states encourage naloxone access by having statewide laws requiring all public high schools to keep naloxone on site for responding to overdoses at school or at school-sponsored events, as of September 2023.
Guidance from national professional organizations and a growing body of research supports schools keeping naloxone on hand as part of their comprehensive school emergency and response plans.School systems making on-site naloxone available should include guidelines regarding when and how naloxone will be administered and provide staff training before implementation.
Youth drug overdose rates are increasing, but youth access to naloxone remains low
Overdose mortality rates among adolescents (ages 14-18) increased by 94% between 2019 and 2020 and 20% between 2020 to 2021.Moreover, in 2021, 77% percent of adolescent overdose deaths involved fentanyl. Not only does this segment of youth using opioids face possible fentanyl exposure, but research shows there is a rise in fentanyl contamination in stimulants, benzodiazepines, and other substances. According to the 2022 National Survey on Drug Use and Health, 14.3% percent of youth aged 12-17 report using any illicit drug in the past year, while 20.9% percent report any lifetime use.
Given the overdose risk to youth, experts highlight a need for increased youth access to naloxone.Although most types of health insurance do not include age restrictions for naloxone coverage, youth access remains low. This may be attributed to several factors, including stigma regarding providing it to youth or incorrect assumptions by pharmacists regarding minimum age requirements for naloxone purchase. Health providers, often pediatricians, may also be less likely to educate youth on overdose prevention or prescribe naloxone. With these barriers to young people obtaining naloxone, making the medication available inside schools is important.
Placing naloxone in schools increases marginalized populations’ access to it and is an inexpensive way to save lives
Racial inequities result in reduced access to substance use disorder (SUD) care, generally. Accordingly, providing access to naloxone in most or all schools is crucial. The differences in naloxone access between rural and urban locations are also a concern, as studies indicate that prescriptions for the medication differ 25-fold between some rural and urban regions.Schools can be a valuable site at which to provide a method of harm reduction to students with less access to SUD care outside of school.
The cost to outfit each school with an adequate amount of naloxone, even at the over-the-counter cost of about $45, is quite modest. Accordingly, placing naloxone in K-12 or 6-12 schools can be a relatively low-cost way to save lives.