Washington schools see use of overdose medication rise

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The number of doses of opioid reversal medication administered in Washington public schools has increased from two to 42 in the past three years, according to new data that mirrors the state's growing problem with drug overdoses.

A state law passed in 2019 requires school districts with 2,000 or more students to have at least one set of naloxone in each high school. Naloxone is a lifesaving drug that reverses opioid overdoses, often administered as a nasal spray, but it could also be an injection. One set usually includes two doses.

The medicine, with the common brand name Narcan, will be available to buy over-the-counter as soon as this week.

The schools' data comes at a time when the fentanyl epidemic continues to accelerate across King County. In this year, at least 704 people have died from fentanyl as of Thursday, which is just eight shy of 2022's total 712 fentanyl-involved overdose deaths, according to data from Public Health — Seattle and King County.

For the past three years, the Office of Superintendent of Public Instruction has collected data from nurses on the number of naloxone doses administered in schools.

In the 2020-21 and 2021-22 school years, OSPI's School Nurse Corps collected this data through an already established health survey. This most recent year, 2022-23, OSPI's Health Services and School Nurse Corps sent a separate survey asking how many doses of naloxone were administered.

In the 2020-21 school year, only two doses were administered statewide. The following year, six doses were administered, and in the most recent school year, it jumped to 42 doses.

"We know it's incomplete data, but it's a little bit of a benchmark," said Lynn Nelson, who is a member of the School Nurse Corps and the president-elect for the National Association of School Nurses.

Nelson and OSPI don't know if the 42 doses were 42 separate potential overdose or if in some cases a person needed more than one dose, which is fairly common. Nelson also said it's not clear if every incident was actually an overdose.



The 42 doses administered could be to students, visitors or staff, said Katy Payne, a spokesperson for OSPI.

The survey was optional for school nurses to fill out. However, in the most recent school year, 241 of the state's 295 school districts participated. That's an increase from previous years. In 2020-21, 224 districts participated and in 2021-22, 238 school districts participated.

Nelson said she didn't want to read too much into the data because it was an informal study. She said, if it was required, she thinks the number of doses administered would rise.

"It's clear we need more naloxone available in the community," Nelson said, "and schools are part of the community."

"We know that the fentanyl out there right now is incredibly deadly," she added. "It's a huge problem. It's going to take a coordinated effort across multiple sectors."

Most of the districts in the state are small and rural, and don't fall under the requirement to stock naloxone, said Nelson. The School Nurse Corps works to get smaller districts up to speed with a fentanyl policy and naloxone supply.

Two doses total were administered in Seattle Public Schools, the state's largest school district, during the 2022-23 school year, said an SPS spokesperson. Just one dose was administered in the 2021-22 school year and none in 2020-21.

The district stocks four doses of naloxone at all high schools and two doses at middle and elementary schools.