Berea Ind., Madison Co. officials opt for more research before deciding whether to accept offer of heroin overdose antidote sprays for schools

Richmond Register, April 27, 2016

Heroin antidote offered to state high schools
Local school districts looking into offer
by Ricki Barker

In addition to pencils, paper and folders, some Kentucky schools will be adding a heroin antidote to their supply lists next fall.

According to Van Ingram, executive director of the Kentucky Office of Drug Control Policy, state education and drug control officials are working with the pharmaceutical company Adapt Pharma, which is offering two free doses of Narcan nasal spray for the emergency treatment of heroin and opioid overdose to every high school in the country.

Adapt Pharma, which is based in Ireland but has offices in the U.S., along with the Clinton Foundation have extended the offer to all high school in Kentucky. The Kentucky Department of Education and the Kentucky Harm Coalition are currently working to arrange education and provide distribution this fall.

Narcan is a brand of naloxone, which has been shown to reverse the effects of an overdose on opioids. The antidote can be administered via syringe or a nasal spray and works almost immediately to get an overdose patient breathing normally again, and does not create a high or have major side effects.

Ingram said it will be up to individual school districts whether they decide to take the free doses offered or not.

“We hope to roll it out this summer and into the fall,” Ingram said.

Kentucky is the second state that has agreed to help facilitate the company’s offer on a statewide basis to school districts who want it, said Thom Duddy, Adapt Pharma executive director of communications.

School districts stocking up on heroin antidotes is not a new idea as Rhode Island now requires it for all middle, junior high and high schools, and Delaware recently passed a resolution endorsing expanded access to naloxone in schools.

As other states grapple with the epidemic proportions of opioid overdoses and the average age of users creeps ever younger, Kentucky schools are prime candidates for keeping the antidote in stock and in reach.

According to the most recent data from the Centers for Disease Control and Prevention, Kentucky ranks among the worst states in drug overdose deaths, at 24.7 per 100,000 residents.

Fayette County Public School officials recently declined the offer of the free doses of Narcan. They cited no need of the resource at the present time.

However, health officials at Madison County Schools said Tuesday they are actively researching the possibility of having the heroin antidote at both Madison Central and Madison Southern high schools.

Berea Independent Schools Superintendent Mike Hogg said the school will have to do more research on the subject before approaching any kind of decision.

Becky Carr, Madison County Schools nursing coordinator, said Tuesday the school is waiting for the Kentucky Department of Clinical Health to update protocols for the Narcan nasal spray.

"The KDE already has a procedure in place for the injection of Narcan, but for our purposes, we will need the protocols for the nasal spray procedure," Carr explained.

Carr said serious discussions of adapting a Narcan program at the high schools will take place as soon as more information is provided.

"It is definitely something we are researching," Carr said of the antidote. "We want to be able to do what's best for our kids. Unfortunately, in our world today, it's possible we could have an overdose situation at one of our schools. With an antidote ready, we could potentially save a life. It would be another tool for us that we hope we would never have to use."

According to Madison County EMS Director Carlos Coyle, the county is already trending ahead of opioid overdoses for this year.

In a previous interview with The Register, the EMS director said the number of times emergency medical personnel have had to administer a heroin overdose antidote has continued to climb over the years.

In 2014, EMS administered 231 doses to 186 patients, and in 2015, the number of doses climbed to 404 for 264 patients.

EMS officials said in addition to the number of overdoses steadily rising, the number of naxolone doses in order to bring a patient back to consciousness is also climbing.

"We have had to use as many as five doses on one patient," Coyle explained Tuesday. "The reason for that is we don't always know what they purchased or what it has been laced with. Some drugs take longer to activate in the system, but we are seeing more and more people collapsing quicker after taking the drug."

Coyle said while older generations of heroin would cause users to lose consciousness slowly, the newer versions are more rapid.

"We used to find people who had overdosed in comfortable positions on couches or in chairs, now we find them on bathroom floors and slumped over in cars that are still running. It happens so fast and time is of the essence," the EMS director explained.

While Coyle stressed the school system must do what is best for their situation, the EMS director said having Narcan in the hands of a trained professional would greatly improve the outcome of people who have overdosed.

"Within seconds of injecting the drug people begin to breath normally," Coyle said. "It's a life-saving drug and with heroin-use so prevalent in our community we see its use in all age groups. It isn't confined to just one stereotypical user."

Duddy and Ingram said having heroin antidotes at schools, which are a focal point of the community, not only helps students but the parents and others attending school functions.

“If it can save lives and it doesn’t cost the schools anything, I think it’s a good program,” Ingram said. “Because it’s not just students who are on school property. This opioid epidemic spans all demographics, all age groups, economic groups and races. Could be anybody on your school property."

According to Ingram, after receiving a carton of Narcan, schools will also receive training on how to properly administer the antidote. Each carton will contain two doses (approximately two milliliters) in a pre-filled syringe that contain an applicator that changes the liquid drug into a spray that is shot up the patient's nose.

Coyle said the need to address the increase in opioid overdoses is of the utmost importance.

"To call it an epidemic is an understatement," Coyle said. "We are losing a generation of people to it. We put a lot of time and resources into things like ebola, which the chances of an outbreak here are slim to none. Yet we ignore things like this, which is truly an epidemic and should be treated like it."

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