‘Imminent’ need for Narcan on campus: School safety leader says fentanyl threat is real, preparation is key

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As the Santa Cruz County Office of Education’s director of school safety, few things scare Jennifer Buesing more than the fentanyl epidemic that shows little sign of relenting.

That is particularly true after the events of Sept. 13 in Hollywood, where a 15-year-old girl died on the campus of Helen Bernstein High School after taking what she believed to be a prescription pill that was poisoned with a toxic level of fentanyl.

The Los Angeles Unified School District has reacted by requiring all of its 1,400 schools, kindergarten through 12th grade, to have the lifesaving opioid-reversal nasal spray Narcan (also called naloxone) on campus and adults trained to use it.

It’s been challenging in Santa Cruz County to get that kind of traction in advance of a potential tragedy, Buesing and others leading the efforts confirmed to Lookout this week.

Why? There are several reasons. First, Buesing says, there wasn’t a Narcan policy in place until June. Second, unlike the large L.A. district, there are 10 different school districts in Santa Cruz County that make independent decisions on such questions as Narcan use.

Further, says Buesing, there has been confusion at the administration level about whether Narcan is appropriate, safe or legal to have around children.

Buesing says it not only checks all three of those boxes — appropriate, safe, legal — but is just like a fire extinguisher you want in place when a fire breaks out: essential.

I would rather be overprepared than traumatized knowing there was something that I could have done. — Jennifer Buesing

“I would rather be overprepared than traumatized knowing there was something that I could have done,” she said.

In April, Lookout’s series “Poisoned” shined a light on fentanyl’s treacherous creep into street drugs masquerading as prescription pills, looked at what people can do to protect their loved ones, particularly the youngest and showed the breadth of community members it has devastated.

It also detailed the challenges of getting Narcan into the hands of people beyond first responders: school nurses, teachers, parents, kids. (Here is one comprehensive local Narcan resource directory).

But there remain no magic fixes to the opioid overdose crisis that has killed an astounding half-million Americans during the past two decades — and, most alarmingly, has put Californians ages 10-19 at increasingly higher risk. (See chart below.)

The California Department of Health’s Safe Schools for All Hub, which was previously devoted to COVID-19, is now largely focused on fentanyl.

I am seeing cases of students overdosing on campus. I do not want to see one of our children fatally overdosing on campus. — Jennifer Buesing

“Fentanyl is said to be the deadliest drug threat our community has ever experienced,” Buesing said. “I cannot stress enough the imminent need for Santa Cruz County schools (to have Narcan in place). I am seeing cases of students overdosing on campus. I do not want to see one of our children fatally overdosing on campus.”

The middle school challenge

While every public high school now has Narcan on campus, and adult staff who are trained to use it, the middle school level is a trickier equation.

“Some have implemented, others have not,” Buesing said. “Some are looking at changing their Narcan policy to include middle schools.”

Experts say many of the most common street drugs first appear in middle schools and children just crossing over into teen life are often the most susceptible to experimentation.

And there is a disturbing new trend that targets them: The U.S. Drug Enforcement Agency and the California Department of Public Health both recently issued warnings about the presence of rainbow-colored fentanyl intended to look like popular candies.

Buesing said she believes getting the opioid antidote into places it could possibly prevent a tragedy like the one that happened in Los Angeles needs to be atop every administrator’s must-do list.

“The smartest thing schools can do is ensure they have plenty of Narcan on their campuses, which are filled with individuals who have been trained to recognize the signs of an opioid overdose and how to administer Narcan,” she said. “Ideally every single school staff, contractor and volunteer would carry it on campus.”

The biggest challenge parents face, she noted, is that today’s teens have easy access to dangerous substances.

“If you have a smartphone and a social media account, which most of our middle and high school students do, you can purchase pills,” Buesing said. “It is safe to assume every one of these fake pills contains fentanyl. Drug dealers are using QR codes and social media to advertise pills and process payments.”

What do local police agencies say? Santa Cruz County Sheriff’s Lt. Patrick Dimick confirmed his office’s concern over the unpredictable nature of fentanyl: “It’s a huge concern for the community. To have such a potent drug, passing through hands, with no guarantee that the buyers are knowingly ingesting fentanyl or what amount.”

Getting it onto campuses

The smartest thing schools can do, Buesing said, is ensure they have plenty of Narcan on campus, as well as individuals who have been trained to recognize the signs of an opioid overdose and in how to administer Narcan.

Currently, 100 individuals countywide — mostly administrators, nurses and school resource officers — have participated in training offered by SafeRx, the wing of the Santa Cruz County Health Improvement Partnership most involved with drug awareness and harm reduction.

SafeRx’s Rita Hewitt says she is actively on the hunt for more schools willing to participate. She’s also in the process of getting a student survey out to schools to gauge awareness about current drug trends and the availability of services.

One holdup to getting Narcan into schools has been drawing up a policy for them to use. That was remedied in June, when the County Office of Education created a blueprint for districts to follow. Buesing said there are now Narcan policies in place at all school districts.

She said many are taking advantage of the state’s Naloxone Distribution Project, which will provide it to qualified organizations like schools and universities at no cost. But the COE doesn’t track which districts are being most proactive.

The superintendents at Pajaro Valley Unified and Santa Cruz City Schools — the county’s biggest districts — confirmed the presence of Narcan at their high schools. SCCS’s Kris Munro said, “Our school nurses have trained office staff on use of Narcan and it has been stocked for several years in our health offices.”

Munro added: “We are not currently planning to distribute to students.”

Getting it into the hands of kids

Hewitt of SafeRx said she and her staff will continue seeking other schools’ participation and that they’re talking to the COE about tabling on campuses and “getting Narcan to youth directly.”

Confusion about whether Narcan is legal for kids to have without a prescription appears to be getting clarified. According to the California Department of Health Care Services: “There is no law or statute that prohibits minors from obtaining Narcan, as you do not need a prescription, nor is parental consent required.”

However, Hewitt noted that many discussions are still ongoing with the legal counsels of individual districts.

Buesing said school policies around medication often go beyond legal policies and might need adjustment: “Some policies are more detailed than others, such as not allowing eyedrops, Tylenol, medicated creams, etc.”

While Narcan is currently going only into the hands of school staff, Buesing hopes it will soon safely be getting to students — and ultimately to their homes, where parents can have easy access in case of an emergency.

“One pill can kill,” she said. “Just as we have a fire extinguisher in every home in the event of a fire, we should also have Narcan.”