Though no one has tracked national numbers, overdoses in schools appear to be rare. Still, a high-profile foundation is partnering with a pharmaceutical company to make sure school nurses are prepared for the worst.
The Clinton Foundation’s Health Matters Initiative is working with Irish drugmaker Adapt Pharma to make the overdose antidote naloxone available to every high school in the United States. Adapt Pharma’s product, also called Narcan, is easy to use: sprayed into the nose of a person experiencing overdose, it reverses the effects of the opioid in about a minute. The project was announced Monday at the foundation’s annual Health Matters Initiative Activation Summit. Adapt Pharma also announced an unlimited grant to the National Association of School Nurses to train nurses in overdose management and addiction awareness.
In 2014 47,055 Americans died of drug poisoning, according to the latest data from the Centers for Disease Control and Prevention. Only about 8 percent of those were among young people between the ages of 15 and 24, but there has been a 38 percent increase in overdoses in this age group since 2004. Experts blame the rise in drug poisoning deaths in all age groups on prescription opioid and heroin overdose.
The naloxone gift is for just two nasal sprays per school – enough to stop two overdoses. But the education dollars have the potential to make real impact, says National Association of School Nurses president Beth Mattey. ”We want nurses to have all the education they can, so they understand the need for and how to use and the protocol to follow when there’s a suspected overdose,” she says.
But it’s not clear how many schools can legally take advantage of the naloxone donation or the training. A few states including New York, Rhode Island, Massachusetts and Kentucky have laws explicitly authorizing nurses to stock and administer naloxone in schools. A majority of states allow the use of naloxone by first responders, but school nurses are not always considered first responders under the law, according to Mattey. Even in states where no laws prohibit school nurses from administering naloxone, nurses may not be protected from liability.
“It depends on the state law, and in some areas even the local district policy,” Mattey says. Last June, she points out, the National Association of School Nurses issued a policy statement calling for naloxone in schools. “I think now we’re putting it on the radar for school nurses and school districts. [Policies are] changing as we speak,” she says.
However, according to a 2015 federal government report, only about 78 percent of U.S. high schools even have a nurse on staff.
According to a spokesperson, the Clinton Foundation will also work with Adapt Pharma to make Narcan available to schools in six focus areas: California’s Coachella Valley; Northeast Florida; Greater Houston; Adams County, Mississippi; Central Arkansas; and Knox County, Illinois.
Still, given the low reported incidence of overdose in schools, some drug policy experts question why the foundation is channeling money and energy in that direction.
“We know where people overdose, and it’s not schools,” says Corey Davis, deputy director at the Network for Public Health Law. “It’s great that the Clinton Foundation is involved in this. It just seems like of all the places to put that money, schools are such a low-yield investment.”
Davis says it would be a better use of funds to ensure naloxone access for people at high risk for overdose. And he says it’s not hard to find them. “People are high-risk when they’re leaving prison, or leaving abstinence-based drug treatments, or even people who have contact with organizations like syringe exchange programs or drug treatment facilities,” he says.
But to Beth Mattey, it makes sense to have naloxone as a part of every school’s emergency preparedness protocol. “Why is naloxone any different than a peanut allergy? We have epinephrine, we have AEDs in the schools, we have Diastat for children with epilepsy. Emergencies happen in the schools. We need the tools necessary to prevent a tragedy.”
The Clinton Foundation plans to distribute the naloxone cartons via state education departments.
Adapt Pharma is making its naloxone product available to schools that choose to purchase more doses beyond the two-dose gift at the same discount rate it offers to public safety departments, EMS and community-based nonprofits: $75 for a two-dose carton. Adapt Pharma’s wholesale price for the drug is $125 per carton.