Narcan being made available free to Ky. schools
Before schools can be stocked with Narcan, staff must undergo training on how to administer it
By Erin Schmitt
HENDERSON, Ky. — Narcan, a drug that can revive people who have overdosed on opioids, is now being made available free to high schools across the country.
While Tri-State school systems haven't started stocking the preventive drug yet, some are considering doing so and have been trained to administer Narcan.
Consider it a sign of the prevalence of the heroin problem in this region and nationwide.
"Heroin usage has gone way up," said Chris Winstead, Henderson County's emergency medical services director.
With federal legislators scrambling to make opioids more difficult to obtain and doctors considering different treatment methods, addicts are turning to heroin to because it's cheaper and more readily available.
"Heroin provides the same effects as prescription opioids," said Kentucky State Police Capt. Sean McKinney.
Kentucky State Police statistics show that heroin is mostly used by people between the ages of 21 and 35. But he said no one, regardless of age, is immune to the drug's addictive properties.
Eighteen deaths have likely been caused by heroin overdoses through mid-September in Vanderburgh County, chief deputy coroner Steve Lockyear told the Evansville Courier & Press.That is already triple the heroin overdose deaths for all of 2015. Victims have ranged in age from 24 to 58.
There have been no heroin overdose deaths in Henderson County in 2016, though there have been some overdoses, said Henderson County Coroner Bruce Farmer.
"We're on the lookout for it and it is becoming more prevalent in this area," he said.
There have been a few multi-drug intoxication deaths where traces of heroin have shown up in the toxicology results, according to Farmer.
To help combat the rising heroin problem, naloxone, also known by its brand name Narcan, is being made available for free to high schools nationwide as an initiative of the Clinton Foundation and Adapt Pharma.
Narcan, administered nasally, can instantly reverse or block the effects of an opioid overdose.
"Some describe it as 'bringing people back,' people who were otherwise unconscious and at risk of dying," said McKinney. "This is a tremendous benefit when time is crucial in saving a life and where EMS or medical facilities may not be close or readily accessible."
Narcan in high schools
Through the Narcan Nasal Spray High School Program, Adapt Pharma will provide a free carton of Narcan nasal spray to high schools across the nation.
Henderson County Schools' oversight team is looking into a district policy and plans to get input from its board attorney before moving forward, said assistant superintendent Nancy Gibson.
"It's definitely something we are interested in doing. It's just we want to make sure, when we write our policy, that it's ironclad," Gibson said.
Should the school system decide to stock Narcan, the district's policy would need to be updated and ultimately approved by the Henderson County Board of Education.
The Evansville Vanderburgh School Corp. has made the decision not to keep Narcan in its schools at this time.
In the case of a suspected opiate overdose in the EVSC, school officials would call 911 and allow medical first responders to make the appropriate decision on the best course of action.
"We will continue to follow the latest research and professional guidance on this topic as we make an informed decision on having Narcan in our schools," said EVSC spokesman Jason Woebkenberg. "... Reports of increased cases of opiate overdoses in our nation are very concerning for all communities. This issue has been seen across all socioeconomic neighborhoods and the results can be tragic."
The Warrick County School Corporation does not stock Narcan at its high schools, either, said superintendent Brad Schneider.
"That is something we would get input from our nurses and building administrators on if they thought that was something we needed to do," he said.
Schneider said he's not aware of any problems with painkiller or heroin overdoses within the schools. The school system has a zero-tolerance policy on drugs.
Webster County Schools is not considering whether to stock Narcan at this time, according to district spokesperson Carolyn Sholar. But Union County Public Schools sent a school nurse to a recent conference to learn more about the overdose drug, said district spokeswoman Malinda Beauchamp.
Before Kentucky schools can stock Narcan, staff must undergo training. The Kentucky Harm Reduction Coalition, a nonprofit agency based in Louisville, provided free training at the Kentucky Public School Health Coordinators Summit on Sept. 14 in Lexington.
Gibson and the Henderson County High school nurse also attended that training, which included a review of Kentucky laws, types of narcotics, differences between a drug high and an overdose, how to administer Narcan, the Good Samaritan Law that provides an exemption from liability for those who report overdose, and information about referring students for treatment.
School staff were taught how Narcan should be used and what procedures to follow. After the nasal spray is administered, school officials are supposed to call 911 and the patient is to be transported to the emergency room to be checked out.
Law enforcement officers and a pharmacist also spoke to attendees about the effects of heroin, Gibson said. After personnel complete training, two doses of Narcan are provided free of charge to school districts in Kentucky if they want it. Once those are used or the drug expires, it will be up to the district or school to provide a replacement.
'This stuff saves lives'
The Centers for Disease Control and Prevention tracks current trends and shifting characteristics of drug overdose deaths. Opioids are the main driver: Opioids were involved in 28,647 deaths in 2014, a figure that's quadrupled since 2000.
Kentucky had 1,077 drug overdose deaths in 2014, up from 1,019 the year before. Indiana had 1,172 deaths in 2014, up from 1,064 in 2013.
Indiana was one of 14 states with statistically significant increases in the rate from 2013 to 2014. Kentucky was one of the five states with the highest rates of death due to drug overdoses, according to the CDCP.
First responders often carry Narcan to help prevent overdose deaths. As part of a pilot program, some Evansville Police Department officers began carrying Narcan in 2015. Vanderburgh County and Warrick County sheriff's deputies also carry it on patrol.
Kentucky State Police officers do not carry Narcan. However, the agency is in the early stages of moving forward to equip each trooper and detective.
Neither the Henderson Police Department nor the Henderson County Sheriff's Office carry the drug.
"I don't know why; we should," said Detective Bill Mills with the Henderson Sheriff's Office. "We should have it. This stuff saves lives."
Mills said heroin sales are on the rise in Henderson County and most of the supply comes from Evansville, which in turn comes from much larger cities such as Chicago.
"It's definitely on the increase," he said. "You can get a rig for about $40. That's what it's going on the street right now for a shot."
Area ambulances in Indiana and Kentucky have stocked the overdose drugs since the 1980s.
"It's used quite often," Winstead said, adding that it's been more frequently used in the last year-and-a-half.
How it works
Narcan attaches to the same part of the brain that receives heroin and other opioids. It blocks the drugs for 30 to 90 minutes to reverse the respiratory depression that would otherwise lead to death from overdose.
If administered to a person who hasn't taken opioids, it would have no effect because there is no opioid overdose to reverse. It also does not get people high.
“Although we hope no student, staff or family member ever falls victim to drug abuse, we cannot ignore the potential that an overdose could occur at school,” said Kentucky Commissioner of Education Stephen Pruitt in a news release. “This is an opportunity for schools to be prepared for that possibility and save a life.”
Narcan can also be used for overdoses of opioid-based prescription painkillers such as Percocet, morphine or those containing codeine.
The downside to the spray is that there is no good way to control the dose, said Winstead, ambulance director for Henderson and Union counties. Patients are administered the whole dose and may be "wild and crazy" when they are revived. He said law enforcement officers need to be nearby after the overdose drug to help with the patient.
Walgreens has made naloxone available without prescriptions in 35 states and Washington, D.C., including Indiana and Kentucky.
Indiana has what's known as "Aaron's Law," which allows Hoosiers to obtain a prescription for naloxone if they believe someone they know is at risk for an opioid overdose. Before the bill was signed into law April 2015, only emergency workers were allowed to carry naloxone.
Indiana treatment centers, overdose prevention organizations, corrections officials and others can dispense and train people to administer naloxone. They are required to obtain a standing order from a medical prescriber and must first register with the Indiana State Department of Health.
The Kentucky General Assembly passed the "Heroin Bill" into law last year. It stiffened penalties for importing and selling heroin in Kentucky, provides more money for treatment programs and increases the availability of naloxone.
Kentucky State Police aggressively targets areas where heroin abuse is prevalent, McKinney said.
McKinney said he thinks it will take a multi-faceted approach that includes enforcement for those who traffic heroin, plus education programs to help communities and families identify people battling addiction. In addition, there should be open communication with treatment facilities and personnel to better understand the patterns of addiction.
"It will take a team effort to make a positive impact," he said. "Heroin has a nasty way of moving in and taking over those who abuse it and leaving destruction in its path."
Copyright 2016 The Gleaner