Naloxone in Schools Saves Lives

If you’ve spent any time in a school, you probably know about the emergency procedures in place to keep students safe from threats like fires, tornadoes and earthquakes. But what about opioids? According to the Centers for Disease Control and Prevention, opioids like fentanyl are claiming the lives of our nation’s kids at alarming rates.^1,2 In 2021, for example, fentanyl was involved in 84% of all overdose deaths among teens.¹ So what can parents and school administrators do to fight back? Treat opioids like other threats, and formulate an emergency plan that includes keeping naloxone in schools for opioid overdoses. Read on to learn more about how naloxone in schools saves lives.

What is naloxone?

Naloxone is an FDA-approved medication called an opioid antagonist.³ An opioid antagonist can counteract the life-threatening effects of opioids in the body and restore normal breathing in someone who has overdosed.⁴ One well-known brand of naloxone is Kloxxado^® (naloxone HCl) nasal spray 8 mg.⁵ Another is Narcan^® (naloxone HCl) Nasal Spray 4 mg.⁶ A single 4-mg dose of naloxone is not always enough to reverse an overdose, however.⁴ One study found that in 78% of cases, two or more 4-mg doses of naloxone were needed to reverse opioid overdose.⁷ The prevalence of stronger, synthetic opioids such as fentanyl may be to blame.^7,8

Is naloxone safe?

Naloxone, which can be used on people of all ages (from infants to elderly adults⁹) should be given to anyone who is showing signs of opioid overdose or when overdose is suspected.³ Giving naloxone will not harm someone who is not overdosing or overdosing on drugs other than opioids, and you don’t need medical training to give it.^4,10 Linda Mendonca, president of the National Association of School Nurses says, “[Naloxone] is just one more tool that can help save a life. If you can save even one life, that’s great.”¹¹

Why is naloxone in schools necessary?

Between July 2019 and December 2021, the total number of monthly overdose deaths in children aged 10 to 19 increased 65% overall, with about 91% of these deaths involving at least one opioid.² An opioid overdose is an emergency situation that must be addressed with emergency treatment. According to Bobby Mukkamala, MD, chair of the American Medical Association’s Substance Use and Pain Care Task Force, “We are facing a national opioid crisis and it’s affecting our young people at an alarming rate. Just as students carry prescription inhalers to treat an asthma attack, we must destigmatize substance-use disorders and treat naloxone as a lifesaving tool.”¹²

Who gives naloxone at school?

Most school districts that stock naloxone require training for a select group of staff who agree to be on-call to administer it if they are in the building during an emergency.¹¹ The school nurse is typically the first to respond to an emergency in the school setting.¹³ (This is because school nurses generally possess the education and knowledge needed to identify emergencies, manage the situation until relieved by emergency medical services [EMS] personnel, communicate the assessment and interventions to EMS personnel and then perform appropriate followup.¹³) In some districts, school resource officers (authorized by local law enforcement) may carry naloxone as well (and administer it as needed).¹¹

Which school districts already have naloxone in place?

A national movement to get naloxone in schools is gaining momentum—districts in California, Maryland, Nevada, Texas, Virginia, Florida, New York, Pennsylvania and North Carolina all have made the decision to stock naloxone.¹ The Los Angeles United School District (LAUSD), the second largest in the country, was one of the first school districts to do so after a 15-year-old student was found in a school bathroom dying from an opioid overdose.¹ The LAUSD now stocks naloxone in all of its schools (it was given at school more than 30 times during the 2022-2023 academic year).¹ In addition to stocking naloxone, all of the schools in the LAUSD and in Prince George’s County, Maryland allow students to carry the spray as well.¹ Intranasal naloxone (e.g., Kloxxado^®, Narcan^®) is available nationwide, and Kloxxado^® is available for bulk order by organizations (including school districts and private schools).

What else can schools do to help prevent opioid overdose?

When it comes to preventing drug use, education is important.¹⁴ Having honest conversations about drugs, making sure kids understand the physical and legal consequences of drug use and knowing what to do in an opioid overdose emergency all go a long way toward preventing young people from becoming statistics.¹⁵ The US Drug Enforcement Agency has compiled a collection of online drug education resources, lesson plans, activities and videos from a number of different websites. These resources are suitable for a number of different grade levels and can be used by teachers as well as parents and caregivers.¹⁴

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Please see the Full Prescribing Information and Medication Guide for Kloxxado^® for complete product details.

NOTE: This article was not written by a medical professional and is not intended to substitute for the guidance of a physician. These are not Hikma’s recommendations, but rather facts and data collected from various reliable medical sources. For a full list of resources and their attributing links, see below.

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