Approaches to preventing opioid-related harms in US higher education: A PRISMA-guided scoping review

Objective: This scoping review reports approaches to prevent opioid-related harms for students in US higher education using the Opioid Use Disorder Cascade of Care framework (OUD CoC). Participants and Methods: Combinations of search terms to identified articles in PubMed, Web of Science, APA PsycInfo, and CINAHL: opioid-related disorders, opioid misuse, opioid overdose, college, university, higher education, students, prevention, early intervention, harm reduction, screening, treatment, recovery. Studies were included if they (1) described interventions, programs, or policies that address opioid-related harms for undergraduate students in the US; (2) specifically mentioned opioids as a substance of focus within the analysis and (3) were published in English. Data extraction categories included study emphasis, rationale, objective, participant category, study type, sampling strategy, primary outcome(s), analytic approach, IRB approval, setting, number of participants, findings, implications, and funding. Results: Included studies (n = 46) were categorized along OUD CoC domains of primary prevention, secondary prevention, treatment, and recovery. A large proportion were primary prevention-focused (61%), used surveys (50%), convenience sampling (41%), and emphasized prescription drug misuse (43%). Twelve studies (26%) examined overdose prevention programs, which found peer-to-peer education and naloxone distribution are feasible and effective strategies for college populations. Conclusions: This review can help college practitioners understand the current evidence-base in preventing opioid overdose and guide them in designing programs at their institutions.