Schools have overdose reversal medications on hand, but some are concerned about stigma

More than 30 states have legislation permitting schools or school staff to carry, keep, or administer naloxone, but some administrators are reluctant to stock it out of fear of being labeled a “bad school.”

A student at Central High School in Pueblo, Colorado, passed out after exiting a restroom the previous year. Jessica Foster, the district’s head nurse, realized she needed to take immediate action when she overheard the girl’s upset companions discussing drugs.

Four minutes distant were the nearest emergency personnel. Foster argued that four minutes was “still too long” if they were entirely not breathing.

Foster claimed that she gave the student a dose of naloxone, a drug that can quickly reverse an opiate overdose. The girl came to.

When a 15-year-old student overdosed in class in December 2021 after taking a fentanyl-laced tablet in a school toilet 45 miles away in Colorado Springs, Mitchell High School administrators didn’t have naloxone on hand. Student X passed away.

Since then, Colorado Springs’ school system has joined Pueblo and dozens of other districts in the state in distributing the life-saving drug, commonly known by one of its brand names, Narcan, to middle and high schools. Colorado offers a program that permits schools to get the medication, often in nasal spray form, for free or at a reduced cost, since the adoption of a state law in 2019.

However, not all schools are on board with the concept. Despite an increase in enrollment since last year, just about a third of Colorado’s districts were signed up for the state’s giveaway program at the beginning of this academic year. Due to the persistent stigma associated with the need for the overdose reversal medicine, several school districts in the dozen counties in the state with the highest number of drug overdose deaths had not signed up.

As deadly opioid overdoses grow, notably from the strong narcotic fentanyl, the federal Substance Abuse and Mental Health Services Administration advises that schools, including elementary schools, maintain naloxone on hand. Additionally, 33 states’ laws specifically permit schools or school personnel to carry, store, or administer naloxone.

Among them, around nine states—including Illinois, where the mandate takes effect in January—require that at least some K–12 schools keep naloxone on hand. Some states, including Maine, additionally mandate that public schools instruct children in how to use nasal spray naloxone.

at Rhode Island, naloxone must be available at both public and private K–12 schools. Nine individuals between the ages of 10 and 18 have received naloxone in educational settings in the last four years, according to Joseph Wendelken, a representative for the Rhode Island Department of Health.

The drug was also made accessible nationally over the counter at the beginning of September, but some addiction specialists are concerned that the $45 price tag per two-dose package may make it unaffordable for people who need it most.

However, the medication is still not as widely used in the public as AEDs or fire extinguishers. According to Kate King, president of the National Association of School Nurses, officials may be reluctant to store naloxone in schools out of concern about providing medical care or because doing so would be expensive and time-consuming. However, the biggest concern she has heard is that schools are concerned about being labeled as a “bad school” with a drug issue or as a school that supports poor decisions.

According to Yunuen Cisneros, community outreach and inclusion manager at the Public Education & Business Coalition, which works with most of the state’s school districts, “school systems are very sensitive about their image. Many of them are unwilling to accept this program because doing so would mean accepting that there is a drug addiction problem.

King argued that’s the incorrect way to think about it. “We really equate it to our stock of albuterol for asthma attacks, and our stock of epinephrine for anaphylactic reactions,” she said.
Health officials in Colorado were unable to estimate how frequently naloxone has been used on school grounds in their state. At least 15 kids between the ages of 10 and 18 have already passed away this year from fentanyl overdoses, but not necessarily in schools. According to the state Department of Public Health and Environment, 34 kids in that age range passed away in 2022. One of them was José Hernández, 13, who passed away from a fentanyl overdose at home in August 2022, just days after beginning eighth grade at Aurora Hills Middle School. His grandma discovered his body over the sink in the bathroom.

According to district nurse Myranda Lyons, Moffat County School District RE-1 in Craig, Colorado, receives its naloxone from a nearby addiction treatment facility. She claimed that when she teaches CPR to school employees, she also trains them on how to deliver it.

Ignacio School District 11Jt Superintendent Christopher deKay said that although the district’s school resource officers already carry naloxone, they also signed up for the state program so that schools may keep the drug on hand in the nursing office in case a resource officer isn’t present.

“It’s like everything — like fire safety training. You never know what will occur at your school, deKay added. We want to be able to react as effectively as we can if the unexpected occurs.

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