Picture a 14-year-old mingling at her first high school party. She is approached by a popular boy from school — the one she has had a crush on for the past year. He asks her if she would like to snort a little heroin with him. Though she’s been lectured numerous times by her parents and health teachers about the dangers of opioids, she suddenly feels the pressure to conform.
Before she knows it, she feels the rush: Her skin flushes, her limbs grow heavy and she collapses. Time is of the essence. If people around her are not equipped with naloxone, a powerful opioid antagonist that can reverse overdoses, she will die.
No parent should ever have to face this scenario, but it has sadly become our reality. Since 1999, overdose deaths have increased 500 percent amongst 15- to 24-year-olds nationwide. One in four Massachusetts teens report having misused or abused a prescription drug at least once, and two in three adults nationwide treated for opioid use disorder started abusing opioids when they were younger than 25.
As of March 14, 2016, Massachusetts has required its public high schools to educate students on the dangers of substance abuse. However, opioid overdose deaths continue to rise, proving that these educational efforts alone are not enough to curb the opioid epidemic. If Massachusetts school administrators really want to reduce the student opioid overdose death rate, they need to teach high schoolers how to administer naloxone — commonly known by the brand name Narcan — so that they can possibly save their fellow classmates’ lives.
Research shows that equipping nonmedical personnel with Narcan and the necessary training saves lives. When Wilkes County, N.C., experienced a surge in overdose mortalities in 2007, health officials created Project Lazarus, a nonprofit organization that focuses on addiction education, data collection and, most importantly, training in how to administer Narcan. As part of this mission, Project Lazarus provides Narcan rescue kits for families which include overdose prevention literature, two doses of nasal Narcan and instructions.
The Centers for Disease Control and Prevention have cited Project Lazarus as a success story in preventing opioid overdoses among rural Americans, noting that more than 200 overdoses were reversed in North Caroline from August 2013 to November 2014. That’s 200 extra lives saved by Narcan. Imagine how many more students’ lives can be saved in Berkshire County if they are equipped with Narcan.
A push by the Berkshire Overdose Addiction Prevention Collaborative will bring Narcan to more than a dozen additional first responder departments across the Berkshires.
Some might ask why we should provide students with Narcan when police officers, EMS personnel and hospital staff are trained in Narcan administration. During opioid overdose, respiratory arrest results in a lack of oxygen flow to the brain, which means time counts. In rural regions, like some corners of Berkshire County, an ambulance or the nearest hospital can be far away, and it could be hours before contact with a medical professional. If an overdose victim does not receive timely medical assistance, they could suffer brain injury or death.
For this reason, the CDC and the Office of the Surgeon General recommend that nonmedical personnel also have access to Narcan. It’s important for parents to know that if their teenager administers Narcan to an individual who hasn’t actually overdosed, it will cause no harm and produce no “high.” It is nonnarcotic and nonaddictive. For these reasons, anyone can ask for a naloxone rescue kit over the counter at any Massachusetts pharmacy without a prescription.
Narcan is not only safe but easy to administer — so easy that in rural Carter County, Tenn., health officials have begun training children as young as 6 years old to administer Narcan. Carter County’s Drug Prevention coalition has given Narcan training to an estimated 600 children and teenagers. If 6-year-olds in Tennessee can capably learn to administer Narcan, so can Berkshire County teenagers.
Opponents of making opioid antagonists more widely available argue that if we equip teenagers with Narcan and tell them that their friends can easily “save” them with just a quick spritz, then they will be more likely to abuse opioids. Their fears are unfounded, however, and show a lack of understanding on how Narcan works and the teenage mindset. Narcan reverses opioid overdoses for only a short period of time — 30 to 90 minutes. It is neither a quick fix nor a substitute for medical assistance; it is simply intended to buy time to get to a hospital.
So as long as school health instructors drive this point home, teenagers will not view Narcan as a reason to start experimenting with opioids. If anything, teaching students how to administer Narcan will make the risks of opioid abuse seem all the more real. It’s one thing to be told not to take opioids because they’re dangerous; it’s another thing to be shown how to save a fellow student’s life in case that person overdoses from opioids. As a teenager myself, I can assure you that the latter is far more effective in preventing recreational opioid use. For this reason, Project Lazarus not only equips people with Narcan but also educates them. As a result, overdoses decreased by 69 percent between 2009 and 2011 in Wilkes County.
Massachusetts needs to provide funding for public high schools to equip students with Narcan administration training and comprehensive education on opioid abuse. Until then, high school administrators should seriously consider implementing Narcan administration training as part of their health curriculums.
Every life lost to opioid abuse is one life too many.