Three speakers at the South by Southwest Education conference in Austin promoted an increasing number of tools—such as naloxone access, early childhood intervention and safe drug disposal—that schools can use toward reducing drug abuse in their communities.

The three panelists joined Darrien Skinner, opioid generalist with Texas Health and Human Services Commission, on March 7 in discussing how best to undercut a current opioid crisis at the school level. The panel was organized by Texas Targeted Opioid Response, THHSC’s public health initiative.

Skinner said opioid-related deaths in Texas increased 82.6% between the start of 2019 and the end of 2021, adding that synthetic or lab-made drugs accounted for more than 1,200 accidental overdose deaths in Texas in 2021—much higher than such deaths where heroin or prescription drugs were blamed that same year.

Dr. Lisa Cleveland, a pediatric nurse practitioner and a professor at the UT Health San Antonio School of Nursing, said synthetic opioids such as fentanyl are now the most commonly drugs involved in overdose deaths nationwide.

“Fentanyl is 100 times more potent than morphine and 50 times more potent than heroin,” Cleveland said, adding that Texas is current only of only six U.S. states where fentanyl overdose deaths have risen more than five fold.

In 2019, UTHSA School of Nursing received $17.5 million to expand statewide its work to provide naloxone, better known as Narcan, to various organizations and train them to use the nasal spray to quickly reverse an opioid overdose.

Cleveland said her naloxone distribution and training program saw a 500% increase in participation by school systems in 2022 over the previous year.

“We saw huge spike in participation in the fall 2022. We can’t say exactly why that was, but it may have been greater awareness that drove educators to action,” Cleveland said.

Cleveland’s fellow SXSW EDU speakers shined a light on mechanisms other organizations are using to install a preventative mindset in schools and, eventually, in local neighborhoods.

Willa Rosen, education specialist with Education Service Center Region 13, oversees the Texas PAX Good Behavior Game, a school-based classroom preventative intervention used by educators to teach children self-regulation.

The game was developed from the Paxis Institute, a global prevention science company that stresses “pax”—Latin for peace—as well as productivity, health and happiness, Rosen said.

According to Rosen, the Good Behavior Game—available for free to schools—is not a curriculum but rather a set of strategies that teachers use to increase their students’ behavioral skills and stamina, which promotes improved attention and positive behavior, among other long-term good habits, on the youngster’s part.

“It chills out your classroom, it dials down the drama, provides more peace and allows more time to focus on instruction,” Rosen said of the game. “It reinforces the joy of being in the classroom.”

Rosen said the game can also be used to help address root sources of substance use and other maladaptive behaviors that might be present in a child’s life.

“We’re just changing the way you teach so you can work collaboratively with your kids to produce a more positive environment,” she said.

The third speaker, Douglas Thornton, an associate professor at the University of Houston College of Pharmacy, said he and his colleagues work with various organizations to emphasize the importance of proper disposal of expired or unused prescription medicines at home and among students.

Thornton said 14.3 million individuals aged 12 or older misused a prescription medication in the past year. Out of those who misused prescription pain opioid, 51% got the medicine from a friend or family member.

Thornton said reminding people of proper storage and disposal of prescription medication removes a potential “trigger” for individuals, especially children and teenagers, who may be tempted to experiment with such drugs.

“Here, we can work with kids, from an early age, to not get into these maladaptive behaviors,” Thornton said.

Thornton also directs the Prescription Drug Misuse Education and Research, or PREMIER, Center at the University of Houston, an organization that is now working with Texas public school systems to remove expired or unused prescription medicines from their campuses. Forty-one independent school districts have enrolled in PREMIER’s drug disposal program since January.

Thornton said the focus is now on enrolling even more school districts, measuring the effect of preventative activities, and incorporating personalized normative feedback to promote safe use and disposal.

Skinner said it is vital to implement these and other programs and resources at the primary school level to reinforce illicit drug prevention.

“It’s important for us to invest in youth, long-term and downstream, because early investment means a reduced risk of overdose,” he said.