Heroin epidemic puts pressure on schools to get antidote

Providence, R.I. • The heroin epidemic that has been taking the lives of teenagers for years is creeping into even younger age groups and putting pressure on the nation's schools to keep a fast-acting overdose antidote within reach of every nurse and teacher.

Although overdoses at school are rare, nurses are increasingly thinking of the drug naloxone as an essential part of their first-aid kits. Administered via syringe or a nasal spray, it works almost immediately to get an overdose patient breathing again, and it does not create a high or have major side effects.

The National Association of School Nurses wants all schools to keep the antidote on hand.

"We're facing an epidemic," said Beth Mattey, president of the group. "People are dying from drug overdoses, opioid drug overdoses. We need to be able to address the emergency."

At least five states this year adopted laws on the use of naloxone in schools, including Rhode Island, which now requires it to be available in all middle, junior high and high schools. Some states allow or encourage schools to buy it. And many schools already have the drug in stock.

Also known by the brand name Narcan, the antidote was first approved by the Food and Drug Administration in 1971. Advocates say it could save a child, parent or school employee who overdoses on heroin or prescription painkillers.

One Rhode Island nurse bought Narcan on her own after attending a lecture and training last fall. Kathleen Gage then took the drug into her 11th-grade health classroom to teach students how to get it at a pharmacy and use it.

"They were really enthusiastic that this could reverse an overdose, and they would have the tool to do it," said Gage, a nurse at Pilgrim High School in Warwick, who also pushed for the state law that requires schools to buy the drug for emergencies.

Rebecca King said she has observed substance abuse as a nurse in a K-8 school in Delaware. Seeing a child collapsed on the floor is the "worst nightmare" of every school nurse, she said.

"Naloxone saves lives," King said. "It can really be the first step toward recovery."

Heroin overdose deaths in the United States nearly quintupled from 2001 to 2013. More than 70 percent of overdose deaths relating to prescription drugs in 2013 involved opioid painkillers — a class of drugs that includes heroin, oxycodone, codeine, fentanyl and morphine, according to the Centers for Disease Control and Prevention.

Overdoses at school are uncommon but not unheard of.

A survey of 81 Rhode Island school nurses who participated in a naloxone training program last year found that 43 percent of high school nurses who responded reported that students in their schools were abusing opioids, according to statistics released by the state health department. Fifteen said they had to call 911 at least once in the past three years for suspected student substance use or overdose.

In Massachusetts, nurses in more than 200 school districts have been trained to use the antidote. The Boston suburb of Easton paid less than $100 to equip the middle school and high school with naloxone in the nurse's office.

Superintendent Andrew Keough said he has heard no complaints from parents and likened the decision to keeping on hand a heart defibrillator or an EpiPen, a pocket injector used to treat severe allergic reactions.