Monday, February 24, 2020
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Md. schools to stock opioid overdose drug

Every public school in Maryland will keep a stock of an emergency opioid overdose treatment drug in the nurse’s office beginning this fall, thanks to a new state law, WAMU-FM reports.

Montgomery County Public Schools will spend about $15,000 for the year to purchase the mandated supply of naloxone, an opioid overdose antidote that has a relatively short shelf life. Schools should play a key role in educating students about drug abuse, said Associate Superintendent Jonathan Brice, but he’s not 100 percent sure the mandate to stock schools, especially elementary schools, will help Maryland’s drug abuse problem.

“It is a state law. It is something we are required to do and we recognize the importance of being prepared in the eventuality that someone might need it,” the station quoted him as saying. “This is a great opportunity for moms and dads to sit down and have another conversation with young people about making wise decisions. We don’t want to miss the importance of having, really sharing, that global message of prevention while we’re dealing with details of a new state law.”

And more than keeping a supply of the overdose antidote handy, simply increasing the level of conversation about opioid abuse may be a nice side effect of this law.

“The key is to start talking about it,” the Baltimore Sun quoted state Delegate Eric Bromwell, a Baltimore County Democrat and one of the lead sponsors of the measure, as saying. “You really need to get to people sooner, and you need to get to them over and over again.”

Hence the requirement to stock the drug even in elementary schools. Rhode Island required naloxone in all its public schools last year, and the program continues this year. Other states, but not all, have different educational or treatment measures around opioid abuse. In Maine, for instance, Gov Paul LePage vetoed measures twice that would have made naloxone more available, saying it would give drug abusers a false sense of security.

Opioid abuse “is everywhere,” the Sun quoted Senate President Mike Miller, a Calvert County Democrat and the bill’s lead sponsor in the Maryland Senate, as saying. “It affects all segments of society, rich to poor. It’s a crisis that we need to identify and make educators as well as parents aware of it, and provide the resources to deal with it.”

I would add that “training” is among the “resources” required. Massachusetts is one state that has provided required training for nurses to administer the naloxone.

The drug naloxone (brand name Narcan) isn’t an extremely expensive drug and can be purchased as a nasal spray. It’s free for high schools, thanks to a program initiated by the manufacturer, Adapt Pharma. In addition, some small grants were made available from the Maryland State Department of Education to stock other schools or provide training.

Yet there has been some criticism of the measure. For one, SB 1060 imposed a mandate on school districts across the state. “Potential significant increase in expenditures for local boards of education or [local health departments] under contract with school boards to provide naloxone and any associated training and to hire community action officials and implement program requirements,” a fiscal note attached to the bill states.

But recent months in Maryland have seen a surge in overdoses of the synthetic opioid carfentanil, which is designed as a sedative for large animals, like elephants, and is about 100 times stronger than fentanyl. The latter is about 50 times stronger than heroin and, because it is often laced in with other drugs, difficult for drug enforcement agents to detect as it comes into the country illegally.

Having a state law that requires the stocking and administration of naloxone in an emergency overdose situation lifts some measure of liability off of the nurses in schools, even as it adds a mandate that those nurses receive (and schools pay for) the proper training.

Furthermore, the idea that access to overdose antidotes somehow gives drug abusers a false sense of security, as stated by Mr LePage in Maine, just isn’t true. Many overdose deaths happen by accident, as users take too much prescription painkiller or another drug that contains a substance, like fentanyl, that neither they nor their dealer knew was in there.

It’s my opinion that this law has the potential to save lives, and anyway, it increases the conversation, heard by (very) young students, about the dangers of abusing drugs, which also has the potential to stop the upward trend of abuse in years to come.

Paul Katula is the executive editor of the Voxitatis Research Foundation, which publishes this blog. For more information, see the About page.

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