Psyched Perspectives: Substance Use Awareness, A Conversation on Advocacy & Intervention

Frank Clark, MD, spoke with Chelby Drafts about her advocacy work to destigmatize substance use disorder and expand naloxone access on college campuses across South Carolina.

Drafts opened by describing her personal connection to the issue: her biological mother had struggled with substance use disorder throughout her life, an experience that Drafts noted was initially a source of shame but that she reframed as a catalyst for advocacy. She emphasized that children of parents with substance use disorder represent a large and often overlooked population, and that growing up in such a household constitutes an adverse childhood experience with well-documented downstream effects on mental health and substance use risk across the lifespan.¹ Drafts noted that genetic vulnerability, environmental factors, and untreated mental health conditions all contribute to the development of substance use disorder, and argued that addressing these upstream determinants through early psychoeducation and emotional regulation skills training is as important as downstream intervention.

Drafts described her collaboration with South Carolina Senator Teder to pass legislation requiring naloxone availability and overdose recognition training across all public college and university campuses in the state—a bill that will go into effect in 2027. She situated this effort within a broader national trend toward mandating naloxone access in higher education settings, noting that in 2024 alone at least 12 states passed laws expanding naloxone availability in educational institutions.² She emphasized that college students represent a population navigating significant identity development and social experimentation, and that ensuring access to naloxone and overdose education during this period is a primary prevention imperative comparable to safe sex education in schools.

Drafts also addressed the particular vulnerability of rural communities, citing limited access to healthcare, educational resources, and harm reduction infrastructure as compounding factors. Clark noted that in South Carolina, women over the age of 60 represent a disproportionately affected population in the context of opioid use disorder, a pattern potentially linked to undertreated pain and inadequate education around opioid prescribing in rural healthcare settings. She described a school-based presentation program she created, titled "You Hold the Pen," focused on emotional regulation and coping skills as a prevention-oriented complement to naloxone-centered intervention.

Ms Drafts is a student advocate for substance use disorder awareness and naloxone access policy in South Carolina.

Dr Clark is an outpatient psychiatrist at Prisma Health-Upstate and clinical associate professor at the University of South Carolina School of Medicine, Greenville. He served on the American Psychiatric Association’s Task Force to Address Structural Racism Throughout Psychiatry, and he currently serves as the Diversity and Inclusion section editor and advisory board member for Psychiatric Times.

References

1. Horte C, Vederhus JK, Abildsnes E. Youth impacted by a family member's substance use: a qualitative exploration of life course experiences and coping. J Child Adolesc Trauma. 2026.

2. Calihan JB, Carney BL, Schmill DM, et al. The call for a school-based approach to opioid overdose prevention. Am J Public Health. 2024.