Dozens of students gathered in Saratoga High School’s student center on Feb. 28 to participate in emergency lifesaving training. Unlike similar efforts in the past, the training wasn’t centered around chest compressions or mouth-to-mouth resuscitation but on how to save someone from an opioid overdose.
The event was part of an effort the Los Gatos Saratoga Union High School District is undertaking to train their entire student population in the use of the overdose-reversing medication Naloxone, commonly known as Narcan. The district is among the first in the Bay Area to do so, spurred by the growing prevalence of fentanyl. High school campuses are not immune to this opioid epidemic, as the Los Gatos Saratoga Union High School District has seen in multiple fentanyl overdoses that have rocked its community in recent years.
A Bay Area News Group survey from last March found that several Bay Area high schools were unprepared to handle fentanyl overdoses but have upped their preparedness in recent months.
The turnout for the Feb. 28 training indicates that students at Los Gatos and Saratoga high schools want to be prepared to help if they witness someone overdose on an opioid. Only 16 students RSVPed for the event, but nearly triple that number turned out.
“Narcan is the CPR of the 21st century,” said Amy Obenhour, who teaches health at Saratoga High School.
District nurse Lisa Tripp took just 20 minutes to lay out the strategies to identify an opioid overdose, explain the dangers of fentanyl and then open boxes of Narcan to pass out to the students in attendance. Both Saratoga and Los Gatos high schools already keep a supply of the nasal spray on campus.
Obenhour has been advocating for Narcan training and awareness for the past three years, and has offered optional Narcan training to her health students during that time. Now, with support from the district, the freshman classes at both high schools are on track to be trained in the use of Narcan through their health classes.
Upperclassmen who haven’t received Narcan training in health class can avail themselves of events like the one on Feb. 28.
Tripp said the effort is being funded by the Narcan distribution project under the state’s Department of Healthcare Services, which was also involved in the district’s effort to train faculty and staff on the use of the nasal spray last year. She said she added Narcan to each of the AEDs, or automated external defibrillator kits, that are around campus at Saratoga High.
An uncontroversial effort
In Los Gatos and Saratoga, where the median household income is around $200,000, parents are known for having strong opinions on the quality and content of their students’ education. Wendy Riggs, a longtime parent in the district who has served as the president of Community Against Substance Abuse, or CASA, and is supportive of the training effort, said she hasn’t heard about any opposition to the Narcan training.
“People like to complain, so if they didn’t like it, they would complain to somebody about it,” she said. “I personally have not heard anything about it.”
Riggs said she’s impressed that the school took such a “strong” step forward on the matter, and she’s not alone in that sentiment.
Keith Humphreys, a professor of psychiatry and behavioral sciences at Stanford University, said fentanyl on school campuses is such a universal problem that he’s glad a district in a wealthy area is taking such a firm stance on the issue, as the problem isn’t isolated to lower-income areas.
“It’s horrible that we have to do this to our kids, but it is necessary because this is the deadliest recreational drug we’ve ever dealt with,” he said of the training. “We are losing people each year who think they’re consuming something else but it turns out to be fentanyl. It may seem like a hysterical reaction to have Naloxone in schools and to teach kids about fentanyl, but it really isn’t.”
Not only is Narcan relatively affordable and its training correspondingly simple, he said, but the medication is largely harmless if administered incorrectly or used on someone who is not experiencing an overdose.
“I would not be afraid if someone sprayed Naloxone up my nose right now,” he said. “It doesn’t harm people who don’t have opioid overdoses.”
Despite the limited controversy on the matter, the district has allowed for students to opt out of the training.
Ryan Lin, a senior at Saratoga High who helped promote the Narcan training on campus, said the trainings have helped him feel more prepared in the event that he does encounter an opioid overdose.
“I think it’s really important just because it makes the community safer,” he said.
Training as harm reduction
The training effort marks a shift in conversations about preventing opioid overdoses in schools, as they contrast sharply to the D.A.R.E., or Drug Abuse Resistance Education curriculum that was a hallmark of the 1980s and placed an emphasis on resisting peer pressure and preventing drug use in the first place.
Instead, the Narcan training effort falls more under the category of harm reduction, an approach to preventing overdoses that puts a focus on reducing the consequences of drug use.
Opioid overdoses, especially fentanyl-induced ones, have become so widespread recently that the language around it has changed as well. Teachers and local leaders have turned to the phrase “fentanyl poisoning” instead of “overdose” to flag the likelihood that people often consume fentanyl unintentionally, and many who experience these overdoses are not necessarily addicted to drugs.
“The reason they use that term is they’re trying to indicate the difference between someone who intended to use fentanyl and someone who, it was laced in something they took,” said Santa Clara County Supervisor Cindy Chavez, who is co-chair of the county’s fentanyl working group.
Harm reduction as a concept and the strategies that fall under its umbrella does have its detractors. The organization Mothers Against Drug Addiction and Deaths (MADAAD), for example, doesn’t support elements of harm reduction that involve distributing drug paraphernalia.
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“Although there are some studies that say clean pipes stop the spread of disease – well, so do wet wipes,” MADAAD co-founder Gina McDonald said.
But the organization is in favor of other aspects of harm reduction, including the Narcan training effort happening in Los Gatos and Saratoga.
“I think it tips over into a gray area where we’re starting to enable drugs with paraphernalia as opposed to preventing an overdose with Narcan,” McDonald said. “I see a clear distinction between that.”
Health teacher Obenhour said the Narcan training is all about arming students with the tools they need to stay safe. And though some of the freshmen she teaches look like “deer in headlights” during her trainings, she has heard from former students and alumni about how valuable they found it to be.
“It’s like buying insurance,” she said. “You never want to use it, but you still have to pay for it.”
Santa Clara County has also begun distributing Narcan by mail to residents in the county free of charge. Residents can contact the county at 408-272-6055 or [email protected] to receive Narcan, or pick up the spray at the Saratoga, Milpitas and Gilroy libraries.
