Not that many years ago, portable AEDs were the tools of emergency medical personnel, used judiciously under physician supervision. Today, they hang on the walls of office buildings, airports, shopping malls, houses of worship, schools and other locations.
Now there’s another lifesaving tool slowly making its way from the EMS toolkit into more mainstream areas: naloxone. In Gaylord, Mich., administrators and staff at Gaylord High School and Gaylord Middle School will receive training this summer to ensure they know how, and when, to use the naloxone kits available in the school offices come fall.
“Our take is, we hope we never have to administer it, but if it can save a life, the downside of using it doesn’t come close to the downside of not using it,” says Brian Pearson, superintendent of Gaylord Community Schools. The free naloxone kits, supplied to the school through a partnership between a pharmaceutical company and a national foundation, were brought to the school district’s attention by Up North Prevention, a community initiative to advance substance abuse prevention efforts in northern lower Michigan. Up North’s Linda Gall, a certified prevention specialist, learned about the program at a conference and brought it to the school for consideration. The district school safety committee made the decision earlier in 2017 to implement the project for the 2017-201 school year.
Pearson explains that committee includes local law enforcement, EMS, the district attorney, various community organizations and parents, and it meets regularly to discuss current issues and how the members can work together to continue to make Gaylord a safe place to learn: “Our goal is to foster a safe and collaborative culture. You need to ensure safety first for kids to learn. You can have the best teachers in world, and if your students don’t feel safe, they won’t learn well.”
The committee worked with the board of education to develop a clear policy on how and when to use the naloxone, and that protocol starts with calling 911 before administering the drug. All teachers will receive basic training from the state police and local EMS on how to recognize the signs and symptoms of an overdose, and office staff will receive more detailed training on using the kits. Corey Hebner, the community state trooper for the Gaylord area, has conducted numerous train-the-trainer sessions for his fellow law enforcement officers, and he will provide oversight to the training at Gaylord. He says its basic focus is on awareness of the signs and symptoms of an overdose, which can include heavy perspiration, a grayish hue to skin, shallow breathing, skittish behavior and/or passing out.
In northern lower Michigan, as in much of the rest of the country, first responders are being faced with heroin mixed with fentanyl or carfentanil, sometimes requiring multiple doses of naloxone to reverse the overdose. Hebner emphasizes the need to call 911 immediately and to assume that one kit may not be enough to help.
“The beautiful thing about naloxone is if it is something else, the drug has no effect and causes no adverse reaction,” Hebner says. Training will also provide staff with information on problem behaviors to watch for that might indicate a need for an intervention that could potentially prevent an overdose, Pearson says.
“Brian is very proactive instead of reactive. He’s looking at the whole picture and we need to see more of that,” Gall says. “If other schools also take that approach, it becomes one more layer of prevention for the whole community.”
Up North Prevention works with various aspects of drug prevention in the community and in the schools in 14 counties, and has assisted with training at 55 local law enforcement agencies in the past two years, resulting in at least 39 lives saved due to naloxone use. Getting the program started in Gaylord, which is the largest school district in the area (approximately 3,200 students in grades K-12), may encourage other schools in the area to apply for the kits as well, Pearson says.
In a small town like Gaylord (pop. less than 4,000), school events like football games and plays draw in hundreds of spectators, and the buildings themselves are also heavily used for local craft fairs, worship services and the like. While Pearson likened the naloxone kits to epi-pens and Hebner drew the parallel with AEDs, they join Gall in agreeing that naloxone is a way of rendering aid in a medical emergency whose time has come.
“Even if there’s only a 1 in 100 chance that we might ever use this to save a life, it would be ridiculous not to do this,” Pearson says.