Across the four schools of the Montpelier-Roxbury district, nurses now have a new tool at their disposal – naloxone, the overdose-reversal drug often known by its brand name Narcan.
“We put it in the same category that each of our buildings has a defibrillator, and each of our buildings have EpiPens,” said Montpelier-Roxbury superintendent Libby Bonesteel.
An “opioid antagonist,” naloxone helps re-establish normal breathing in someone suffering from an overdose. There is no risk of abuse – it does not get someone high – and there are minimal side-effects. The medication can be injected intravenously or into the muscle; Narcan is the nasal-spray version of naloxone, and created specifically with non-medical personnel in mind.
Other districts in Vermont also keep naloxone, but doing so doesn’t appear to be the norm — yet. Jeff Francis, executive director of the Vermont Superintendents Association, said he only knew of three districts currently stocking naloxone – Montpelier-Roxbury, Springfield, and Hartford. However, he’s gotten several inquiries from superintendents in recent years on the subject.
Nationally, more schools are increasingly keeping the overdose-reversal drug on hand, according to media reports. At least two states even passed mandates requiring schools to do so. The manufacturer, Adapt Pharma, has also offered to give Narcan away to high schools and colleges for free.
Since 2014, the Vermont Health Department has been giving Narcan out free-of-charge at designated distribution centers across the state to those who are at risk of overdose. In 2018, according to preliminary data published by the state, the Health Department distributed over 7,000 kits, which reversed a reported 425 overdoses.
A standing order issued by the commissioner of health in 2016 allows any Vermont pharmacy to sell naloxone to anyone who wants it without a prescription, and the order also allows insurers and Medicaid to cover the cost of Narcan.
But the state hasn’t used schools as distribution centers or offered Narcan to districts. Instead, it’s tried to get naloxone directly into the hands of those who use drugs, their friends and their family members.
“We know based off of 911 and health care data that the vast majority of overdoses are happening at residences in the community,” said Stephanie Busch, the injury prevention grants manager and naloxone distribution coordinator at the Health Department.
Overdoses on school grounds are very rare, according to the Health Department. Officials say that, between 2015 and 2019, fewer than five overdoses have been reported a year at Vermont schools, according to EMS data. But they have happened.
Both Bonesteel and Zach McLaughlin, superintendent of the Springfield School District, said there hadn’t been any overdoses on district property that they knew about during their tenures. But they said they wanted to be proactive.
“If I have things that put me in a position to keep kids more safe, I’m going to do that,” McLaughlin said.
Deborah Hopkins, the president of the Vermont Association of Addiction Treatment Providers, said there’s value in giving schools Narcan, despite the rarity of overdoses on K-12 campuses. If anything, she said, it helps get a fact-based conversation going about addiction and drugs. A lot of people, for example, still think naloxone is only available as an injectable drug, Hopkins said, and don’t realize there’s a nasal-spray version.
“Even being able to show the product – it becomes less intimidating,” she said.
But she also said she’d like policy makers to consider schools as a useful point-of-contact to get Narcan directly into households.
“Personally, I’d like to be able to find a way to get it to kiddos that may want to access it to keep it in their homes, because they may have someone living in their homes that struggles with substance abuse disorder,” she said.
