Schools stock up on overdose antidote

Residents of the West Linn-Wilsonville School District near Portland, Ore., elected Kelly Sloop to the school board in May 2021. The pharmacist and mother of three said that the state’s prolonged school closures and decriminalization of drug possession have created a double whammy for Oregon residents. “We have a mental health crisis amongst our youth,” Sloop said.

Early this year, Sloop and other members of the school board voted unanimously to stock Narcan in its high schools. With a rising number of drug overdose deaths among young Americans, some other schools are doing the same.

According to the National Center for Health Statistics, 16,849 people in the U.S. died of a drug overdose in 1999. Two decades later, that number had grown to 70,630. A 2018 study reported that opioid-related deaths among children and teenagers nearly tripled from 1999 to 2016.

Naloxone, often referred to by the brand name Narcan, is an opioid antagonist that can reverse the respiratory symptoms of opioid overdoses. The treatment only works temporarily but can buy valuable time before more medical help is available—and if a person is not overdosing but is given Narcan anyway, there are no harmful side effects. Narcan can be administered with a nasal spray or by injection.

“That’s one of the things that school nurses do as part of their public health expertise and preparedness is to be ready for any emergency,” said Linda Mendonca, president of the National Association of School Nurses. “It’s one of the emergency drugs that’s kept on hand at school … [for] anybody that might be within that school building. … It’s like having the AED or having an EpiPen.”

An NASN position paper endorses the use of naloxone in schools as part of their “emergency preparedness and response plans.” Mendonca said she hasn’t heard arguments against naloxone in schools, though she noted that schools would need to budget for it.

She added that another barrier could be misplaced optimism: “It could be just a school community or school district [thinking] … ‘This wouldn’t happen in our school.’”

As of August 2020, 27 states had laws addressing naloxone use in schools, with seven states requiring school districts to institute a policy for the overdose drug, according to a review by the Legislative Analysis and Public Policy Association. In 2019, Oregon legislators passed Senate Bill 665, requiring the State Board of Education to formulate guidelines for opioid overdose responses in schools, including the use of naloxone if available.

Gail Strobehn-Simmons launched her Oregon-based nonprofit Need 4 Narcan last year a week ahead of the anniversary of her then 30-year-old son’s 2012 death due to a heroin overdose.

Strobehn-Simmons said her son first used drugs when he was 14, and she hopes that naloxone will soon also be available in Oregon middle and elementary schools. (It’s currently only available in high schools.) “The biggest problem that I personally have seen is that the school’s saying ‘Oh no—we don’t have a problem in our school.”

Sloop, the West Linn-Wilsonville school board member, contacted Strobehn-Simmons last fall about getting Narcan into her district’s schools. Once the board gave its approval, Strobehn-Simmons donated Narcan to the district that she had received through a private gift. Sloop said the school resource officer trained staffers—including counselors and coaches—on administering the overdose reversal drug.

Mendonca pointed out drug overdoses aren’t going away. “Mental health, isolation … so many things have been exacerbated by this pandemic,” she said. “This is something we can’t pretend isn’t still happening because it is.”