Question: I’ve been hearing a lot about Naloxone and the opioid crisis. Should schools be doing something about this? What is the teacher’s role when it comes to administering medication?
Answer: The fentanyl crisis has been in the news for quite some time now and the incidents of overdose in Alberta are on the rise. This is of concern to everyone, and we all play a role in reducing this threat. I asked my colleague Robert Mazzotta, co-ordinator of Member Services, to provide his insights into the problem and to teachers’ role. His response follows.
Fentanyl is a powerful narcotic, often mixed with other street drugs, that when ingested can render an individual unconscious and can lead to death. The primary role of the school is to educate students regarding the risks associated with the use of opioids and other drugs that may contain fentanyl. As teachers, we need to ensure our students develop healthy lifestyles and understand how to make proper choices in their lives. Preventative measures need to be at the forefront. We want our students to be safe.
Some school boards are looking into having Naloxone kits available in schools as a tool to combat a potential overdose by a student. There are a number of concerns that need to be considered before such a decision is made and implemented.
According to occupational health and safety legislation, an employer must
- conduct a hazards assessment and ensure appropriate controls are in place,
- develop safe work procedures and provide training to workers (not necessarily teachers),
- ensure the equipment (the Naloxone kits) is in working order,
- assess the risk of worker exposure and
- identify controls to reduce the risk of exposure to hazards related to the administration of Naloxone (http://work.alberta.ca/documents/OHS-bulletin-CH076.pdf).
It is also important that school board policy cover the use of non prescription medication in schools to ensure that all staff involved are covered by board insurance should something go wrong. School board policies often prohibit members of staff from administering to a student drugs that have not been specifically prescribed for that student. If the employer says that teachers cannot give students aspirin, how could teachers assume they are authorized to give students Naloxone?
There are also practical matters to be considered. For example, Naloxone is available as both a nasal spray and as an injectable. It is not recommended, however, to use the nasal spray kit, as an individual who has overdosed may experience depressed breathing that may render the nasal spray form of the medication ineffective. The injectable form of the medication is medically preferred and comes in kits with four vials of Naloxone and four syringes, as more than one dose may be needed to have the desired effect. Injecting Naloxone requires the first responder to draw the medication into a syringe and then administer the injection, perhaps several times if warranted — this is very different from using an EpiPen auto-injector to administer epinephrine.
The current information on the Alberta Health Services website states that the Naloxone kits can be prescribed or dispensed only to a patient or individual using opioids. However, a call to HealthLink and to a pharmacy has confirmed that anyone can pick up a kit. The law has not changed, but it appears that current practice has. It is important to review the information as it is changing, particularly in light of these contradictions.
The Association’s position is that teachers are there to teach, not to administer medication. This is why most schools have appropriate policies, safeguards and procedures in place in advance of an emergency as well as designating appropriately trained, noncertificated individuals to be responsible for medication administration. Administering Naloxone should be no different. ❚
Questions for consideration in this column are welcome. Please address them to Dennis Theobald at Barnett House (firstname.lastname@example.org).