The White House is sending a letter to schools nationwide, urging them to keep naloxone on hand and train staff and students to use it. Rapidly increasing numbers of under-18s are dying of opioid-involved overdose. Yet many school districts in the United States do not yet have the overdose-reversal drug on campus. Those that do are already saving lives.
“In the midst of this fentanyl overdose epidemic, it is important to focus on measures to prevent youth drug use and ensure that every school has naloxone and has prepared its students and faculty to use it,” states the administration’s letter to schools—dated October 30, and signed by Education Secretary Miguel Cardona and Office of National Drug Control Policy (ONDCP) Director Rahul Gupta.
“Our schools are on the frontlines of this epidemic, but our teachers and students can be equipped with tools to save lives.”
“Studies show that naloxone access can reduce overdose death rates, that its availability does not lead to increases in youth drug use, and that it causes no harm if used on a person who is not overdosing on opioids,” the letter continues. “It is important to note that individuals should not be afraid to administer naloxone, as most states have Good Samaritan Laws protecting bystanders who aid at the scene of an overdose. Our schools are on the frontlines of this epidemic, but our teachers and students can be equipped with tools to save lives.”
A 2022 CDC report found that in the period from July-December 2021, median monthly overdose deaths among youth aged 10-19 more than doubled from the same period in 2019—an increase of 109 percent. Deaths involving illicit fentanyl and its analogs nearly tripled, rising 182 percent. Almost 25 percent of all fatalities involved counterfeit pharmaceutical pills.
From July 2019 to December 2021, a total of 2,231 overdose deaths in this age group were recorded. Of those, 89 were of children aged 10-14.
The White House letter cites one fact from that report which underlines the needlessness of this devastating loss of young lives, but also points to an obvious way to save many.
In two thirds of adolescent overdose deaths, at least one bystander was present. Yet in most cases, as the CDC notes, “they provided no overdose response.”
Many schools have been taking recent, belated action to make naloxone available.
Multiple school districts did not respond to Filter‘s request for comment about their naloxone policies. A representative for the Orange County, Florida, school district told Filter that it does not have a naloxone policy because school staff do not carry or use it; instead, school resource officers—on-campus law enforcement—are trained and equipped.
Many schools have been taking recent, belated action to make naloxone available. As detailed in an October report, NPR asked 20 of the largest school districts whether they mandated that their sites stock naloxone. In 2022, only five of the districts did so. But this year, that number has grown to 11. Three more of the districts—in Chicago; Charlotte, North Carolina; and Montgomery County, Maryland—do not currently require naloxone but told NPR that doing so is a “high priority.”
The Los Angeles Unified School District, the second largest in the US, required all K-12 schools to carry naloxone, beginning in the 2022-2023 academic year. In that first year alone, the medicine was administered in 31 different cases of suspected overdose. The county public health department provides schools with naloxone at no cost, and the district has nurses, wellness center providers and trained volunteers who are ready to use it, as well as school staff.
In the state of Maryland, schools have already been required to stock naloxone in nurses’ offices after lawmakers passed a 2017 bill to address opioid use disorder and overdose among youth. A Prince George’s County district representative told NPR that naloxone was administered around 45 times in the past year. This year, the district is also allowing students to carry it.
New York State, meanwhile, “encourage[s] schools to implement an opioid overdose prevention program” and advises school districts how they can obtain two cartons of naloxone for free from the manufacturer. But in New York City, officials have reportedly been slow in getting schools equipped, even as communities in surrounding suburbs of Long Island and the Hudson Valley have made progress. In October, NYC education officials claimed that all high schools had been stocked with naloxone, though some schools said they hadn’t yet received their supplies.
Local policies on naloxone use and access often continue to confuse the issue.
The Biden administration—while responsible for much harmful misinformation about fentanyl—has taken some steps to inform young people about overdose risks and prevention. An ONDCP ad campaign aimed at students, “The Real Deal on Fentanyl,” includes information about using naloxone and where to find it. “Naloxone is available without a prescription in all 50 states,” it states. “Check a retail pharmacy shelf or ask a pharmacist how to get naloxone. Look for resources from your local health department. Use the map at HarmReduction.org or select your location on the Next Distro website.” The Department of Education also provides schools with advice on planning for an opioid-related emergency.
Yet local policies on naloxone use and access often continue to confuse the issue. For example, several Washington, DC, area districts have naloxone on campuses but different rules on who can carry and use it, according to Axios. Prince George’s County (Maryland) and the City of Alexandria (Virgina) allow students to carry the medication, though only with a doctor’s note. But students in Alexandria are not permitted to administer it to other students—perhaps the clearest case imaginable of a school rule worth breaking.
Correction, November 6: This article was edited to replace a reference to “Alexandria County” with the City of Alexandria.