When fraternity members at the Kappa Sigma chapter house at Louisiana State University thought their brothers were experiencing drug overdoses last March, they called 911. The following day, a Louisiana State Police detective arrived at the house with a search warrant in hand.

The detective’s warrant referenced the reported drug use — the two members suspected they overdosed on fentanyl and an unknown substance — and police confiscated drug paraphernalia in the three-story house, the local newspaper, The Advocate, reported.

The call to 911 might have saved the lives of the two students, who recovered after being stabilized at the hospital, said Allison Smith, the program administrator for the Louisiana Center Addressing Substance Use in Collegiate Communities, or LaCASU, a statewide coalition of institutions that research and address student drug and alcohol use. But the call and the police response also raised important questions.

“What happens when a call for help is made, but then subsequently followed up by law enforcement action?” Smith wrote in an email. “Would that deter students from calling for help?”

Though the raid did not result in charges against the students, the incident led Smith to consider whether university policy and state law can prevent students from seeking emergency medical services when illegal drugs are involved.

Most colleges have medical amnesty policies in place to protect students from university discipline when they call emergency services, according to Students for Sensible Drug Policy, an organization that promotes student health and safety over law enforcement. But these policies — including Louisiana State’s — do not necessarily protect students from state, local or campus police action, such as the raid on the Kappa Sigma house.

Louisiana State added medical amnesty to its code of conduct in July 2018, after receiving recommendations from a Greek Life Task Force created after the 2017 hazing death of Max Gruver, a student pledging the Phi Delta Theta fraternity. The university had already been practicing the policy, but it was not formalized in writing, according to The Reveille, Louisiana State’s student newspaper.

“If someone is overdosing, you don’t want the first thing you think to be, ‘Am I going to get in trouble?’” said James Cafran, coordinator for the Collegiate Recovery Program at Sacred Heart University in Fairfield, Conn.

Sarah Dunlap, a health science major at Northeastern University in Boston, can relate to such sentiments. She lost her brother to a drug overdose when he was 25 years old. Although her brother did not die at a college, Dunlap is doing research on health-science curricula that teach overdose-reversal methods. The research is part of her capstone project, which she plans to use to lobby Northeastern to create such a curriculum.

Dunlap said when she thinks about her brother’s death, she wonders whom he was with and whether they were worried about being charged for drug possession. “Was that an excuse not to seek help?”

“I think it’s a huge deterrent,” Dunlap said. “Even with the paraphernalia, which is not a direct charge, a lot of people would have those concerns.”

State Good Samaritan laws are another confusing factor for students when determining whether to seek help. The laws do not typically align with institutional policies and are not widely discussed on college campuses, said Brandee Izquierdo, executive director of Stop the Addiction Fatality Epidemic, known as the SAFE Project. The national organization was founded by two parents whose college-age son died of an opioid overdose. It does outreach to college campuses about educational practices and policies that reduce drug-related deaths.

Good Samaritan laws generally protect bystanders and people suffering medical emergencies from certain drug-related charges, but they can vary from state to state. In Louisiana, a Good Samaritan law protects those who call for emergency medical help from controlled substance possession charges but not from drug paraphernalia possession charges, according to the Network for Public Health Law, or NPHL.

Overdoses are the leading cause of accidental death in the U.S. as of 2017, according to the Centers for Disease Control and Prevention, but Good Samaritan laws across the country are typically outdated and have not been prioritized over legislation to punish drug dealers for providing drugs that led to an overdose death, Izquierdo said. Louisiana’s law was last amended in 2014, and New Mexico’s is the oldest, dating back to 2007, the NPHL reported. Several states have no law to provide drug overdose immunity.

Colleges and universities have also not made it a priority for students to be aware of these laws, which could decrease their willingness to call 911 in life-or-death situations, she said. The issue is especially relevant for college fraternities and sororities, which Izquierdo called a “catalyst for extensive drug use.”

“Oftentimes, people are afraid that they’re going to be a target” of law enforcement authorities and campus disciplinary proceedings, Izquierdo said​. Students may also be afraid of getting friends or others in legal trouble or subjecting them to possible campus code of conduct violations.

They worry “that they’re outing themselves or their brothers and sisters,” Izquierdo said. “Their best bet becomes not doing anything at all.”

The widely publicized 2017 hazing death of Timothy Piazza, a 19-year-old fraternity pledge at Pennsylvania State University, is a case in point. Beta Theta Pi fraternity members waited more than 12 hours to call 911 after seeing Piazza, who had been forced to drink excessive amounts of alcohol, fall down a flight of stairs, CNN and other news outlets reported.

Collin Wiant, 18, an Ohio University student, died from asphyxiation after allegedly being forced to do inhalants as a pledge in November 2018, according to a wrongful-death lawsuit filed by Wiant’s parents. Wiant’s fraternity brothers did call 911 when they discovered he was unresponsive, but it was too late — emergency services arrived and found him dead, CNN reported.

Higher ed institutions have addressed excessive alcohol use and hazing more vigorously as a result of student deaths, but they have not been as focused on preventing drug overdoses, which are still highly stigmatized, Izquierdo said. Colleges hesitate to implement overdose-prevention education or addiction-recovery programs because they don’t want to be associated with drug use, which can damage a college’s reputation and affect enrollment and retention, she said.

The University of California, Santa Barbara, which has a College Recovery Program, has taken a proactive approach to overdose prevention and is exploring more “progressive” strategies, such as providing fentanyl test strips, to reduce overdose deaths, said Angie Bryan, manager of the Gauchos for Recovery program.

“It’s not because we have more substance use here than anywhere else — it’s because we understand the reality that students use substances,” Bryan said.

Bryan said there have been multiple overdose reversals this semester near the campus in Isla Vista, Calif., where many students live. The reversals suggest the person overdosing or a bystander either called 911 or administered naloxone, an overdose-reversal drug, before it was too late, she said.

UC Santa Barbara’s version of medical amnesty, the Responsible Action Protocol, aligns with California’s Good Samaritan law. It protects student bystanders and those who need medical assistance from drug or paraphernalia possession charges and penalties, and university disciplinary measures beyond educational sanctions such as mandatory alcohol and drug abuse education programs and counseling. (There are some exceptions for students who live in residence halls and have repeat offenses.) The university distributes information about protections in a Just Call 911 campaign, but Bryan said the protocol is new and still not widely understood by students.

The university also focuses prevention methods specifically on Greek organizations, whose leaders are required to attend annual training on administering naloxone, Bryan said. Organization representatives that attend the training are given a naloxone kit to keep at fraternity and sorority houses. The training is intended to mitigate hesitations about calling 911.

“They’ve expressed concern about being sanctioned as an organization if they make this call,” Bryan said. “They have this fear that they will be disciplined as an organization.”

After the overdose incident at Louisiana State, the university placed the Kappa Sigma chapter on disciplinary probation from July until May 2020, for reasons unrelated to drug violations, Ernie Ballard III, the university’s media relations director, wrote in an email. Members of the fraternity also faced charges of hazing and theft last year, The Advocate reported.

Cafran, who leads Sacred Heart’s recovery program, believes Louisiana State and local police appropriately applied the medical amnesty policy in that case. It’s important to consider medical amnesty and law enforcement action on a case-by-case basis, he said, adding that the police search of the fraternity house may have saved more lives if fentanyl was distributed to others there.

“The focus should be on getting the person help, not getting the person in trouble,” Cafran said. “But if someone is dealing drugs — deadly drugs, with fentanyl — it’s within the police’s right to get a search warrant. Someone trying to profit off of someone else dying is a big deal. That in and of itself is putting students in danger.”

Police have to make a hard choice in these situations and determine which method will save more lives, said Dunlap, the Northeastern student.

“You’re playing a numbers game — you’re saving 20 lives instead of just one,” Dunlap said. “You have to consider the police working with the people, and not just working from the inside out, looking to intimidate people.”