Los Angeles public schools will supply campuses with the reverse overdose drug naloxone in the wake of the death of a Bernstein High School student, putting the nation’s second-largest school system at the forefront of a strategy that is increasingly preferred by public health experts.
The move, which will affect some 1,400 elementary, middle and high schools, is part of the district’s recently expanded anti-drug strategy, which was quickly launched in response to student overdoses. Officials said on Thursday that nine students in the district have overdosed in recent weeks, including seven linked to the Bernstein campus and Hollywood High School. The response plans will also include extensive parent contact and peer counselling.
The death of 15-year-old Melanie Ramos, who died in a school bathroom last week after taking a pill she bought from another student, has shaken the campus community and left parents in the 430,000 student district concerned. The pill contained fentanyl, an opioid that is lethal in small doses.
Naloxone is very effective at reversing opioid overdoses when given quickly via nasal spray or injection.
LA schools Sut. Alberto Carvalho said that dispensing naloxone, also known by the brand name Narcan, is a matter of saving lives, and that the medication can be administered quickly and relatively easily.
“We have an urgent crisis on our hands,” said Carvalho. “Research shows that the availability of naloxone along with overdose education is effective in reducing overdoses and death – and will save lives. We will do everything we can to ensure that no other student in our community becomes a victim of the growing opioid epidemic.”
Candidates for training include school nurses and school police, but the scope would likely be wider. Carvalho cited the example of a deputy director who had been a military doctor.
“He can do it. He has the training,” Carvalho said in an interview. “I think we’ve kept a pretty short-sighted view of who can do this. The training really isn’t that difficult.”
Even older students would have the potential to be educated, but, “I’m not saying we’re going to do that here. But the training is not complex and we can significantly expand the number of individuals who can do this in a protective way.”
The highest priority would be to get the medication to high schools, followed by high schools.
The decision makes sense, said Dr. Gary Tsai, director of substance abuse prevention and control for the provincial health department, issued a warning last week about the growing danger of illicit opioid pills.
“The best tool, of course, is prevention,” Tsai said, but the recent death of the Bernstein student “by itself would demonstrate the need to have naloxone on hand,” Tsai said. “It tells you that students have been exposed in some way. And the chance of them being exposed on campus, bringing counterfeit pills or coming into contact with counterfeit pills on campus, that’s clearly a risk. It is necessary and appropriate for schools to have naloxone on campus.”
California law allows, but does not require, K-12 schools to provide and administer naloxone. Michigan has adopted similar rules.
However, some California colleges and universities are required to stock the drug under a law signed into law by Governor Gavin Newsom in August.
While access to naloxone in K-12 schools may seem uncommon, it’s not unheard of.
The Palos Verdes Peninsula Unified School District recently had a local physician train all of the district’s registered nurses on how to administer naloxone, and it is available to them in that district’s high schools, Supt said. Alexander Cherniss.
Rhode Island requires all schools to have naloxone and it can be administered by “any trained nurse-teacher” without fear of liability. School staff can also refuse to manage the medication. New York state offers every high school four free doses of naloxone, but they don’t have to accept it. Currently, New York City schools don’t have a policy of stockpiling it, a district spokesperson said.
The nasal version of naloxone is easy to use, experts say. The injection version requires the ability to use a needle and syringe. Naloxone won’t harm anyone if that person overdoses on medications other than opioids, so it’s always better to use it in the event of a suspected overdose, according to the U.S. Centers for Disease Control and Prevention.
The county health department is providing free doses of naloxone to the district, which also receives support from the Los Angeles Trust for Children’s Health and Children’s Hospital Los Angeles.
The county health also helps the district develop training and education materials. The district has secured sufficient doses for secondary schools to be distributed in the next two weeks. At the beginning of October, the training for district staff in the use of naloxone will start.
Providing naloxone in schools can be controversial. Some parents might interpret its availability as a school district giving up its ability to educate students about drug rejection. Some fear it will even encourage drug use, said Annette Anderson, deputy director of the Johns Hopkins Center for Safe and Healthy Schools.
But she said parents should keep in mind what she called an “explosion” in the level of risk, noting that law enforcement reported an increase in the number of illicit opioid pills seized from 300,000 in 2018 to about 10 million in 2021.
Research indicates that students were already dealing with a mental health crisis before the COVID-19 pandemic, which made matters worse. Such trends underscore the need for additional steps beyond making naloxone available, she said.
“We’re seeing an unprecedented number of violent events in schools,” Anderson said. “I think this is all part of a trend where our young people are struggling with what it means to face modern society. We, as caring adults, need to be more aware of how we connect with our young people, to help them solve problems, mediate conflict – in fact, it is youth development. All of these issues just point to how COVID, and especially COVID school closures, is halting the growth and social development of our youth.”
The LA Unified announcement also emphasized mental health and preventive approaches. The Health Information Project organization will be engaged to train high school students and seniors to provide health education to their freshman peers.
Parents’ awareness of how to recognize and deal with drug abuse in their children will become a major focus of parenting, Carvalho said.
The school system already provides education about drug abuse at all levels — and it’s been updated to include the risks of fentanyl. Such course materials and strategies are under constant review, officials said.
The new higher education rules require California community colleges and Cal State campuses to supply naloxone to campus health centers. They also require colleges and universities to provide educational materials on how to avoid overdose during student orientation.
The law, which also calls for similar action from the University of California Board of Regents, goes into effect in January. The legislation “enables students to prevent even more unnecessary deaths and cuts perhaps one less parent from getting a terrible phone call that will change their lives forever,” said Senator Melissa Hurtado (D-Sanger), who introduced the measure, in a statement after the bill was signed.
Times staff writers Debbie Truong and Alejandra Reyes-Velarde contributed to this story.