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FDA Policy Change Welcomed As Student Overdoses Rise

On Wednesday, the FDA approved the over-the-counter distribution of Naloxone — often referred to by the brand-name Narcan — in nasal spray form.  This is a welcome development coming during a time where school officials and leaders have been scrambling to intervene amidst a recent spike in opioid overdose in minors — and when Fentanyl, a synthetic opiate 50-100 times stronger than morphine, is being increasingly found laced into other drugs, which are increasingly finding their way into the hands of minors.

The FDA approved the spray form of Naloxone, often referred to by brand name Narcan, in 2015. Yesterday the FDA approved the drug, which is safe for use in infants, for over-the-counter distribution.

Within the Fairfax Health District (FHD), which includes Falls Church, Fairfax City, and Fairfax County, non-fatal overdose incidents in minors have increased dramatically in recent years, from 12 in 2021 to 27 in 2022 — and there have been 9 more in just the first two months of 2023.  Data on overdoses specific to minors in Arlington County and Alexandria were not immediately available. However at least two separate youth overdose incidents are known to have occurred in Arlington, including one fatality, and both acknowledge experiencing the same increase.

Falls Church City Public Schools (FCCPS) officials say they welcome this morning’s FDA decision to expand access to Naloxone.  “We are excited about this change — it opens access and removes barriers to this life-saving medication.” said Rebecca Sharp, Executive Director of Special Education at FCCPS, “As a school division we will be consulting with our partners at the Health Department and our school administrators, and reviewing our policies and regulations.”

In neighboring Fairfax County, every school has trained staff to administer Naloxone, which is in every FCPS building as of November 2022.  “We take substance abuse disorder very seriously at Fairfax County Public Schools,” said Providence District School Board representative Karl Frisch, who said priorities have included fentanyl testing strip availability, access to Narcan, improved curricula, hiring more prevention specialists, and exploring establishing a “recovery high school.”

First used to treat opioid overdose as an injectable in 1971, Narcan can quickly reverse an overdose and restore breathing, a common cause of overdose fatality.  It does so by binding to the same receptors opioids need to bind to in order to cause their effect.  First responders and healthcare providers have regularly carried Naloxone for decades.  Narcan itself is safe enough to be administered to newborn infants — it only gets in the way of the opioids.  Despite this, due to its classification as a prescription drug, students have not been permitted to possess Narcan, and distribution to students has not been allowed.

“All of our secondary staff have been trained to use Naloxone and administrators and school security coordinators all have Naloxone on them,” said Frank Bellavia, Director of Communications for Arlington County Public Schools, who said school clinics are stocked with Narcan and boxes are currently being installed with Narcan around schools.  Though Bellavia says the FDA change this morning was a welcome one, “Virginia Code says that only staff can carry Narcan,” so a change will need to come from Richmond before students are allowed to possess Narcan.

Ensuring training and supply for Naloxone has been the most recent FCCPS effort in the fight against opioid overdose.  Last week, the Meridian High School PTA hosted a REVIVE training that drew over 115 parents and students.  FCCPS uses the REVIVE model, Virginia’s Opioid Overdose and Naloxone Education (OONE) program, which trains people on how to recognize and respond to an overdose using Naloxone.

Sharp says all FCCPS Secondary Administrators, Coaches, and Health Aides have been provided REVIVE training, with the remainder of secondary staff being trained in the coming weeks.  FCCPS also plans to continue providing REVIVE programming for parents and students (with permission).  Dates for future training will be made available through the FCCPS Morning Announcements daily e-newsletter as well as on the FCCPS website.

Though Sharp outlined a comprehensive list of efforts ranging from mental health mitigation to educating student leaders (including on Narcan administration, once legal to do so), she says the most important mitigator remains unchanged over the years.  “The most important strategy there is in our toolbox as parents and educators is talking,” she emphasizes, encouraging parents to talk to their children, know who they interact with, and monitor their social media and phone conversations.  “This is a community issue that is going to take all of us together to protect our students.”