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Naloxone in Schools

One Pill Can Kill

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The Opioid Epidemic

  • Young adults (age 18 to 25) are the biggest abusers of prescription opioid pain relievers, ADHD stimulants, and anti-anxiety drugs

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(National Institute on Drug Abuse, National Institutes of Health, U.S. Department of Health and Human Services, 2016)

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The Opioid Epidemic

  • In 2014, 467,000 adolescents were current nonmedical users of pain reliever, with 168,000 having an addiction to prescription pain relievers

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(Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality, 2015)

Photo source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, 2016

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The Opioid Epidemic

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Data on Opioid Use

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Data on Opioid Overdose Deaths

Graphic Source: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, 2016

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The Opioid Epidemic

  • A trend exists for adolescents using prescription opioid agents to substitute heroin because it is significantly cheaper than pills (approximately half of the cost) and is often more readily available

(Fogger & McGuinness, 2015)

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Heroin Use

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Opioid Overdose

  • Opioid drug attaches to brain receptors that affect breathing
  • Person slows breathing and eventually stops breathing
  • Oxygen starvation eventually stops other vital organs like the heart, then the brain

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(National Institute on Drug Abuse, 2014)

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Overdose

Oxygen starvation leads to:

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Unconsciousness

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Coma

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Death

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Within 3-5 minutes without oxygen, brain damage starts to occur, soon followed by death

(Harm Reduction Coalition, n.d.)

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Average EMS Response Time

  • The average EMS response is ??

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  • Within 3-5 minutes without oxygen, brain damage starts to occur, soon followed by death

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Community Access to Naloxone

  • Do EMS, police and fire fighters carry naloxone? In Waco, yes!
  • Does school’s police office carry naloxone?

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District Policy

  • District policies that may conflict with Stock naloxone

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Good Samaritan Law

  • Good Samaritan Law in our state…….

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Support of Naloxone

  • There is support for a Stock Naloxone Program from

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Safety of Using Naloxone

  • Naloxone is the first line treatment for opioid overdose
  • Should be administered IMMEDIATELY
  • Parents & school administrators should not be concerned about adverse health effects of naloxone
    • If the person has not overdosed on an opioid, there is no effect on the body!

(Green, Heimer, & Grau, 2008)

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Naloxone

  • Cost of naloxone: $150
  • Shelf life: 12-18 months

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Photo source: Amphastar Pharmaceuticals, 2016

Currently not FDA-approved for nasal administration with an atomizer and requires assembly.

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Cost of Naloxone

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  • Cost of naloxone: free-$59
  • Shelf life: 12-18 months

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(College of Psychiatric and Neurologic Pharmacists, 2015)

Photo source: Adapt Pharma, 2016

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Cost of Naloxone

  • Cost of naloxone: expensive!
  • Shelf life: 12-18 months

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(College of Psychiatric and Neurologic Pharmacists, 2015)

Photo source: Kaleo Pharma, 2016

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Next Steps

  • Are you ready to see Narcan in your school?

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References

  • Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. (2016). Injury Prevention & Control: Opioid Overdose. Available at: http://www.cdc.gov/drugoverdose/data/statedeaths.html
  • College of Psychiatric and Neurologic Pharmacists. (2015). NALOXONE ACCESS: A Practical Guideline for Pharmacists. Available at: http://www.montcopa.org/DocumentCenter/View/9770
  • Fogger, S. & McGuinness, T.M. (2015). Adolescents at Risk Pain Pills to Heroin: Part II. Journal of Psychosocial Nursing, 53(2), 27-30.
  • Green, T.C., Heimer, R., Grau. L.E. (2008). Distinguishing signs of opioid overdose and indication for naloxone: an evaluation of six overdose training and naloxone distribution programs in the United States. Addiction, 103(6): 979–989.
  • Harm Reduction Coalition. (n.d.) What is an overdose. Available at: http://harmreduction.org/issues/overdose-prevention/overview/overdose-basics/what-is-an-overdose/
  • National Institute on Drug Abuse. (2014). Prescription Drug Abuse. How do opioids affect the brain and body? Available at: https://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/how-do-opioids-affect-brain-body
  • National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services. (2016). Abuse of Prescription (Rx) Drugs Affects Young Adults Most. Available at: https://www.drugabuse.gov/related-topics/trends-statistics/infographics/abuse-prescription-rx-drugs-affects-young-adults-most
  • Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Rockville, MD: Substance Abuse and Mental Health Services Administration. Available at http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf