This March 12, 2019 file photo shows the University Village area of the University of Southern California in Los Angeles. AP Photo/Reed Saxon

Nine students at the University of Southern California have died this semester.

Four of the 9 deaths are believed to have been caused by drug or alcohol overdoses.

USC Vice President of Student Affairs sent a warning letter to students about the dangers of opioid use.

It’s an issue that schools across the country are increasingly dealing with.

USC and schools around the country are struggling with how to respond to the ongoing crisis.

Visit Insider’s homepage for more stories.

LOS ANGELES — It’s an unusually hot November day on the University of Southern California campus. Skateboards clatter across brick and bikes whizz by as students rush to class. Murmurs of the upcoming USC versus UCLA game bounce around the courtyard as the soothing sound of a fountain whooshes nearby.

While a veneer of typical, carefree collegiate life shines brightly on campus, students and administrators have been grappling with a series of deaths in the community with no clear way to handle their mourning.

Since the semester’s start, nine students have died. According to a USC public safety official, four of those deaths were caused by suspected drug or alcohol overdoses. (Three students died by suicide, one from a traffic incident, and the cause of the other death has not been disclosed.)

USC’s administration has warned students about the dangers of drug and alcohol abuse. In a letter to students on November 12, Winston B. Crisp, the vice president of student affairs, specifically spoke out about „the dangers of abusing opioids.“

A young man rides a bicycle on the campus of the University of Southern California (USC) in Los Angeles, California. ROBYN BECK/AFP/Getty Images

„We want you to be informed about the dangers of abusing opioids. The effects of alcohol mixed with these drugs can be fatal,“ Crisp wrote. „In addition to the direct effects of each substance, drugs shared for recreational use can be mixed with other substances to increase its effects, sometimes without a user’s knowledge.“

The number of students deaths this semester appears to be higher than usual. Between four and 15 of USC’s 47,500 students typically die over the course of an entire year, officials told the Los Angeles Times. Six deaths were reported last year.

It’s just one story in an epidemic of opioid abuse that continues to take lives around the country. College campuses are not exempt.

Flickr/Be.futureproof

Fatal overdoses from prescription painkillers in the United States tripled between 2001 and 2016. And between 1993 and 2005, the percentage of college students using Vicodin, Oxycontin, and Percocet increased by 343%.

Approximately 10% of college students said in a 2016 survey that they used opioids for nonmedical reasons, and between 2% and 3% said they had moved from prescription opioids to heroin.

Some students feel the mental health aspect of drug use is being ignored

In interviews with Insider, many USC students said that while they might not personally use opioids, they knew someone or had friends who knew someone who was.

Carl Albert, a screenwriting student, said his own life has been affected by the issue.

„I haven’t witnessed anyone using opioids,“ Albert said. „But I have had a number of friends — including one of the people who died who was a friend of mine — be personally affected by opioids. It’s definitely an issue.“

FILE - In this March 12, 2019, file photo, people pose for photos in front of the iconic Tommy Trojan statue on the campus of the University of Southern California in Los Angeles. The death of nine students since classes began a little more than two months ago has left students and administrators at the University Southern California shaken and seeking answers. The Los Angeles Times reports the latest death was discovered Monday, Nov. 11, 2019, when the body of a 27-year-old student was found in an off-campus apartment. (AP Photo/Reed Saxon, File) Associated Press

A 2016 study published in the Journal of Drug Abuse found that around 50% of students are offered „a prescription drug for non-medical purposes“ by the time they reach their sophomore year.

„I feel like no matter what, in a college setting, people are going to use drugs,“ said one fourth-year music industry student. „But talking to multiple people about it in class made me aware that opioids are, like, a really big thing on campus. And most people just brush it off because they think it’s commonplace.“

One of the biggest concerns, she said, is the confluence of mental health and opioid abuse. It’s a problem across numerous college campuses.

In 2016, a 19-year-old University of South Carolina student named Rachel Bandman died after purchasing oxycodone from a local drug dealer. The college sophomore was suffering from depression and texted with the man who sold her the drugs in the days prior to her death, „It’s frustrating how I can’t die.“

A woman holds a plastic bag of OxyContin tablets sold in China in southern China\'s Hunan province on Sept. 24, 2019. Representatives from the Sacklers\' Chinese affiliate, Mundipharma, tell doctors that OxyContin is less addictive than other opioids — the same pitch that their U.S. company, Purdue Pharma, admitted was false in court more than a decade ago. AP Photo/Mark Schiefelbein

Earlier this month, A.J. Hunt, the former South Carolina student who sold her the drugs, was sentenced to 24 years in prison.

Incidences of suicide and drug overdoses are „both kind of going up at the same time, almost twin epidemics,“ Johns Hopkins University psychiatry professor Dr. Paul Nestadt told the LA Times. Both are „often driven by an ambivalence about life,“ he said.

Many schools, including the University of Texas at Austin and Bridgewater State University, have responded to the increase in usage by instituting new programs.

One new initiative at Bridgewater is the distribution of 60 „opioid overdose kits“ across the campus. The kits contain the anti-overdose drug Naloxone, commonly known as Narcan, and are available for use by both the public and the school’s students. A similar program was instituted at the University of Washington. And residence advisers at the University of Texas – Austin now receive training in administering Narcan as a part of their orientation.

People sit by the Leavey Library Reflecting Pool with the VKC Library in the background, at University of Southern California in Los Angeles, California, U.S., March 13, 2019. REUTERS/Mario Anzuoni

Other schools, like Rutgers University, have created residential recovery programs for students who are struggling with drug and alcohol abuse. There are currently around 200 of these programs across the country, and some states — including New Jersey, West Virginia, and North Carolina — offer grants to schools to implement such programs.

„I know the USC administration and health center are making a lot of efforts to help with addiction and mental health,“ the music industry student continued. „But I feel like they need to do more than just send a link or a phone number and be like, ‚oh be careful.‘ There needs to be more of an open dialogue in a comfortable environment, or even a seminar or required class about mental health, stress management, and drug use. It would be more of a personal, impactful interaction than just sending a link in an email.“

Students say they don’t seek out help from school health services

In a letter addressed to students on November 9, USC President Carol L. Folt attempted to dispel rumors about the student deaths, stating that „there is a great deal of speculation about the causes of these deaths and most are being attributed to suicide. This is not correct.“ (Three of the students who died this year died by suicide, according to the Los Angeles Times.)

„These tragic losses have resulted from a number of different causes. In some cases, the cause of death is still undetermined, and in others, the loved ones do not want details disclosed,“ Folt wrote.

university of southern california usc REUTERS/Mike Blake

Folt also told students to seek out on-campus and online resources for mental health and grief counseling. But USC student Adam Miller said few students view USC’s health department as a place they can turn to at a time of need, and he wasn’t even sure what services they offered.

„I’ve noticed some drug use, but the recent email [about opioids] took me a bit by surprise,“ student Adam Miller told Insider. „What I will say is extremely common is poor mental health. Many people I talk to are overworked and overstressed and likely don’t have anyone to talk to about it.“

„I believe it could explain some of these deaths better than simply drug use,“ he continued. „In any case, mental health could be a factor in students using drugs in the first place.“