Saving Lives- A Case for Stocking Narcan in our School Health Offices Presentation to School Committee September 21, 2015 Lee Waingortin, BSN, RN, NCSN, CCM Director of Nursing, Hudson Public Schools

Schools stock up on heroin overdose antidote CBS, wtsp. com7:58 a. m Schools stock up on heroin overdose antidote CBS, wtsp.com7:58 a.m. EDT September 14, 2015 Easton school nurses to carry overdose-reversing drug NarcanThe Enterprise UPDATED 6:48 PM EDT Jul 15, 2015 Armed with Narcan, Pilgrim High nurse ready to save lives Warwick Beacon on line 9/8/15 Heroin epidemic puts pressure on schools to get antidote Seattle times 9/11/15

THE OPIOID PROBLEM Massachusetts Data: The number of fatal opioid overdoses in rose from 526 in 2010 to 1008 in 2014 Massachusetts Dept of Pubic Health Data Brief: Fatal Opioid-related Overdoses among MA Residents, April 2015 A Public Health State of Emergency was declared by then Gov. Patrick-this allowed first responders (Police/Fire) to carry and administer Narcan.

Local Community Data-ADD YOUR COMMUNITY DATA HERE Unintentional Deaths from Opioid Overdoses Source: Registry of Vital Records and Statistics, MDPH 2014

WHAT ARE OPIOIDS? Medications that relieve pain Heroin and prescription medications such as codeine, morphine, oxycodone and methadone Medications that relieve pain Attach to the opioid receptors in the brain and reduce the intensity of pain signals reaching the brain

OPIOID OVERDOSE An overdose occurs when there is too much opioid in the system. Opioids Block receptors that control breathing resulting in respiratory failure, then cardiac failure, then death.

OPIOID OVERDOSE RISK FACTORS opioid dependence use of prescription opioids, in particular those taking higher doses; Use of opioids in combination with other sedating substances; household members of people in possession of opioids (including prescription opioids). World Health Organization-Information Sheet on Opioid Overdose, 11/2014

NARCAN© (Naloxone)

It is both safe and effective and has no potential for abuse. According to the MDPH Pilot Project Core Competencies: Naloxone usually acts dramatically, allowing slowed or absent breathing to resume. It is both safe and effective and has no potential for abuse. Naloxone has been used by paramedics in ambulances and by emergency room clinicians for decades. While not a controlled substance, naloxone is what is known as a “scheduled” drug and therefore does require a prescription.

HOW DOES NARCAN REVERSE AN OVERDOSE? Narcan knocks the opioid off the receptors in the brain and restores breathing. Narcan acts quickly-within 1-3 minutes- to reverse the overdose. Narcan is the only effective medication to reverse an opioid overdose

How does Narcan affect overdose? Restores Breathing Key Point: Naloxone knocks the opioid off of the opioid receptor to restore breathing

Death following opioid overdose is preventable if the person receives basic life support and the timely administration of the opioid antagonist naloxone (WHO, 2014)

WHY STOCK NARCAN IN OUR SCHOOLS? does not create a high and therefore has no “street value”. does not have any major side effects will only be administered only by trained school nurses and trained substitute school nurses is administered via the nostrils-there is no needle to be stuck by or concern about disposing.

ADD LOCAL RESOURCES HERE AND STAKE HOLDERS THAT SUPPORT NARCAN IN SCHOOLS

Additional –ADD REASONS YOUR COMMUNITY/SCHOOL DISTRICT SHOULD SUPPORT NARCAN IN SCHOOLS Narcan, along with epiPens and AEDs, saves lives Number of Narcan prescriptions and administrations are now included in MDPH ESHS grant school nurse data collection According to DPH, at least 75 school districts have Narcan in their school health offices.