BU, BMC Researchers Work with High School Students to Build Peer-Led Overdose Prevention Program
All summer of 2025, in a classroom normally occupied by aspiring doctors and healthcare professionals at the medical school, Boston high school students met to build something important. The students, most of them rising seniors at the John D. O’Bryant School of Math & Science in Boston’s Roxbury neighborhood, gathered once a week to cocreate (alongside BU medical professionals) a curriculum meant to teach their peers about drug overdoses: what they are, how to prevent them, how to recognize someone in distress, and what to do about it.
The program they devised—largely built by teenagers, for teenagers— could help fill a critical educational gap, says Sarah Bagley, an associate professor of medicine and pediatrics in the school’s Clinical Addiction Research & Education (CARE) Unit. For adults, Bagley says, treating and preventing opioid overdoses generally means treating drug addiction, too. But this isn’t usually the case when it comes to young people and teenagers, who more often overdose accidentally and aren’t necessarily addicted to opioids.
“We think that some of the risk factors for youth are a little bit different,” says Bagley, who is also a primary care physician at Boston Medical Center (BMC), Boston’s safety-net hospital. “Not as many of them may have opioid use disorder, and therefore may not need treatment to prevent overdose.”
For adults, she says, preventing overdose likely means using methadone and suboxone—medical interventions that help reduce a patient’s withdrawal symptoms and cravings for opioids. But this sort of protracted medical care may not be necessary to treat a young person experiencing an opioid overdose.
“A lot of teenagers are using drugs maybe for the first time or intermittently, and are accidentally or unknowingly exposed to fentanyl. This potent opioid can then lead to an overdose,” she says. “The opportunity to prevent that introduction from happening isn’t necessarily engaging them in treatment—it’s making sure they understand that the drug supply has a lot of fentanyl in it. It’s a different approach.”
The question then becomes how to build an educational model that will reach busy teenagers and also be understandable and approachable. It’s a question Bagley and her colleagues at BMC and the schools of medicine and public health put to the experts: teenagers themselves. They launched an equity-centered, peer-led overdose prevention program at the O’Bryant School, cocreated directly with students, to address this critical public health challenge.
“Our group has been thinking a lot about how to provide more community-based education, so that youth can learn about those risks for themselves, but also so they can talk to their friends and family and other people in their community about overdose,” Bagley says. More than 40 high school students applied to join the program.
The researchers narrowed it down to about half that, 17 students. Throughout the summer, a team of BU and BMC addiction and harm-reduction researchers met with the O’Bryant students to teach them about public health, social determinants of opioid abuse, overdose risk, and more. The students then broke into groups to design an overdose prevention curriculum. One group built a website filled with useful information about the risk factors for overdose; another produced short, catchy videos about how to compassionately confront a friend who may be using drugs; and another designed a presentation on recognizing signs of an overdose and what to do about it.
The students and researchers continue to explore ways to get these robust, peer-designed resources into the hands of Boston students. “The final products that these students created are amazing,” Bagley says. “They’re educational while still being accessible. They’re just wonderful resources.”