any program at any grade level that has been certified for meeting even their lowest bar for evidence.
First, we just really wanted to get this information out there, because up until now there was no easy way to look up what your kids’ school was doing for prevention. So we built this searchable database, and now any parent can select their school district, see what prevention program is taught, and see how we rated it. And listeners can find a link to that data portal in the story about our investigation that was published on OPB, or they can find it by going to thelundreport.org.
Miller: What did you hear from local or national experts about the kinds of curricula that are most effective? The lessons that make it, say, more likely for a student to delay the age at which they’ll try drugs?
Green: Prevention science is fairly new, but already scientists have learned quite a bit. They told me that fear tactics don’t work and neither do one-time events like assemblies or a classroom visit from, say, Officer Bob. But what does work are embedded programs or more lengthy curricula that focus on building social and emotional skills, like developing empathy, building confidence and knowing how to self regulate.
In middle school and high school, that looks like combining those lessons with lessons about substances and peer pressure and resistance, that’s been shown to work, and so do programs that counter peer rejection. And then when you’re looking at early elementary school programs that never mention drugs, but that focus on self-regulation and learning to identify emotions are considered some of the best approaches to substance use prevention.
Miller: OK, so that’s what experts say districts should be doing. But if, as you found out, 60% of districts are not using evidence-based curricula, what are kids in general being taught?
Green: School districts are taking a really wide variety of different approaches to this. Districts listed more than 90 different branded curricula and programs related to prevention. And then there’s all the other stuff like assemblies, lessons on fentanyl and social media campaigns. In terms of the content that students are getting, it’s all over the map - from a new version of DARE that’s still taught by police officers on one end, to a harm
reduction-focused curriculum on the other.
Then there’s really a range of strategies as well. About 20% of districts are essentially teaching a chapter in a health book for their strategies, and others have found ways to adopt evidence-backed programs. And then many are deploying different mixes of teaching supplements that haven’t been well researched. And I think it’s also important to note that districts are all adopting these social-emotional learning programs following a law that was passed in 2021. Although we found that these programs really run the gamut, too, in terms of how evidence-based they are.
Miller: Amelia, you talked to a group of students who are in a drug prevention club at West Linn High School. What did you hear from them about why they wanted to be in this club?
Templeton: Well, they said high schoolers often tune out messages coming from adults, but they are concerned about the degree of substance and alcohol use in their school, and they’re hoping that the message might land differently if it’s coming from other teens. Some of them specifically said they were concerned about younger kids in their life they know, or friends, and they’re trying to channel that into doing something good.
And for some kids it was also about their family history. That might mean a parent in recovery. One club member is the daughter of a local paramedic who has treated a lot of people for overdoses and she carries Narcan with her. So they had a variety of different reasons for coming to it.
Miller: What did you hear about just how prominent these issues are for kids these days?
Templeton: Well, that group of students told us that even after decriminalization, in their school, experimenting with street drugs, harder drugs, is very much outside the norm. But cannabis, drinking alcohol, vaping, nicotine - those things are just extremely common and they were shocked at how common it was. But cannabis, drinking, vaping - these things, they said, were really just common. One of the students, Aiden Sauer, a sophomore, described vaping in particular as just a big part of high school culture.
Aiden Sauer [student]: When I was in middle school, the biggest scandal of the year was a group of people getting caught vaping in the bathroom. But now that happens daily, like every class period, and now that we’ve gotten older and everyone has more access to things, more freedom. It’s all so much more in our faces now.
Miller: So what are the members of this club - and this again, is in West Linn High School - what are they doing to try to get their classmates to make safer decisions about alcohol or drugs?
Templeton: A lot of it is what you’d expect from a school club - monthly meetings, speakers, videos that they’re sharing on their school’s broadcasting system. Holly Pearce, who’s a senior, said that what she’s really trying to do is start a conversation about drinking and substances with zero judgment so that there’s no shame for kids who are curious, but also no shame for young people who opt not to try these things.
Holly Pearce [student]: We have to just give everyone the tips and just the knowledge and the education about it. And specifically, also just having everyone kind of know about themselves and their family and their genes and what they’re susceptible to so that you can make an informed decision. That’s what I think it really comes down to, because you can’t force them to not do drugs, you can’t force them to not drink at a party. Like, it’s just having the knowledge because a lot of kids, with that knowledge, will end up saying no.
Miller: Emily, I’m curious what stood out to you in terms of the differences of what these kids are learning about drugs and alcohol in classes versus what they have been hearing in this club?
Green: We learned that this group of kids got a lot of what sounded like scare tactics from the lessons they were getting at school. They mainly learned about drugs in health class and they learned that they’re bad for you and it’s bad to do them. For Clara Alexander, a 14-year-old freshman, this had some implications for the people in her personal life.
Clara Alexander [student]: In my neighborhood, we had, like, block parties and it would usually be like all the kids went together and they ate food and they talked together while the parents either drank or smoked. And when I had the education about these people being in like, in quotes, “bad people,” it made me wonder if, if my dad was a bad person or if the people who live next door, if they were bad people too. Like, before I learned that these actually weren’t bad people - they were hurting, I’d wonder, are my friends that are older than me, or my cousins - are they bad people too? It’s really disappointing that that’s the way that they try to convince people to not use. It doesn’t make anything any better.
Green: You’ve learned that these are people that are hurting. Is that something that you being in this club has helped you learn, or have you learned some of that from school, or where did that knowledge come from?
Alexander: I’ve learned it both from my mom’s sobriety and this, like, this club, has solidified that.
Miller: Amelia, the broader context here that our Oregon listeners probably need no reminder of, but it’s worth mentioning in the context of this conversation, the broader context is that we are in a state where voters have decriminalized the possession of all illicit drugs, including meth and heroin and fentanyl. How does that play into what we’re talking about?
Templeton: A couple of ways, I think. First, I think it adds some urgency to trying to figure out how to support young people navigating these decisions. Most of the students we talked to said, this is kind of an extra confusing issue right now. And then second, the curriculum that have evidence behind them - and often that might look like a clinical trial in some other state 10 or 15 years ago, that showed the kids who went through the curriculum were less likely to initiate smoking or drinking, or started later. Most of those trials haven’t been done in a state like Oregon where drugs are fully decriminalized. So I think it’s a little hard to know fully what is effective now.
Green: And I would add to that, that this is exactly why prevention scientists say it’s so important that communities and school districts, whenever they implement any kind of prevention strategy program or curricula, that they track whether or not it’s actually working in that setting, at that point in time.
Miller: Emily, speaking of Measure 110, Portland Public Schools (PPS), I learned in your reporting, is one of three districts in the state that uses a curriculum developed by the New York-based pro-decriminalization advocacy group that funded the Measure 110 campaign. What are PPS kids being taught?
Green: PPS teaches this program called Safety First, and it was promoted as the first harm-reduction based curriculum for high schoolers in the country. And it teaches the effects of drugs on the body, but it also gives advice for safer drug use, such as “start low and go slow” when trying a new drug for the first time. Don’t mix drugs.
Last spring, PPS’s use of the curriculum sparked some concern because it was teaching lessons that were designed by the Drug Policy Alliance, which is an advocacy group whose mission is drug decriminalization and legalization. It also backed Measure 91 to legalize cannabis in Oregon. Its mission is not childhood education. And I think this shows in a study that the Drug Policy Alliance funded. Among other things, it measured the program’s success in increasing students’ level of drug policy advocacy after being taught with the curriculum.
Miller: Amelia, fentanyl is such a new scourge in terms of illicit use and widespread availability. And I imagine that the process of assessing any curriculum to know if it’s effective, if there’s evidence to back it, that has to take some amount of time. So do we even know what is more likely to work in this age of these super powerful, everywhere synthetic opioids?
Templeton: I think we don’t, I think that’s another area where there’s a rapidly evolving situation and the state does require schools to teach specific content around the dangers of synthetic opioids and counterfeit pills, which I think makes good sense. But at the same time, we don’t have a lot of information about if the way that we are teaching those things is effective. So that’s another place…coming up with some way to try to track, is this changing the decision students are making? [It’s] important, if we’re going to take the time to teach them these things in the classroom.
I will say, one thing we do know works to counter fentanyl is Naloxone, and there’s also a push to get more Naloxone into schools. Lots of fentanyl overdoses are witnessed by other people. So there’s prevention education, but there is also obviously room for harm reduction in this conversation.
Miller: Amelia, how did the high schoolers you talked to talk about peer pressure or just social norms?
Templeton: I was really interested in that, in part because it’s hard for me to imagine my past self in high school being willing to join a drug prevention club even if I was like, totally that kid. And yeah, they definitely feel peer pressure. The president of the club, a senior, Jonathan Garcia, told us that it was really hard at first to choose to be the face of, “Don’t do drugs in high school,” but he has found a lot more acceptance than he was expecting. Here’s what he said.
Jonathan Garcia [student]: In the beginning, it was like, “oh, what are they gonna think of me?” Like, am I gonna get invited to parties? Am I gonna do all that stuff? Then later on, and as I got more involved, I was like, no, this is good and I don’t care if people don’t want to be my friend because this is a good thing. It’s not a bad thing. It’s a good thing that I’m speaking up for this issue and we need more people to do it. And so it was more of like, in the beginning, it was like, “oh, I’m gonna lose friends,” but I haven’t. It’s been more of like a “thank you,” because no one else would.
Templeton: So do you get invited to the parties?
Garcia: Yes, still do.
Miller: The perfect follow up question to ask – kudos for that.
Templeton: It was a credible answer, too. If you met this guy, you’d totally believe that he can pull that off.
Miller: I can also say he’s a very fast talker. Emily, what did you hear from experts about the age at which these lessons should start, and what’s happening in terms of different grade levels in Oregon?
Green: Experts say prevention programs should start as early as preschool. And again, I’m not talking about drug-focused programs. We’re speaking about social/emotional learning focused programs. We just looked at K-12 for this project, and what we found is that more than half of Oregon’s districts aren’t using evidence-based, backed programs at the elementary school level and many are relying on health class to get the job of prevention done. And districts told us there are challenges in even teaching just that. There are a lot of competing priorities and health and substance use prevention just aren’t rising to the top of the list for a lot of districts.
But we also found that about 38% of districts are using programs that have some science backing them up in their elementary schools. In fact, we visited an elementary school in Forest Grove that’s made it a big priority, embedding the program into every classroom and into the school’s teaching culture.
Miller: What about parents? What role should parents play in all of this?
Green: One of the incredible things that we saw in a lot of the districts where really robust prevention is happening, is that it’s being driven at the grassroots level by teachers and by parents who decided to get involved. Like most states, Oregon schools are local-controlled. Schools have a lot of autonomy in what they want to teach. So when parents get involved and start going to board meetings and lobbying their districts for better prevention practices, they can make a real difference.
I think West Linn High School is a good example of that. The kids that we heard from today are members of a really robust club that’s led by Pam Pearce. She’s the mother of three kids who grew up in the West Linn-Wilsonville school district, and she got involved after researching what prevention programs her kids were getting, and now she’s running this prevention club that has, if you can believe it, more than 180 teenage members just at that high school.
Miller: Emily and Amelia, thanks very much.
Green/Templeton: Thank you, Dave.
Miller: Emily Green is the managing editor of The Lund Report. Amelia Templeton is OPB’s health reporter.
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