Opioid education and naloxone distribution (OEND) programs have been implemented to prevent overdose deaths by expanding knowledge, training, and access to take-home naloxone (THN), yet overdose mortality continues to rise. Expanding naloxone access on college campuses represents a potential strategy to address this persistent challenge, as students may encounter overdoses in their broader communities. Prior studies demonstrate that campus-based OEND programs improve knowledge and attitudes toward people who use drugs, but little is known about which campuses provide naloxone, how it is distributed, or the extent of student acceptance. To address these gaps, the present study aims to examine the prevalence and correlates of student support for naloxone distribution and explores student perspectives at a large public university in the Mountain West.
The study recruited University of Nevada, Reno students aged 18 or older through convenience sampling, yielding a final sample of 614 participants. Using an explanatory sequential mixed methods design, data were first collected through an online survey assessing support for naloxone distribution, perceptions of take-home naloxone, familiarity with people who use drugs, overdose experiences, stigma, and demographics. Survey data were analyzed using descriptive statistics and bivariate tests (Chi-square or Fisher’s Exact Test, α = .05). Based on these quantitative findings, the first author conducted virtual semi-structured interviews with 16 participants from April to July 2023. Interview participants were purposively selected to represent diverse perspectives on naloxone distribution. Interview data were thematically analyzed using NVivo software. Quantitative and qualitative findings were integrated at the design, methods, and interpretation levels to provide a comprehensive understanding of students’ perspectives on naloxone distribution.
According to the findings, 84.5% of students supported naloxone distribution, with higher support among graduate students (92.6%) and liberals (92.8%) and lower support among males (77.5%) and conservatives (61.0%). Students perceived naloxone positively, as 84.9% agreed it increases safety, 74.3% agreed it connects people to services, 64.5% disagreed that it encourages drug use, and 68.5% disagreed that it increases crime. The median Level of Familiarity score with people who use drugs was 9 (IQR = 7–9.8), with support significantly higher among those with a family member (87.1%) or personal experience of substance use (92.3%). Seventeen percent had witnessed an overdose and 44.2% knew someone who had died from one, though these experiences were not significantly related to support. Stigma was relatively low (median Social Distance score = 7), and willingness to interact with people who use drugs—for example, accepting them as family (92.9%)—was strongly associated with support. Qualitative interviews echoed these findings, with students describing naloxone as a life-saving safety tool and emphasizing low- or no-barrier campus access points alongside education and stigma-free spaces.
Takeaway: College students support naloxone distribution on campus, demonstrating positive perceptions and low stigma while highlighting the importance of accessible programs and education for broader community impact.