HOW SCHOOLS CAN RESPOND TO OVERDOSES
More students across California and the U.S. are overdosing from fentanyl that is increasingly being distributed as pills understood to be a different substance, and sometimes in colors and shapes that appeal to adolescents and young children.
Rainbow fentanyl can be found in many forms, including pills, powder, and blocks that can resemble sidewalk chalk or candy.
All school-based health centers and schools should have naloxone available and staff should be trained to use it. Anyone can administer naloxone if they are given instructions.
Naloxone Resources
Watch our recorded webinar on how one school-based health center is integrating naloxone for overdose treatment.
See our SBIRT Quick Guides for more information on how your school-based health center can address and treat substance use.
Frequently Asked Questions on Utilizing Naloxone has helpful background information.
For more information on naloxone, please see the California Department of Public Health’s Naloxone webpage.
How to Get Free Naloxone
Schools and SBHCs can obtain free naloxone from the Naloxone Distribution Project offered by the California Department of Health Care Services (DHCS).
Schools can also obtain free naloxone from the Free Narcan (noloxone HCI) for Schools Program offered by Emergent Biosolutions.
Websites Recommended by Our Youth Board & School-Based Health Providers
Our Youth Board and school-based health providers from across the state reviewed existing substance use prevention websites and found these websites to be the most youth-friendly and impactful:
Case Study
By Sai Tulugu
La Clínica is a federally qualified health center (FQHC) that operates several school-based health centers (SBHCs) in partnership with the Oakland Unified School District. The health center was founded in 1971 by a group of students at the University of California, Berkeley, as a community-based clinic to address the lack of high-quality and consistent healthcare for low-income residents in the East Bay.
La Clínica has been a pioneer in its approach to training providers to administer Naloxone – a medicine that rapidly reverses an opioid overdoses in as little as 2-3 minutes – in SBHCs. The Naloxone distribution programs started out of a concern from an employee who noticed the hyper-prevalent use of narcotics in the community, often being found in colorful, attractive forms to draw the attention of children.
Karen Gersten-Rothenberg, an associate medical director at La Clínica de la Raza, said SBHCs should focus on how opioids are distributed in the community when coming up with a strategy for addressing opioid use.
A common strategy is a drug exchange where the community can safely dispose of excess prescription or recreational substances in a safe, hygienic center. These centers could also be an opportune setting to distribute naloxone and answer questions about the use of naloxone.
Another strategy is an education program, where peer-health educators come to classrooms and explain to students what naloxone is and where they can access it.
Gersten-Rothenberg underscores the importance of using the harm-reduction model to give students the autonomy to make their own decisions about their health, while providing them the resources to be safe in the case of a medical emergency.
Addressing Concerns
SBHCs may encounter concerns from the community, school board, or other entities. Focusing on community problems is an important strategy to explain to community members that the role of naloxone distribution is not to encourage opioid use, but rather to prevent emergencies from occurring due to misuse.
Another long-term goal of some public health entities is to educate pharmacists about naloxone and change the standard of care to require naloxone prescription with a standard opioid prescription.
Normalizing naloxone in the pharmaceutical setting, may influence opinions in the general public and lead to normalization in SBHC settings.
Support for Schools & SBHCs
The Naloxone Distribution Project (NDP) was created by the California Department of Health Care Services and provides free naloxone to registered entities including schools, universities, and community organizations.
Some steps to take include:
- Complete an application for the Naloxone Distribution Project (NDP)
- Ask for basic demographic information
- Obtain a Naloxone standing order or physician prescription
- Licensure Information (FEIN Number, Nonprofit status, etc)
- Develop a Distribution Plan
- Once naloxone is received, complete overdose reversal forms and submit to NDP
Using Naloxone
Telltale signs of an opioid overdose include
- an unresponsive person
- shallow and/or difficult breathing
- a person who is going in and out of consciousness
- a black circle in the pupils.
When in doubt, it is usually best to administer Naloxone as this medication has no effects on a person not in overdose.
In a person undergoing an opioid overdose, naloxone administration temporarily blocks opioid receptors and causes immediate relief.
Side effects such as body aches, increased blood pressure, fever, etc., and professional medical help should be sought.
Rescue breathing may be performed if possible. The person should also be watched until professional medical help is available.
Naloxone Distribution Resources
- Naloxone in Schools Toolkit – National Association of School Nurses
- Free Narcan for Eligible Schools – California MAT Expansion Project
- Naloxone Distribution Project – California Department of Health Care Services
Sai Tulugu is a member of the California School-Based Health Alliance Youth Board.