Fifteen-year-old students in Texas are writing graphic novels about their encounters with opioids—not as a school assignment, but as a lifeline to their peers. At Texas A&M University, Joy Alonzo and Marcia Ory are leading a quiet revolution in youth drug prevention, replacing fear-based lectures with peer-driven, skill-building programs that speak to teens in their own language. For years, schools have relied on shock tactics—gruesome stories, dire warnings, and one-off assemblies—hoping to scare students away from drugs. But the numbers tell a different story: since 2019, youth opioid overdoses have tripled year over year, and overdose deaths among 15- to 24-year-olds rose 49% between 2019 and 2020. It’s clear the old methods aren’t working.
Alonzo, an associate professor of pharmaceutical sciences, and Ory, a regents and distinguished professor in public health, are pioneering the Texas Opioid Prevention for Students (TOPS) initiative, funded by the Texas Opioid Abatement Fund Council. Their approach is rooted in behavioral science and peer influence. "Kids between the ages of 14 and 18 are most at risk of abusing illicit opioids because that's also around the age you start having more agency as a person, having a driver's license or a job that supplies you with your own money, while also not having fully developed the part of their brain that strategizes consequences," Alonzo explains. And the threat isn’t distant—it’s personal. Cartels are targeting youth through trusted friends, turning peer networks into pipelines for illicit drugs.
TOPS doesn’t just talk at teens—it engages them. The program includes a graphic novel co-written by 15-year-olds detailing real experiences with opioid misuse, and a multiplayer video game called "Trust Hustle" that simulates high-pressure situations where friends might push each other to use or sell opioids. These tools are designed to build resilience, not fear. The curriculum, developed by Texas A&M Health behavioral scientists, is also training teachers, coaches, and other trusted adults on how to have honest, effective conversations about fentanyl and substance use. Aligned with "Tucker’s Law," which mandates fentanyl education in Texas schools, the program offers six flexible modules—schools can choose what fits, from training and exercises to games and support materials.
What sets TOPS apart is its focus on accountability, life skills, and sustained behavior change. Rather than assuming teens will avoid drugs because they’re scared, the program empowers them to make informed choices and support one another. It’s not about avoiding use once—it’s about building the capacity to say no, again and again, even when the pressure comes from someone you trust. As Alonzo puts it, "We want kids to know they have the capability to not use in the first place and to provide the treatment and the resources needed to be able to stop using and live productive lives if they develop substance use disorder."
With youth opioid crises escalating even as national rates stabilize, TOPS offers a hopeful model: meet young people where they are, listen to their stories, and equip them with real tools. The future of prevention isn’t fear—it’s connection.