Editor’s note: This story was updated on Jan. 6, 2022, with new information from the Colorado Department of Public Health and Environment to include Cherry Creek School District.
As the number of fentanyl overdoses began to climb, Colorado policymakers created a program to put the life-saving opioid antidote naloxone inside police departments, universities, workplaces and schools.
But two years later, when annual deaths from fentanyl have surpassed 500 and fake painkillers laced with the synthetic opioid are killing an increasing number of high school and college students, just three school districts in the entire state have taken advantage of the program.
Only Boulder Valley, Clear Creek and Cherry Creek school districts have ordered doses of naloxone — a nasal spray or an injection that can reverse an overdose if it’s given in time — from the Colorado Department of Public Health and Environment bulk purchasing fund.
Health officials are concerned the slow start is because of stigma associated with drug use, and they fear school leaders are not seeking the opioid antidote because it might cause parents or others to think certain schools or districts have a bigger drug problem than others. State officials initially said only two school districts had ordered naloxone but later amended that number to three.
“We applaud the schools that have a naloxone program and want to make clear that schools that make naloxone available do not necessarily have higher statistics of overdose but rather are being proactive in preventing overdoses,” said Andrés Guerrero, manager of the overdose prevention unit at the state health department. “Prevention is key as we are seeing increases in overdose due to fentanyl in the Colorado drug supply.”
While 176 out of Colorado’s 178 school districts have not asked for free naloxone, the bulk purchasing program has helped dozens of other entities, mainly law enforcement agencies and harm reduction centers where people go for clean needles and information about drug treatment. The fund paid about $337,000 for about 10,500 doses of naloxone in 2020, dispensing the doses to 90 entities statewide.
This fall has been particularly busy, with orders totaling $547,322 since September. The fund has $1.24 million still available.
The naloxone bulk purchasing fund, created by 2019 legislation and put in place in January 2020, uses federal and state funding to buy naloxone at wholesale prices and distribute to first responders, campus police, harm reduction centers, workplaces, recreation centers and schools. The doses are free to school districts and other agencies that apply to the program.
Boulder Valley was the most recent school district to apply, receiving enough this fall to place at least one dose of the nasal spray in all 64 school buildings and bus terminals by early next year. The district said nurses are receiving training on how to use the spray with a goal of having doses officially in place soon after the winter break.
After a string of overdose deaths and nonfatal overdoses in the community last school year, Boulder Valley students were increasingly requesting naloxone and training in how to use it, school officials said. The district has been working since last May to get naloxone, and officials noted that not all potential opioid overdoses occur because of illegal drug use.
Boulder Valley’s decision to place a dose in every school is a long time coming, said Kelly Luck, who for two years was an addiction counselor at Arapahoe Ridge High School in Boulder. Luck, who left the job last spring to return to work as a substance abuse counselor at a community treatment center, said two students overdosed while she worked at the alternative high school that specializes in career and technical education.
The first time it happened — on her first day on the job — there was no naloxone on hand after a student took “fake benzos,” the street term for knockoffs of the anti-anxiety medication, Xanax. But Luck was ready the second time. When another student was found unconscious at school, she pulled out her own dose of the nasal spray she had started carrying with her at work.
Luck said she pushed for two years, making requests in her school and to the district, for Boulder Valley to purchase naloxone, sold under the brand name Narcan. “I was almost horrified to learn the first day that there was no Narcan in the building and it’s not standard protocol for anyone to carry it,” she said. “I am not the only person who has had this frustration.”
Luck picked up several doses of Narcan on her own and passed them out to teachers and staff at school, she said.
She wonders why every school in the state doesn’t have the opioid antidote at arm’s reach, just in case. The drug can restore breath to a person who has stopped breathing, keeping them alive until paramedics have a chance to arrive. School officials and parents who don’t think naloxone is needed on campus are naive, Luck said.
“Kids are doing every drug imaginable in the bathroom at high school,” she said.
Clear Creek School District received naloxone for its two elementary school campuses and combined middle and high school campus last year, a credit to the community’s “very forward-thinking school board,” Superintendent Karen Quanbeck said.
“The thinking is that it could be used for anyone who is in need, whether it’s a visiting family member or a member of the public or a kid,” she said. “It’s not specific to students.”
The opioid antidote is kept in a locked box by the school nurse’s office, not far from EpiPens in case of anaphylaxis from bee stings and kits used to stop severe bleeding from a wound. So far, no one has had to use it, said Quanbeck, who has been superintendent for three years and said there has not been an overdose on school grounds.
Office staff, health staff and other employees learned to use the nasal spray during virtual trainings last year and this year. Quanbeck said the district has not received any negative feedback about the program
“I hope we never have to use it, but it’s here if we do,” she said. “It’s thinking about all the things we can do proactively to ensure our community is safe.”
Denver Public Schools does not yet have naloxone on its campuses but is making plans to do so, said district spokesman Will Jones. “We recognize that opioids are a problem in society at large,” he said via email. “In order to be proactive, we will have naloxone in our middle and high schools to help in case opioids find their way into our schools.”
The district’s nursing team is still in the process of determining how to order the opioid antidote and has not yet applied to the state program.