Chalk Talks - Legal Issues around Naloxone and Public Schools

By Morgan, Jessica | Journal of Law and Education, Spring 2018 | Go to article overview

Chalk Talks - Legal Issues around Naloxone and Public Schools


Morgan, Jessica, Journal of Law and Education


I. INTRODUCTION

Unintentional drug overdose is one of the leading causes of preventable death in the United States.1 For young people in middle and high school, this reality reaches uncomfortably close to home.2 According to the Centers for Disease Control and Prevention, the rate of overdose among high school students nearly doubled from 1999 to 2015.3 From 2014 to 2015, overdose deaths increased by 19% among high school aged children (15-19).4 Furthermore, in a study conducted to estimate risk of future opioid misuse among high school adolescents, legitimate opiate use in the high school years (to manage pain) is "independently associated with a 33% increase in the risk of future opioid misuse after high school."5 Thus, when an adolescent correctly uses opiates to manage pain, they are at higher risk for opiate misuse later in life.

As overdose deaths steadily rise, policymakers scramble to address what is widely becoming known as an "epidemic." So much so that Adapt Pharma, an Australian pharmaceutical company, announced in 2015 that it would provide Narcan nasal spray, a brand name for naloxone, which is an opiate inhibitor that prevents overdose death, to all public high schools in the United States at no cost.6 Many districts hesitate to stock the antidote, fearing inevitable liability, though the drug has been touted as a miracle worker. Some states have adopted legislation affording immunity to those who administer of Narcan to an overdose victim, including school personnel.7

The opiate epidemic is complex and dynamic, and calls for effective strategies to end abuse, combat addiction, and prevent overdose. The epidemic's effect on the lives of young people gives rise to a number of legal issues, including an increase in legal protections for those willing to take action in overdose situations that occur behind schoolhouse doors, and the reduction of barriers to accessing the counteractive-drug.

II. THE CRISIS: AN OVERVIEW

Opiates are derivative of opium, extracted from poppy plants (papaver somniferum).8 Opiates can be naturally derived, like heroin, or synthetically designed to mimic opium's effects, like fentanyl and methadone.9 This family of drugs is known for analgesic (pain relieving) effects, and for inciting euphoria and respiratory depression when used to get high.10

According to the Centers for Disease Control and Prevention, "in 2015 there were over 22,000 deaths involving prescription opioids, equivalent to about 62 deaths per day."11 Nearly all of these deaths were preventable.12 Overdose occurs when an opiate "overwhelm(s) the opiate receptors of the brain, causing respiratory suppression."13 Respiratory depression leading to cardiac arrest is the most common cause of death by overdose.14 Recently, many of these deaths have been attributed to a mix of heroin and fentanyl, which is commonly used as an additive in batches of heroin.15 Fentanyl, an opiate derivative commonly prescribed for extreme pain, is known for its frighteningly dangerous, and often underestimated, potency.16

While many people use opiates to manage pain, the drugs can be overprescribed and lead to dependency.17 Many states have taken legal action against opiate makers, citing a correlation between marketing campaigns, over prescription, and astronomical rates of addiction that have overwhelmed entire communities.18 In recent years, manufacturers have altered the chemical makeup of prescription opiates to prevent abuse, and costs have risen.19 Thus, the drugs are not only more difficult to get than in year's past; they are also more expensive.20 Many people who became dependent on opiates via legitimate prescriptions, or pharmaceutical abuse, then turned to heroin for relief.21

III. AN ANTIDOTE: NALOXONE, NARCAN, AND ADAPT PHARMA

Naloxone is another member of the opiate family, yet this derivative is a "pure opioid antagonist that quickly and effectively revives overdose victims by displacing the opioid molecules from the receptors in the victim's brain. …

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