Opioid Abuse in Public Schools
By Celia Rose
School nurse Tammy Adkins is on the front-line when it comes to drug abuse at Rock Bridge High School.
“A lot of times I get called in to assess the students if something doesn’t seem feel right,” Adkins said. “I do an assessment of are they medically stable or are they showing the signs of possibly being under the influence [of drugs.]”
Adkins has noticed an increase in prescription drug abuse in recent years at Rock Bridge High School. Luckily, Columbia Public Schools implemented Narcan, the opioid overdose antidote drug, about one year ago. Because of this, Adkins can now save a student from an opioid overdose.
Opioid abuse is a national epidemic. There were 951 opioid overdose deaths in Missouri in 2017, according to the Missouri Department of Health and Senior Services. People under 25 years old are most at risk for a heroin addiction, which is a type of opioid, according to the Center of Disease Control. These statistics pose concern for high schools across the country because of their relevancy to high school-aged students.
Although Narcan can immediately save a life, it is not a long-term solution to opioid abuse. Mental health issues are often a cause of opioid use. In order for more students to gain long-term healing, they must take mental health into account.
Where mental health comes in
“I mean we can talk about drug use,” Jim Marshall, educator about drug abuse, said. “But we can’t leave coping and depression out of it because that’s part of it.”
Marshall’s son, Cody, died from an overdose in 2011. Cody was self-medicating his depression, Marshall said. Marshall now speaks at high schools around Missouri to educate students and adults on why students are turning to drugs now more than ever.
Marshall cites poor coping skills, mental illness and smartphones as factors of the increase of drug usage. He says that parents teach children bad coping methods when they baby them too much.
“Thirty percent of all high school kids have suffered depression. That’s horrendous,” Marshall said. “And the schools don’t know they have those wounded dogs walking in every day.”
Columbia Public Schools has student support policies in place, as well as educational services. Although they are not a rehab facilitator, Michelle Baumstark, community relations director for Columbia Public Schools, said in an email that Columbia Public Schools would refer to agency that could provide necessary services.
Students first learn about using or abusing substances in third grade, and learn about specific drugs and effects in sixth grade, according to the Missouri Department of Elementary and Secondary Educations health curriculum guidelines. However, the curriculum does not state when or if students learn about the relationship between mental illness and drug use.
“Since I’m an educator, I’m about, ‘let’s start this in the schools,’” Marshall said. “I mean if we’re going to admit that 30 percent of our kids are going to be depressed, and we can’t change it, we better find a way to teach them how to deal with it.”
Narcan in Columbia Public Schools
Missouri’s Department of Health and Senior Services issued a statewide standing order in 2017 allowing for Narcan dispersal without a prescription by protocol to a licensed physician.
The nurses, and other safety personnel at Columbia Public Schools, go through training in order to gain authorization to administer Narcan to a student or adult in case of an emergency. Adkins said there is talk of allowing administers and school resource officers to also become authorized to carry and administer Narcan on campus.
“Knock on wood, I have not had to administer Narcan,” Adkins said.
Baumstark confirmed that no one has had to administer Narcan at Columbia Public Schools.
Although Naloxone, the generic of Narcan, was first introduced in the 1970s, recent forms of the drug – such as nasal spray – have fostered national attention now that firefighters and police officers carry it.
Carl Tunink, resident physician at University Hospital describes opioid dependence as the buildup of opioid receptors. This buildup requires more of a drug in order to get the same response.
“Addiction is when you get that buildup, but you liked the pleasure of a feeling that comes along,” Tunink explained. “Now you have to take more and more to get that same high, and more and more until you start needing [the drug.]”
Tunink explained that Narcan binds to opioid and flushes them out, stopping an overdose
“It’s very nice in the fact that someone who’s in an overdose isn’t breathing or responding,” Tunink said. “We can give them Narcan and they wake up immediately.”
Although Narcan worsens opioid withdrawal, the effects are not fatal, and the drug can save a person’s life.
So far, Adkins mainly gets called into situations to determine whether a student is under the influence of drugs when their behavior seems off. She assesses the student showing symptoms of drug use. The student is then further investigated for drug possession and use.
Adkins has yet to administer Narcan, but with the growing drug abuse at Rock Bridge High School, she must be prepared to administer to students or adults.
“We have AEDs [in schools] for someone who might have a heart attack. So, now we have someone dying every eight minutes of an overdose, why wouldn’t you have something like that in every public facility?” Marshall said.
