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Why districts are stockpiling naloxone in response to the opioid crisis

Citing concerns about student use of opioids — and fentanyl in particular — a growing number of districts have equipped schools with naloxone, a drug that temporarily reduces the harmful effects of overdoses.

The Los Angeles Unified School District became the latest to do so last month when it said it would stockpile the drug and train trained personnel in its use, part of a multi-pronged response to a ” devastating epidemic of all-too-common overdoses in Los Angeles.”

Los Angeles police reported a series of overdoses among high school students in the city, one of whom died in a school bathroom on September 13 after she and her friends took what they believed to be pills of Percocet. These pills appear to have been mixed with fentanyl, an extremely potent synthetic opioid, police said.

“No child in Los Angeles, in any school system in our country, should die as a result of contact with fentanyl,” LAUSD Superintendent Alberto Carvalho told Education Week in a video interview.. “This is a crisis that is not unique to Los Angeles. It is not unique to schools. This is a national crisis that requires bold leadership.

Other districts — from Des Moines, Iowa to Denver — have also stockpiled naloxone in recent years, some empowered by state law changes that make it easier. Here’s what educators need to know.

What is naloxone?

Naloxone is an “antagonist” drugmeaning it fights the effects of other drugs by blocking brain receptors that respond to opioids, such as heroin, oxycodone and fentanyl, according to the National Institutes of Health.

Given quickly – usually by nasal mist – the drug can stop the symptoms of an overdose, such as shallow breathing and slow heartbeat, to give medical staff a chance to intervene.

Naloxone, a generic term for the drug, is also known by the brand name Narcan.

Is it safe for schools to use naloxone?

“It’s just one more tool that can help save a life,” said Linda Mendonca, president of the National Association of School Nurses, an organization that has advocated for naloxone in schools.. “If you can save even one life, that’s great. »

She compared it to rapid epinephrine injectors that many schools carry to respond to severe allergic reactions.

Federal health agencies say naloxone is relatively safe to administer, even to people without medical training. Importantly, it doesn’t harm people receiving it if they don’t have opioids in their system, which means health officials aren’t worried about people misadministering it, said Mendonca.

Some local and regional health departments have provided residents with free naloxone, urging them to carry it so they are better equipped to respond to an emergency. Some counties even provide free naloxone from vending machines. And the majority of state laws provide statutory immunity to lay people administering the drug.

Who administers naloxone in schools?

State naloxone laws vary, and legislatures have changed their laws in recent years to make dispensing, prescribing, and administering the drug easier. As of 2020, 27 states had laws allowing K-12 schools to enforce it, according to the most recent analysis from the Legislative Analysis and Public Policy Association.

Of those states, six require school districts to have a naloxone policy that details how it will be used: Arizona, Maryland, Oregon, Rhode Island, Tennessee and Washington.

Most school districts that stock the drug require training for a select group of employees who agree to be on call to administer it if they are in the building in an emergency. LAUSD, for example, said it plans to offer training to “appropriate personnel, such as nurses, wellness center providers and trained volunteers” in cooperation with the local health department.

In some schools, school resource officers carry naloxone with the permission of local law enforcement who employ them in cooperation with districts.

Drug costs vary, with the brand name Narcan costing up to $140 for a two-dose kit. Schools have factored these costs into safety budgets, worked in conjunction with local health departments, or secured grants to help cover expenses.

Why are more schools offering naloxone?

Over the past decade, drug prevention organizations have encouraged schools to stockpile naloxone because it is often centralized in communities. Equipped with the drug, school staff could be ready to respond to overdoses among parents, spectators at sporting events or even pedestrians near campus, they said.

But schools have increasingly cited concerns for students themselves as they adopt naloxone policies.

In March 2016, a school nurse in Anne Arundel County, Maryland used naloxone to save an overdosed high school. student just 10 days after her school began wearing it, the Baltimore Sun reported.

When the Des Moines, Iowa, school board approved a naloxone policy on Oct. 4, documents listed “11 times in the 2021-22 school year that district nurses allegedly used naloxone on students.” if she had been available,” the Des Moines Register reported..

While federal data shows that drug use among teens hit a record high in 2021, many illicit drugs themselves are significantly more potent and dangerous, increasing the risk of overdose in young people, warn public health officials. It’s partly because drug dealers mix drugsoften surreptitiously, with agents like fentanyl making them much stronger, said an April study published in the Journal of the American Medical Association.

There were 518 overdose deaths among American adolescents in 2010, according to this study, a number that has increased to 1,146 in 2021. Teenage overdoses have also become more likely to lead to death during this period. .

What else can schools do in the event of a fentanyl overdose?

Schools should match their overdose response efforts with prevention, said Mendonca, of the National Association of School Nurses.

Students need drug prevention education that makes them aware of the increased potency of drugs in recent years and how to address concerns about peer use, she said.

The push comes after the Drug Enforcement Administration warned in August about “rainbow fentanyl.” which is sold in the form of pills and colored powders which may be more appealing to teenagers.

Some districts have also offered workshops for families and community members to learn more about the problem, how to identify the warning signs of substance abuse, and how to intervene.

The Los Angeles school system plans to train high school juniors and seniors to teach health education to freshmen using a peer-to-peer model, the district said. The school system also plans to create a safety task force and provide training through its parent academy.

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