Several school districts in Grays Harbor County have been stocking school buildings with naloxone, an opioid overdose-reversal drug, in an effort to protect students during a national opioid epidemic and an increasing prevalence of opioids in the Harbor.
The action heeds progressive opioid response policy in Washington state, one of 10 states that mandates certain school districts to carry naloxone.
Superintendents say new school policies prioritize the opioid epidemic as a public health crisis and provide a framework for administering anti-overdose medication. Accessibility to anti-overdose medication — and proper training — is the best way to prevent death in the event of an overdose, according to public health officials.
“What we are experiencing as a nation related to the opioid crisis is that it can affect anyone anywhere,” said Wilma Weber, community health specialist with Grays Harbor County Public Health Department. “Naloxone is the best tool to have in your emergency/first aid kit to help prevent an overdose death no matter where an overdose occurs.”
Naloxone can be administered through either a nasal spray or injection. It reverses the effects of an opioid overdose — fentanyl, heroin, prescription medication or others — by restoring breathing to a person whose breath has significantly slowed or stopped, according to the Centers for Disease Control and Prevention.
Because of the statewide opioid problem, the Washington state Health Officer issued a standing order for naloxone, meaning anyone can possess, store, deliver, distribute or administer naloxone,” and naloxone is available in pharmacies without a prescription.
Superintendents say recent opioid policy is in response to state requirements and recommendations, as well as a public health precaution, not necessarily a reaction to an observed opioid presence in schools.
“(Naloxone) is almost like a fire extinguisher,” said Angela Crowther, North Beach school district superintendent, in an interview. “You have to have a fire extinguisher handy in case something happens, and then you hope you never use it.”
While schools haven’t yet had problems with student overdoses — opioids, particularly fentanyl pills — are most likely circulating in high schools in Grays Harbor County, according to Detective Sgt. Darrin King of the Grays Harbor Drug Task Force.
“My thought would be that there have been (fentanyl) pills in all the high schools,” King said. “I hope I’m dead wrong.”
Fentanyl is a snythetic opioid 50 to 100 times more powerful than morphine, according to the Drug Enforcement Administration. King said the increased abundance of fentanyl pills has been signaled by a drop in the drug’s street value — a year ago, fentanyl pills sold for $15 each, and now the pills sell for just $2 each. Those pills might come in the form of multi-colored rainbow fentanyl, which could be more enticing to young people, King said.
And while King said he hasn’t yet seen it in the Harbor, marijuana-laced fentanyl is becoming more common.
“Any drug you buy on the street now, you have to assume it has fentanyl in it,” King said.
Opioid-related death rates nearly doubled from 2019 to 2021 and are high in rural counties such as Grays Harbor, according to the University of Washington’s Addiction Drug and Alcohol institute.
Grays Harbor is one of 21 sites nationwide in the Rural Response Initiative, a federally-funded program aimed at implementing “community level overdose prevention techniques.” In July, Grays Harbor Public Health received additional funding from the Rural Response to the Opioid Epidemic grant, allowing the county to provide both naloxone medication — in the form of NARCAN kits — as well as training for staff on how to administer it.
During the trainings, participants learn to identify symptoms of an opioid overdose and the proper technique for delivering the naloxone nasal spray, according to Weber. The county health department in August provided naloxone training to all North Beach staff, including teachers, counselors and administrators, according to Crowther.
“It was a two-hour training, so it was pretty intense,” Crowther said.
Naloxone won’t harm someone if they are overdosing on drugs other than opioids, or if they aren’t overdosing at all, according to the CDC.
The health department provided overdose training to Hoquiam High School in early December, according to Hoquiam School District Superintendent Mike Villarreal. Villarreal said 10 to 15 people were trained, including principals, athletic directors and office coordinators, and the district is in the process of training all of its staff to administer naloxone.
The Washington state Office of Superintendent of Public Instruction, which provides guidelines to school districts carrying naloxone, training should occur annually before the start of the school year and “throughout the school year as needed.”
Those trained staff, in addition to school nurses, are then eligible to access and deliver naloxone, which is located in specific school buildings.
Aberdeen School District has stocked two NARCAN kits each in Miller Junior High, Aberdeen High School and Harbor Learning Center, according to Richard Bates, director of special education with the district. Staff completed trainings at the beginning of the school year, Bates said.
Although Harbor schools have carried naloxone for months, recent policies outline where and how naloxone can be administered. North Beach and Aberdeen have already passed such policies, while Hoquiam’s school board is currently reviewing one.
“The policy itself recognizes that there’s a health crisis,” Villarreal said, adding, “It also makes it a priority, that we’re going to try to take this by the horns, essentially.”
In 2019 Washington passed a law mandating school districts with 2,000 students or more must keep at least one set of opioid overdose reversal medication in each of its high schools. Out of school districts in Grays Harbor, only Aberdeen is large enough to meet the state’s requirement.
The law put Washington on the leading edge of opioid legislation nationwide. Thirty states have laws addressing naloxone in schools, and 10 of those states require schools to carry the drug, according to a summary of state laws from the Legislative Analysis and Public Policy Association. Oregon and Arizona are the other two Western states that require schools to carry naloxone, and a similar bill is pending in California’s Legislature. Other states recommend that schools carry naloxone but don’t require it.