Life or death lessons: Schools are taking on the fentanyl crisis but drug curriculum a patchwork

By the age of 19, Jordan Miller was already addicted to drugs and reaching out to his parents for help. By 24, he'd taken a deadly cocktail of oxycodone pills — enough to stop his heart.

His mother, Leslie McBain, has told the heartbreaking story of her son's overdose at every high school in British Columbia's Gulf Islands region over the past two years.

"My message is one of safety. If you decide to do this, here's how to stay safe," she said.

It's a refrain she repeats to students over and over again: never use alone, always carry naloxone, watch out for your friends at parties and know how to recognize an overdose.

• 'More we need to do': Overdose deaths in Vancouver surpass last year's total
• Drug education in B.C. schools changing to reflect overdose crisis

As the spread of opioid-related overdose deaths in Canada continues to move east, more and more kids will likely hear warnings like McBain's when they head back to school this fall.

But while a front line in the fight against the overdose crisis has opened up in Canadian classrooms, where students go to school seems to affect how they learn about the risks associated with contaminated substances.

Western schools lead country

Predictably, Canada's westernmost provinces and territories — those hardest hit in Canadian authorities' battle against fentanyl — have been active in updating their school programming to reflect the continuing crisis.

British Columbia's Ministry of Education has added modules on overdosing to its Grade 6 and high school curriculum, and several larger B.C. school districts have programs dedicated to teaching kids about the risks associated with drug contaminants.

Meanwhile, inquiries to provincial and territorial health and education ministries found that Yukon is the only province or territory in Canada to have trained all its school administrators in how to use naloxone and to stock every school with a naloxone kit.

But it's a different story on the country's East Coast. At provincial education departments in the four Atlantic provinces and Quebec, no updates have yet been made to include specific information about fentanyl in school curriculum.

Spokespeople for the Nova Scotia and Newfoundland Labrador governments said a school curriculum update to include new information about opioids was under consideration. A New Brunswick Education Department spokesperson said it was working to provide information about fentanyl to school districts and parents for the upcoming school year.

As Canada's overdose problems worsen, the disparity among different regions of the country worries people like McBain, who co-founded Moms Stop The Harm, a network of more than 300 mothers from coast to coast who lost children to an overdose or whose kids are going through addiction.

"Now the message is so much more critical,"  she said. "We're talking life or death, not, 'Don't try it because we don't want you to.' "

• Police probing source of Montreal overdoses, believe drugs spiked with fentanyl
• Carrying on after son's deadly overdose: Mike Zettler's story

'That could have been me'

It's an issue that's also on the mind of students like Jessica Spirak, a 12-year-old going into Grade 7 at Ottawa's Earl of March Secondary School this fall.

Chloe Kotval, a 14-year-old from Kanata, the same neighbourhood where Spirak lives, died of a drug overdose in February. Ever since, Spirak and her mother Tanya have been working to try and get more drug education on opioids in Ontario classrooms. After months of lobbying, they succeeded in having a nurse meet with students at Jessica's school.

"I'm just thinking that could have been me in two years if I wasn't knowledgeable of this," said Spirak. 

Statistically, school-age children are not those most affected by overdose deaths. In B.C., the province so far hardest hit by overdose fatalities, the largest concentration of overdose deaths have been from people in their 30s, and the provincial health officer has not designated schools as high-risk environments, said Mark Lysyshyn, a medical health officer with Vancouver Coastal Health.

Still, McBain said it's imperative young people across Canada be prepared for the risks as they get older: one in every five of the mothers in her organization had a school-age child die from overdose or has one experiencing an opioid addiction.

'Patchwork' of programs

According to Elaine Hyshka, an associate professor at the University of Alberta's School of Public Health, the apparent inconsistencies in drug education programming for school-age kids across the country reflect the "inequities and a patchwork" of harm-reduction, prevention and awareness initiatives in Canada.

"To my knowledge no [provincial or territorial] jurisdiction has comprehensive education around overdose prevention, public awareness, training for health professionals, training for people who are using drugs or at risk of overdosing," said Hyshka.

Even in B.C., which Hyshka said "far leads the country" when it comes to access to harm reduction services and drug education policy, the amount of information kids will learn about how to be prepared in the case of an opioid-related emergency may depend on the size and resources of their school board.

Art Steinmann oversees the School Age Children and Youth (SACY) program, a partnership between Vancouver Coastal Health and the Vancouver School Board that is one of the most extensive drug education efforts in Canada. Since last fall, he said the program has put special emphasis on showing students in Grades 8 to 12 how to recognize and react to an overdose.

But Steinmann said training like the SACY program isn't offered by smaller school districts, which can't dedicate the same amount of resources to educating youth about fentanyl and overdosing.

'What do we do?'

Another problem, according to Cindy Andrew, a consultant with the University of Victoria's Centre for Addictions Research of B.C., is that Canadian educators are still trying to find the most effective way to address youth drug education.

"The data around drug ed, so classroom-based stuff, there aren't many successes over the many, many years." Andrew said.

• Toronto harm reduction workers hope drug testing strips can help prevent fentanyl overdoses
• Naloxone kits now in rural eastern Ontario English schools

Often, drug education programs take the form of "one-off, bring in the police officer with the bag of salt and show the grain of salt that can kill somebody" demonstrations, said Andrew, who recently helped develop new curriculum modules related to opioids and overdosing for B.C. schools.

"We know from years of drug education that scaring people, youth in particular, around drugs and giving them very frightening information that you hope will discourage their use, is something that does not work," said Lysyshyn, who has been leading Vancouver Coastal Health's response to B.C.'s opioid emergency.

Lysyshyn said when schools are trying to teach kids about the risks of drug use and overdosing, they need to have discussions that are open to kids' questions so students — especially those who are already using drugs — feel they can talk to their teachers without fear of being judged or punished.

"They need that advice about not using alone, this is what an overdose looks like, because currently that's the only thing that will save them from dying," Lysyshyn said.

He also said it's "very ineffective" for schools to focus on statistics and information specifically about fentanyl — as fact sheets and advisories sent out to parents often do — because it is a contaminant in other drugs, not a new drug young people are trying.

Lysyshyn said school curriculum shouldn't be specific to the dangers and risks of fentanyl. Rather, it should be about "building resilient students so that they can make good choices."

"There were contaminants before fentanyl and there are more contaminants other than fentanyl now," he said. "The situation has become very severe but it's an issue that has always existed around street drugs."

Watch a Facebook Live with CBC health reporter Kas Roussy and Dr. Sharon Cirone, as they discuss teens going back to school amid a national opioid crisis.