This paper highlights the critical role schools play to address the current opioid crisis. In the current crisis of fentanyl poisoning, school-based interventions and overdose prevention strategies must be adapted to the context of fentanyl, and innovation approaches must be deployed. This paper discusses a continuum of overdose prevention and intervention strategies and activities practiced in educational settings, challenges for addressing the fentanyl and xylazine public health crisis in youth, and future directions.

Fentanyl consumption in youth has a high probability of being deadly. As a powerful synthetic opioid, fentanyl’s highly addictive properties and high potency, even in small doses, make it a dangerous opioid with a high probability of lethality or, at a minimum, the occurrence of lifelong negative consequences on an adolescent’s quality of life, health, academic performance, and legal issues. This paper aims to present a continuum of overdose prevention and intervention activities currently being practiced in educational settings. These considerations are rooted in evidence-based research and aim to increase the effectiveness and impact of school-based activities combating the fentanyl and opioid epidemic, discussing challenges for addressing the fentanyl and xylazine public health crisis in youth, effective integrated strategies, and future directions.