Opioid overdose reversal medication and rescue breathing are evidence-based interventions known to result in positive outcomes for individuals experiencing an opioid related overdose. The district shall utilize the Opioid Related Overdose Policy Guidelines & Training in the School Setting published by the Office of the Superintendent of Public Instruction.

Opioids and Overdose
Opioids are a class of drugs derived from opium poppy or entirely created in a lab. Opioids include morphine, codeine, oxycodone, hydrocodone, hydromorphone, heroin, meperidine, fentanyl, and methadone. There are prescription opioids and opioids that are created and obtained illicitly.

An opioid overdose happens when someone has taken too much of an opioid. Synthetic opioids such as Fentanyl are especially dangerous due to the potency and can be added to non-opioid illicit drugs. A person may experience non-life threatening effects such as nausea, vomiting, or sleepiness. A person may also experience life threatening effects that may lead to death, including infrequent or absent breathing, slowed or irregular heartbeat, no response to stimuli, and severe allergic reaction. An opioid overdose may occur intentionally or in many cases unintentionally after injection, ingestion, or inhalation of an opioid, known or unknown. Assessing an individual for responsiveness and breathing is critical to a successful outcome of a person experiencing an opioid overdose. 

An opioid overdose requires immediate medical attention. If any type of overdose is suspected, including an opioid related overdose, district staff will call 911 and alert a first responder. The school nurse, designated trained responder, or trained staff person located at a health care clinic on public school property or under contract with the school district will follow the Washington Department of Health steps for administering naloxone for a suspected opioid related overdose (https://doh.wa.gov/sites/default/files/legacy/Documents/Pubs//150-126-NaloxoneInstructions.pdf).  Naloxone is effective only if there are opioids involved in the overdose. Naloxone will not reverse the effects of alcohol, benzodiazepines, or cocaine. Washington’s Good Samaritan Law provides some protections when calling 911 to save a life, even if drugs are at the scene according to RCW 69.50.315. The victim and person calling 911 cannot be prosecuted for simple possession. 

Obtaining and Maintaining Opioid Overdose Medication
If a statewide standing order for intranasal or auto-injection intramuscular forms of naloxone is available, the district will obtain and maintain those forms of opioid overdose reversal medication exclusively. 

The district may seek to obtain opioid overdose reversal medication through donations from manufacturers, non-profit organizations, hospitals, and local health jurisdictions. The district may also purchase opioid overdose reversal medication directly from companies or distributers at discounted pricing. The district must maintain written documentation of its good faith effort to obtain opioid overdose reversal medication from these sources.  

The district health services department shall ensure that the opioid overdose reversal medication is stored safely and consistently with the manufacture’s guidelines in each of its public schools. The health services department will also routinely monitor the inventory of opioid overdose reversal medications and maintain a supply within reasonably projected demands. Medication expiration dates will be documented a minimum of two times per year, to ensure enough time for reacquiring the medication prior to the expiration date.

Opioid overdose reversal medication shall be clearly labeled in an unlocked, easily accessible cabinet in a supervised location. Consider storing opioid overdose reversal medication in the same location as other rescue medications, first aid kits or AEDs. Additional materials (e.g. barrier masks, gloves, etc.) associated with responding to an individual with a suspected opioid overdose can be stored with the medication.

Training
School-based health centers are responsible for training their personnel. 

The district will ensure each public school has at least one personnel member who can distribute or administer opioid overdose reversal medication.  Training may take place through a variety of platforms, including online or in a more conventional classroom setting. Training may occur in small groups or conducted one-on-one and may be offered by nonprofit organizations, higher education institutions, or local public health agencies, consistent with OSPI’s guidelines and this policy/procedure.

The district will maintain a log of all designated trained responders for each public school. The log will include a list of all persons who are designated trained responders, a list of their trainings with the date and location of the training and the name of the trainer or organization.

Individuals who have been directly prescribed opioid overdose reversal medication according to RCW 69.41.095 lawfully possess and administer opioid overdose reversal medication, based on their personal prescription. However, such “self-carrying” individuals must either show proof of training as verified by a licensed registered professional nurse employed or contracted by the district or participate in district training in order to be counted toward district designated trained responders. 

Liability 
The district’s and practitioner’s liability is limited as described in RCW 69.41.095. 

Revised:  December 2024