Discussions are in the works to allow school nurses to administer to their students a drug that reverses the effects of an opiate overdose.
The Vermont Medical Society’s School Nurse Advisory Committee is debating the merits and dangers of allowing nurses to administer naloxone, a drug currently carried by Vermont State Police and many other first responders who can save the life of someone who is overdosing from heroin or other opiates.
“This is new enough so that we’re aware of it and we’re discussing it,” said Paula Crossett, a nurse at U-32 High School in East Montpelier and president of the Vermont State School Nurses Association. Crossett also serves on the School Nurse Advisory Committee.
“This is something we’ve discussed,” Crossett said. “We know the issue is coming, but it’s something we need to research.”
If it does happen, Vermont will not be the first state to allow school nurses to administer Narcan, the commercial name for naloxone.
According to news reports, the school board in Montague, Mass., voted unanimously to allow nurses to keep Narcan on hand, and school officials in New York state are considering the same proposal.
In Vermont, nurses can administer drugs to students only by a doctor’s order. However, a nurse can receive a standing doctor’s order to administer epinephrin — used to treat allergic reactions — to any student when the nurse believes the student is experiencing a serious allergic reaction. The administration of Narcan could work the same way.
The issue appears to be twofold: While the School Nurse Advisory Committee creates policies that determine what a nurse is allowed to do and how to do it, the question of whether Narcan will be allowed in a school rests with individual school boards around the state.
In November, the Valley News reported the Hartford School Board voted not to allow nurses to keep or administer Narcan; school officials in Hartford did not respond to requests for an interview.
Officials with the Agency of Education also declined requests for interviews, referring all questions on the subject to the Department of Health.
Michael Leyden, deputy director of Emergency Medical Services in the Department of Health’s Office of Public Health Preparedness, said his department has no plans to weigh in on the value of Narcan at school, but said it would support nurses who wish to be trained in the drug’s administration.
“We have no intention of mandating or requiring this,” Leyden said. “We support the local process that would go on at a school to make the decision. As a department, we would be willing to offer the same guidance we’ve offered to law enforcement.”
Leyden said the Department of Health has trained state police in the administration of Narcan and supplied them with the drug, with police officers giving the drug to people overdosing “a few times when they were in the right place at the right time.”
The training itself is brief and simple. It is offered at numerous drug treatment facilities around the state, and can take anywhere from 15 minutes to an hour to be trained in how to recognize the signs of an overdose and to administer the drug though a nasal mist spray.
After the training, which is open to any member of the public, the trainee is sent home with Narcan.
Leyden said Narcan itself will not get a user high, which means no risk of abuse, and a person who ingests the drug without opiates in his or her system will not experience a reaction. The drug is safe to administer to young people, although smaller children should receive a smaller dose, Leyden said.
Jeff Francis, executive director of the Vermont Superintendents Association, said the discussion is still in the very early stages and will require a lot more information before individual school districts can make an informed decision.
“I think the Health Department has a point when they say it’s a local issue. As an association, at least, I would want to be sure that my members have more information than I have right now,” Francis said.
“If it becomes a matter that schools are going to deliberate, they need to get the best information available from the experts, such as the Department of Health,” he said.
And while her association has no official position on the issue, Crossett said having Narcan on hand could be another tool to help ensure student health.
“My thought is, I want to keep all students safe,” Crossett said. “It’s something else that could keep students safe.”
Josh O'Gorman is a reporter for the Vermont Press Bureau.