Action Plan to Reduce Opioid Overdose Deaths on K-12 Campuses

BY Charles R. Davis

Drug overdose and poisoning deaths are at epidemic levels in the U.S.  In 2021, the most recent year we have complete data [1], 106,699 deaths were associated with drugs.

This is nearly 300 people everyday.  And of these deaths, 70,601 or nearly 70% were connected with opioids; a class of drugs that include heroin, oxycodone, morphine and of course, fentanyl [2, 3, 4], the drug we have heard so much about.  Early readouts of 2022 and 2023 data all point to these numbers continuing to increase.  Although there are multiple reasons why the U.S. is facing its current drug epidemic and associated, devastating outcomes, if you think about the data a little, an immediate question may come to mind, in particular about opioids.  “What is it about opioids that causes them to be such a problem and their use, potentially so devastating?”  Here are some possible reasons.  Opioids affect the user’s body in important ways.  Opioids: 1) give the user a strong sense of wellbeing and pleasure; 2) reduce pain. This sense of wellbeing, pleasure and pain reduction can be important reasons why opioids are repeatedly sought after by users; and 3) depress some of the body’s automatic functions.  For instance, opioids slow breathing and reduce the rate that the heart beats.  Thus, when used in a non-controlled setting, a high-dose of an opioid or opioid combination can depress breathing and heart rate so much that death occurs.  And this is where the concern about synthetic (man-made) opioids, like fentanyl, present such a big challenge.  Fentanyl [5, 6] is many times stronger than opioids like morphine and heroin.  As a result, when an opioid is used in a non-controlled setting and it knowingly or unknowingly contains fentanyl, the risk of an overdose or a poisoning death is greatly increased. 

 Why is communicating this information about drug overdose and poisoning, especially opioid types, important?  In part, it is due to the sheer number of lives being unnecessarily lost every day, each year.  Also important, because of the number of people affected, we clearly know that drug overdose and poisoning do not discriminate.  That is, drug overdose and poisoning are equal opportunity actors [7], especially when it comes to opioid related substances.  These drugs do not care about a person’s age, sex, religion, ethnicity, what state he or she lives in, job title, educational achievement or social status.  Individuals from all walks of life can be victims or potential victims of opioids’ deleterious consequences. 

 The fact that drug overdose and poisoning, especially opioids, are equal opportunity actors means our nation’s schools are not immune from their devastating impact.  Furthermore, not only are students potential victims, but school staff, faculty, administrators, and visitors are also vulnerable.  Although identifying and addressing the long-term solutions of the U.S. drug epidemic are outside the purpose of this blog-contribution, it is critically important to share what actions a single, caring and informed individual can do immediately, if he or she encounters a person suspected of having an opioid overdose or poisoning event, especially in our schools.  For example, at Pierre Van Cortlandt Middle School (PVC) (Croton-Harmon Union Free School District, Croton-on-Hudson, NY) we took advantage of the March 29, 2023 Food and Drug Administration’s (FDA) ruling [8] where “naloxone (medication that rapidly reverses the effects of an opioid overdose) nasal spray product is now available without a prescription” and created and implemented an Opioid Action Plan [9]; a plan that is applicable to and can be implemented in any K-12 campus.  Although PVC has not experienced any events requiring naloxone to be administered, it is confidently projected our targeted action will proactively and positively reduce the likelihood of opioid related deaths for students, faculty, staff, administrators, and visitors, if they occur.  Finally, it is important to share that all 50 states and D.C. [10] have Good Samaritan laws that protect a person from liability if they try to save the life of an individual suspected of an opioid overdose or poisoning.  

Article details

Action Plan and Model to Reduce Potential Opioid Overdose Deaths on K-12 Campuses
Charles R. Davis, PhD, MSN, RN, FNP-C, Michael Plotkin, MA, BA, Nichole Kelly, MA, BA
First published online July 13, 2023
DOI: 10.1177/1942602X231185718
NASN School Nurse

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