When three teenagers died of fentanyl overdoses last year in Larimer County, Colorado, it shocked the community and “flipped families upside down,” said Tom Gonzales, the county’s public health director.

Several schools began stocking naloxone, a medication that reverses opioid overdoses. Community organizations trained teens to use it. But county and school officials wanted to do more.

That’s when they turned to opioid settlement funds — money coming from national deals with health care companies like Johnson & Johnson, AmerisourceBergen, and CVS, which were accused of fueling the epidemic via prescription painkillers. The companies are paying out more than $50 billion to state and local governments over 18 years.

Much of that money is slated for addiction treatment and efforts to reduce drug trafficking. But some is going to school-based prevention programs to reduce the possibility of addiction before it begins. In some cases, school districts, which filed their own lawsuits that became part of the national settlements, are receiving direct payments. In other cases, state or local governments are setting aside part of their share for school-based initiatives.

Many parents, educators, and elected officials agree that investing in prevention is crucial to address the rising rates of youth overdoses, depression, and suicidal thoughts.

“We have to look at the root causes,” said Diana Fishbein, a senior scientist at the University of North Carolina-Chapel Hill and leading expert on applying prevention science to public policy. Otherwise, “we’re going to be chasing our tails forever.”

But the question of how to do that is fraught and will involve testing the comfort levels of many parents and local officials.

For generations of Americans, addiction prevention was synonymous with D.A.R.E., a Drug Abuse Resistance Education curriculum developed in the 1980s and taught by police officers in schools. It “dared” kids to resist drugs and was used in concert with other popular campaigns at the time, like “just say no” and a video of an egg in a frying pan with the narration, “This is your brain on drugs.”

But decades of research found those approaches didn’t work. In some cases, suburban students actually increased their drug use after participating in the D.A.R.E. program.

In contrast, prevention programs that today’s leading experts say show the most promise teach kids how to manage their emotions, communicate with others, be resilient, and build healthy relationships. They can have long-term health benefits while also saving society $18 for every dollar invested, per a federal analysis. But that approach is less intuitive than simply saying “no.”

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