Lawmakers debate whether school nurses should stock antidote to heroin overdose |
On Board Online • November 24, 2014
By Connie McKinney
Special Correspondent
To date, there have been no reported cases of heroin overdoses taking place in New York State schools. But legislators have been debating whether schools are adequately prepared to deal with that possibility.
Legislation that would allow schools to stock a heroin overdose antidote failed to pass the state Legislature last spring. Notably, a bill that passed the Senate in the last session, S.7661, would have authorized "any person employed" by a school district to administer an opioid antagonist such as Narcan.
Also known as naloxone hydrochloride, Narcan can reverse the effect of an overdose from heroin and other opioids, a class of drugs derived from opium and used as painkillers. Some emergency medical teams have carried and used Narcan for years, and police departments across the state have begun to do so recently in response to the current heroin problem.
Current state law and regulations do not allow schools or BOCES to stock Narcan, according to Martha Morrissey, an associate in nursing for NYSED's Office of Student Support Services.
School nurses generally do not stock any medications that are not specifically prescribed for a student. One exception involves medications to treat anaphylaxis (a severe allergic reaction). State law permits district medical directors (a physician or nurse practitioner) to prescribe a drug such as an Epi-Pen that is non-patient specific. Nurses can use the Epi-Pen if a student is experiencing anaphylaxis.
A new law that goes into effect in February will allow schools to keep Epi-Pens on hand and authorize teachers trained in their use to administer them to students even if the student doesn't have a prescription. Gov. Andrew Cuomo also signed legislation that will allow students with asthma, allergies, diabetes or other conditions to carry and administer inhalers, insulin injections or other medications while at school.
One issue in emergency use of non-patient specific medications involves the potential legal liability of school nurses if they administer the drug.
State law protects bystanders who take emergency action in good faith, but does not protect medical professionals acting within the scope of their employment.
"Any person, including a nurse, who administers Narcan as a good Samaritan has liability protection under Public Health Law section 3000-a; this is also reiterated in Public Health Law section 3309(4)," according to the state Department of Health. But, "as stated in Public Health Law section 3000-a, this does not relieve a nurse from liability for damages for injuries or death caused by an act or omission on the part of such person while rendering professional services in the normal and ordinary course of his or her practice."
Alan Wilmarth, administrative director of behavioral health for United Health Services in Binghamton, said physical education teachers should have Narcan available in case of an overdose. Students sometimes hide drugs in locker rooms and may try heroin before or after gym class, he said.
"I think it can save lives," he said of Narcan. "It's worthwhile to invest in the training and worthwhile to have the medication on hand."
Another public policy issue involves the unintended consequences of widespread availability of overdose antidote, Wilmarth said. Some addicts have told him and other members of his staff that having Narcan gives addicts a sense of safety.
"It's actually giving them permission and encouragement to further intensify their use," he said. "They tell us, 'It was my night to go as far as I could.' They intentionally used more than they thought they could tolerate in order to get more of a sense of euphoria and ended up in an ICU on a vent."