When a classmate died of a drug overdose, Symmes Culbertson bought a black suit for the funeral.
“It didn’t feel right to wear a blue sports jacket,” the 23-year-old political science major said.
What he didn’t count on was how many more funerals of classmates he would attend — six since he began attending Louisiana State University in 2013. “The number of people that I have known by name or in passing that have died from prescription drug overdoses, just in my college years, is well into the teens,” Culbertson said.
These kinds of events have become increasingly common at U.S. colleges, where many students view mixing pills and chasing them with alcohol as a rite of passage, rather than a dangerous and often deadly practice.
“It’s a dirty secret,” said April Rovero, whose son, Joey, a student at Arizona State University, overdosed in 2009 after taking prescription opioids, benzodiazepines and alcohol. (Dr. Lisa Tseng, who prescribed the drugs that led to the deaths of him and two other young men, is now serving a 30-years to life prison sentence for illegally prescribing the medication.)
In the year that followed, she said nine more students from there also died at the hands of drugs.
National addiction expert Dr. Drew Pinsky said one thing that is killing many students is mixing opioids with benzodiazepines, such as Xanax — something he says doctors should never prescribe together because it can be lethal.
Since 1999, drug overdose deaths of those 15 to 24 have quadrupled to 5,376 a year, far surpassing the number of those dying from alcohol-related accidents.
“These are perfectly healthy young people,” said Rovero, who founded the National Coalition Against Prescription Drug Abuse. “Every one of these deaths is avoidable.”
'A Perfect Storm'
Ken Hale, associate director of the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery on the Ohio State University campus, said "a perfect storm" has hit college campuses and the nation, starting with “the drug-taking culture in which we live. We use more medication than any other country.”
In 2016, the nation filled more than 4.5 billion prescriptions, including antibiotics, cancer drugs and other drug treatment protocols — an average of more than 14 per person.
But Hale said many of those prescriptions are the powerful and often addictive opioids. Even though the U.S. makes up less than 5 percent of the world’s population, it consumes 80 percent of opioids.
As a result, these drugs are easily available to students through family members or friends, he said.
With these prescription drugs come misperceptions about safety and legality, he said. Of those addicted to heroin, 80 percent started on prescription drugs.
“If I go to a party and someone says, ‘Here’s some heroin,’ flags go up, but if someone hands me a Vicodin (an opioid painkiller), they don’t,” he said.
College campuses have become incubators for the bigger problem, where students “may not hit the wall in college, but they start behaviors that led to the problem we have,” he said.
Hale noted that the No. 1 cause of death of those under 50 is drug overdose and that fact has contributed to the U.S. seeing life expectancy decline for two years in a row for the first time since the 1950s.
Ohio State is one of more than 100 colleges that have recovery centers, where students can live, Hale said. “College dormitories are not a good environment for someone trying to get sober.”
Funeral for a friend
Culbertson grew up in Greenville, a fast-growing small town in South Carolina. “In high school, the most hardcore thing was weed,” he said.
By 2014, pills had begun to seep into college life, no longer just for the weekend parties.
Students took Adderall, the stimulant used to treat Attention Deficit Hyperactivity Disorder, if they needed to study or take a test.
And students who didn’t have classes till the afternoon might visit the bar and get Xanax, sometimes chasing that tranquilizer with alcohol — what can be a deadly combination.
When 2015 came, so did news about a high school classmate, a former cross-country track star who became hooked on opioids after hurting his back and blowing out his ACL.
His sister, Callie, had helped him get sober, letting him live with her for six months.
Afterward, she kept in touch by telephone. One morning she learned on Facebook that he had overdosed — news that stunned her because she had just spoken to him the night before.
She and Culbertson attended the funeral, and she couldn’t believe that so many people attending were high, doing the same drugs that killed her friend.
Since that funeral, she knows of eight people from her hometown who have died of overdoses.
“Everybody knows somebody this has touched,” she said. “The problem is no one is changing.”
'He only took five'
Culbertson returned to LSU, and the next funeral of someone he knew took place just a few months later.
The environment has become “so accepting of the drugs,” he said. “If you don’t enjoy them, then you’re the a--hole — at least if you speak up about it.”
More funerals followed, and last January, he got a call that a friend of his had just overdosed.
Culbertson had just seen his friend the night before, taking Xanax in a bar. “We were with him at midnight,” he said.
When it was obvious he needed help getting home, friends took him there. He never woke up.
Word came that he had died of fentanyl, a drug up to 50 times stronger than heroin, and that fentanyl may have been mixed with the Xanax pills.
After this death, Culbertson said some slowed down in their drug taking, but no one quit.
Months later, he heard of a classmate back home who had been hooked on opioids before secretly moving to heroin and overdosing.
On Oct. 14, hours after LSU defeated Auburn University in football, Culbertson and his friends met at a bar.
After midnight, a friend informed him that he had just stolen a bottle of liquor from the bar, and that he was going back to his place to celebrate with his girlfriend.
The next morning, a friend called him in tears, letting him know their friend was dead.
“That’s crazy,” Culbertson replied. “He only took five (Xanax) sticks last night.”
As soon as he hung up, he realized the insanity of his own words, nonchalantly saying that his friend had taken five Xanax bars.
“And I thought that was completely normal,” he said. “And that’s what has come to scare me — the culture here is so accepting of it that even me, who doesn’t do any of this stuff, it’s normalized to me. My thinking had gotten as distorted as anybody engaging in the culture.”
He wore the dark suit for his friend’s funeral in New Orleans and returned home to write out an idea for a short film, based on what he had experienced.
The next day, he pitched his idea to his film class. His movie proposal, “Only the Good,” resonated with his fellow students.
“I just wanted to tell the story about my peers that shows everybody thinks they’re having a good time, and while that’s true 90 percent of the time, there’s that 10 percent of the time where you not only do, you die from it, but it devastates the lives of the people that care about you.”
Turning a blind eye
Rovero would like to see learning about medicine safety start in kindergarten, saying schools and colleges need to do a better job of educating students.
“Colleges should be educating students about how addictive and dangerous these drugs can be, especially mixed with other drugs and alcohol, and about the risk factors and signs of addiction and overdose,” she said.
Students should be trained to aid those in trouble, she said. “Parents should work with their administrators to have resident assistants have a naloxone rescue kit on hand in dorm settings, just in case, and everyone with a kit needs to be trained to use it.”
All incoming LSU freshman receive orientation regarding alcohol, drug use and sexual violence prevention. University officials say they continue to work with students to identify and reduce high-risk drinking, providing addiction programs and services, including the Anxiety and Addictive Behaviors Clinic.
Culbertson praised LSU for its all of its efforts, including education, outreach and support groups.
But there is a huge hurdle, he said. “There’s not much a support group can do when people aren’t looking for support. Nobody feels like they have a problem.”
The problem is one of perception, he said. “Students don’t really identify themselves as drug addicts, and everybody else is turning a blind eye.”