Lo­cal schools pre­pare to treat stu­dent over­doses

Sys­tems stock­ing nalox­one amid opi­oid epi­demic

Baltimore Sun - - FRONT PAGE - By Pamela Wood

Baltimore-area school sys­tems are stock­ing their health suites with nalox­one, the heroin over­dose drug, and train­ing nurses to ad­min­is­ter it.

Use of nalox­one has be­come com­mon­place for paramedics, po­lice of­fi­cers and fam­ily mem­bers of ad­dicts as the num­ber of opi­oid-re­lated deaths has in­creased dra­mat­i­cally in Mary­land and across the coun­try.

Now schools say they must be pre­pared as well.

“We can’t hide our head in the sand,” said Mary Na­suta, nurse co­or­di­na­tor for Har­ford County schools, which will stock nalox­one in mid­dle and high schools after a train­ing pro­gram for nurses this month. “We­have to re­al­ize if this is a prob­lem in the com­mu­nity, it can be a prob­lem in our schools, and we have to be ready for it.”

Anne Arun­del County schools be­gan stock­ing nalox­one — also known by the brand name Nar­can — in school health rooms last spring. Baltimore County and Car­roll County started pro­grams this school year.

Of­fi­cials in Howard County and Balti-

more City say they are work­ing on plans to put nalox­one in schools.

Ten days after the launch of Anne Arun­del’s pro­gram in March, a school nurse used the drug to save a high school stu­dent who was over­dos­ing, said Karen SiskaCreel, the county’s di­rec­tor of school health.

“Alot of peo­ple said, ‘Oh, you’ll never give it in schools. You’ll never need it.’ I said, ‘I don’t want to wait for a child to die,’ ” Siska-Creel said.

Nalox­one can quickly re­verse the res­pi­ra­tory dis­tress of a per­son who has over­dosed on heroin or an­other opi­oid drug. The lat­est ver­sion of the drug is a nasal spray that’s rel­a­tively easy for any­one to ad­min­is­ter, even those with no med­i­cal train­ing. Kits con­tain two doses and cost $100 each.

It cost $12,500 to stock each of Anne Arun­del’s 125 schools, Siska-Creel said.

Siska-Creel’s staff cre­ated a train­ing pro­gram and ob­tained train­ing cer­ti­fi­ca­tion from the state. Nalox­one train­ing is now part of ori­en­ta­tion for new school nurses, she said. Train­ing in­cludes how school nurses can dis­tin­guish opi­oid over­dose from other med­i­cal emer­gen­cies a child might have, such as an al­ler­gic re­ac­tion.

Siska-Creel plans to ex­pand train­ing to other school em­ploy­ees as well.

“Heroin is an epi­demic. It’s ev­ery­where. I just didn’t see it get­ting bet­ter,” she said. “We needed to put our­selves in a po­si­tion where we were able to take care of our stu­dents.”

In 2015, a record 1,089 peo­ple in Mary­land died of opi­oid-re­lated over­doses — in­clud­ing from heroin, fen­tanyl and pre­scrip­tion opi­oids. They ac­counted for 86 per­cent of all of the state’s drug- and al­co­hol-re­lated over­dose deaths.

Opi­oid-re­lated deaths in Mary­land have more than dou­bled since 2010, ac­cord­ing to state data. Deaths from heroin specif­i­cally have tripled dur­ing that pe­riod.

Over­dose deaths due to heroin have in­creased among all age groups, in­clud­ing those younger than 25.

In Mary­land, health of­fi­cials have iden­ti­fied nalox­one as a way to save peo­ple from dy­ing of over­doses.

Since 2014, nearly 35,000 peo­ple who are not med­i­cal pro­fes­sion­als have been trained on how to use nalox­one. The group in­cludes friends and rel­a­tives of ad­dicts and em­ploy­ees of treat­ment pro­grams. Once trained, in­di­vid­u­als can buy nalox­one with­out a pre­scrip­tion in Mary­land.

State of­fi­cials say those 35,000 peo­ple have ad­min­is­tered the drug 1,181 times.

Po­lice of­fi­cers in many ju­ris­dic­tions carry nalox­one be­cause they some­times ar­rive at over­dose calls be­fore paramedics. When the An­napo­lis Po­lice Depart­ment in­sti­tuted a nalox­one pro­gram in 2014, an of­fi­cer used the drug to save a man from an over­dose within 10 min­utes of com­plet­ing the train­ing.

The Na­tional As­so­ci­a­tion of School Nurses rec­om­mends school nurses be trained in ad­min­is­ter­ing nalox­one be­cause of the chance some­one might over­dose in a school.

“There is a prob­lem in this na­tion and that prob­lem tran­scends all com­mu­ni­ties,” said Donna J. Mazyck, ex­ec­u­tive di­rec­tor of the Na­tional As­so­ci­a­tion of School Nurses. “The po­ten­tial for an emer­gency and the need to re­spond is there.”

If some­one over­doses in a school, the school’s nurse is likely to be the first health pro­fes­sional on the scene, Mazyck said.

The as­so­ci­a­tion of­fers on­line ed­u­ca­tional ma­te­ri­als on nalox­one, paid for by a grant from Adapt Pharma, which man­u­fac­tures the nasal-spray form of the drug. The com­pany an­nounced this year it would of­fer free nalox­one kits to all U.S. high schools.

Mazyck said it’s ul­ti­mately up to school sys­tems to de­cide whether to use nalox­one or not. “It’s one of those de­ci­sions that is driven by the school it­self, not a com­pany,” she said.

The Baltimore-area school sys­tems that stock nalox­one have bought the drug ei­ther through school or health depart­ment bud­gets.

In Har­ford County, the sys­tem had re­lied on law en­force­ment of­fi­cers as­signed to schools to carry nalox­one in the event of an over­dose. But Na­suta, Har­ford’s school nurse co­or­di­na­tor, said the heroin epi­demic, cou­pled with the fact that vic­tims are get­ting younger, made it im­por­tant to have school nurses in­volved.

She doesn’t have re­ports of stu­dents us­ing heroin in schools, but she said it could be hap­pen­ing.

“It’s al­ways a pos­si­bil­ity, and we need to pre­pare for emer­gen­cies,” she said.

Since the be­gin­ning of this school year, all Baltimore County pub­lic high schools and al­ter­na­tive schools — 28 schools al­to­gether — have had nalox­one on hand. School nurses were trained to use the drug over the sum­mer, said Deb­o­rah Somerville, co­or­di­na­tor of health ser­vices for the school sys­tem. “We see it as an emer­gency medicine,” Somerville said.

Baltimore County schools re­ceived nalox­one kits from the county Health Depart­ment as part of its over­all nalox­one drug and train­ing ex­pen­di­ture of about $60,000 this year.

Somerville said the county chose to put the drug in high schools and al­ter­na­tive schools — which of­fer ex­tra sup­port to stu­dents fac­ing par­tic­u­lar chal­lenges — be­cause teens are more likely than younger stu­dents to use heroin or opi­oids.

Baltimore County’s pro­gram is fo­cused on nalox­one avail­abil­ity dur­ing the school day — Somerville noted po­lice of­fi­cers and paramedics, who also carry nalox­one, are of­ten present dur­ing sport­ing events and other after-school ac­tiv­i­ties. School nurses some­times are on duty dur­ing other af­ter­school events.

Car­roll County de­cided to put nalox­one in mid­dle and high schools this school year. Of­fi­cials there say they have not had an over­dose in a school in the past, and haven’t yet used nalox­one since nurses put it in their emer­gency bags this year.

In Howard County, plans are in the works to train nurses in nalox­one use after the win­ter hol­i­days, ac­cord­ing to schools spokesman John White. For now, school re­source po­lice of­fi­cers sta­tioned in Howard’s mid­dle schools and high schools carry the drug.

Baltimore City schools do not have nalox­one on hand and school po­lice of­fi­cers do not carry the drug, said Edie House, a city schools spokes­woman.

City health of­fi­cials are de­vel­op­ing a nalox­one pro­posal to present to school of­fi­cials, but there’s no time­line for when a pro­gram might be put in place, said Sean Naron, a city Health Depart­ment spokesman.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.