The desperate cry of a mother finding her 17-year-old son dead from a painkiller and another prescription drug instantly silences hundreds of Pennsylvania high school students who listen to her 911 call played at an early morning assembly.
That recording, played as the roughly 500 students look at an urn holding the dead boy's ashes and photos of dozens of other teens who died of overdoses, is the gut-punch that anchors a new educational program aimed at combating the rising abuse of prescription opioid abuse among U.S. young adults.
"All these kids were around our age, said Michael Senn, an 18-year-old senior at the school Downingtown High School East, after the program. "It felt personal."
Senn and his classmates had just sat through a presentation by Narcotics Overdose Prevention and Education, or NOPE, one of a handful of prevention programs cropping up around the United States offering high school and middle school students education about prescription opiate painkillers.
The new programs, launching in Pennsylvania and Illinois, come as concerns grow that the drugs, accounting for 71 percent of all prescription drug overdose deaths, are drawing younger and more suburban users.
Nationwide, prescription opioids caused more than 16,000 deaths across all ages in 2013, a 50 percent increase from three years before, according the Centers for Disease Control and Prevention. Law enforcement officials say that abuse of the drugs has also contributed to a spike in heroin usage and deaths from heroin overdoses as some opiod users switch to the cheaper narcotic.
In an approach that experts say may be more effective than generalized anti-drug curricula of the past, the new programs target painkillers, a narcotic of choice for teenagers.
Developers of the programs emphasize the of use lengthy studies and interactive computer programs and focus on the science of addiction instead of scare tactics widely used in Nancy Reagan's "Just Say No" campaign of the 1980s and 1990s.
BUMPS IN THE ROAD
Even with fresh ideas, experts say, the new programs face a rocky road to success.
"The whole field is sort of in withdrawal," said William Hansen, who runs All Stars, a leading school drug-prevention provider based in Greensboro, North Carolina.
One of the biggest obstacles in the anti-drug program field - funding - was exacerbated in 2011, when money for the former Office of the Safe and Drug Free Schools and Communities, a financial lifeline to school prevention programs, was slashed.
Schools' focus on academic testing in recent years has knocked anti-drug programs off of their priority lists, said Hansen, who recently began writing a grant proposal to add special prescription drug education to his curricula.
The new programs also come at a time of heightened criticism of anti-drug programs in schools.
The most-used school prevention program Drug Abuse Resistance Education, or DARE, launched in Los Angeles in 1983, has been criticized in multiple evaluations, including in a 2001 U.S. Surgeon General report, for failing to prove its effectiveness in deterring drug use.
The "Just Say No" mantra has been openly mocked for being overly simplified.
The new programs contend they have developed more effective strategies.
"Our program really is looking at adolescent brain development, addiction on a brain level," said Christopher Adzia, the program manager of an opioid-abuse prevention program at the Robert Crown Center for Health Education.
The Heroin Prevention Education program uses interactive software based on the life of a recovering teen heroin addict who began abusing opioid painkillers after having his wisdom teeth pulled and moved on to intravenous heroin use.
In hour-long programs, NOPE instructors teach students how to recognize symptoms of drug overdoses and emphasize the importance of quickly seeking medical attention for overdose victims. The programs also work to teach teens that prescription drugs are not safe to use other than under a doctor's orders.
Around the same time that Chester County in Pennsylvania contracted with NOPE, schools in DuPage, Illinois, rolled out the curriculum developed by the Robert Crown Center.
Officials in other states are looking to follow suit.
Lawmakers in states including New Jersey, New York and Wisconsin have proposed measures to require public schools to educate students about the dangers of opioid drugs.
Downingtown School District prevention specialist Christina Forsythe said the first NOPE presentation at her high school appeared to be a success.
Senn, who sat at the back of the school's auditorium with friend, Megha Reddy, 17, agreed but was cautious.
"It will affect them," he said of the presentation's impact on his classmates. "How deeply it registers, I'm unsure of."