ap photo The overdose-reversal drug Narcan is displayed during training for employees of the Public Health Management Corporation (PHMC) in Philadelphia.

The Marshalltown Community School District will have a supply of Narcan nasal spray when students return for the 2023-24 school year.

Stacey Tool-Crawford, the high school nurse, said the Marshalltown School Board reviewed a new policy to carry Narcan, also called Naloxone and used to reverse opioid overdoses, during the June 19 regular meeting.

The Iowa legislature, she said, passed a law which stated school districts could carry a stock of Narcan due to the increasing incidents of opioid overdoses. The law gives districts the ability to combat the overdoses at a local level. Tool-Crawford said the step would not be necessary if there had not been a huge uptake regarding opioid overdoses.

“There has been an increased uptake in vaping, and sometimes opioid derivatives are in vape cartridges,” she said.

According to Tool-Crawford, vaping cartridges can be laced with opioids, and the student may not know it. She said the contents of the vapor are not always advertised.

“Unfortunately, kids don’t always know what they are vaping,” Tool-Crawford said. “It’s very frightening.”

The district has installed vaping monitors in school bathrooms in an effort to reduce the amount of vaping taking place in the buildings. Being the high school nurse, she knows there has been a large increase in the last few years of the number of vaping incidents. Some of those have been more than nicotine.

Tetrahydrocannabinol (THC), the psychoactive compound of marijuana, has been the most common illegal substance found. District personnel are concerned about the possibility of synthetic fentanyl being in the vape pens. Fortunately, she said they have not encountered that yet.

“We want to be prepared. We have not seen opioid overdoses from vaping,” Tool-Crawford said. “It is not something we hope to see, but know there is an opportunity for it to happen. We like to be prepared and keep our students and staff safe.”

To ensure that safety, Tool-Crawford said the supply will be kept in nurses offices within district buildings. Administering personnel are not restricted to nurses, either. She said emergency response staff will be trained on how to use the Narcan, plus any additional personnel who would benefit from the training.

“We will send an email to staff to make them aware we have it,” Tool-Crawford said.

School resource officers (SROs) have been carrying Narcan with them for a few years, but Tool-Crawford said they cannot afford to wait for an SRO to arrive on scene. Timing is crucial, and the sooner a student is given Narcan, the better.

“After the Narcan is administered, it is two, three minutes before it takes effect,” she said.

The amount given depends on how much opioids are in the system, the size of the person and any underlying medical conditions. Personnel can act quickly when overdose symptoms are spotted, such as:

• Slow respiration;

• Confusion;

• Small pupils;

• Blue skin;

• Loss of consciousness.

Tool-Crawford said if there is a belief the student has possibly digested or vaped opioids, the Narcan spray will be provided.

“If it is not an opioid overdose, based on the symptoms, the Narcan will not hurt them,” she said. “Sometimes it is difficult to know for sure if it is opioids. With the information we have, we treat it as if it is.”

A second dose can also be administered, and Tool-Crawford said it will not have negative effects. Of course, in the event of a suspected overdose and administered Narcan, first responders will be notified.

Each dose will be recorded. Every month, the nurses in each school will perform a monthly count and check the expiration dates of each.

“We have ordered a maximum of five per building,” Tool-Crawford said. “That way, we have it in place in case we need it. If Narcan is used, we have to report it to Iowa Health and Human Services.”

Highlighting the scope of the problem, Tool-Crawford said people outside the district can access Narcan.

“The truth is, a layperson can go to a pharmacy and get Narcan because it is such an epidemic,” she said. “You can’t wait until it’s accessible because it saves lives. We want to make sure our students are safe, and we are prepared. We want this accessible for our students and staff so there is no concern for an opioid overdose.”

Contact Lana Bradstream at 641-753-6611 ext. 210 or lbradstream@timesrepublican.com.