Respond to Student Opioid Overdoses

The U.S. is suffering an opioid overdose epidemic. Overdoses involving opioids such as fentanyl killed 69,710 people in 2020, up from 50,963 in 2019, according to provisional data released by the National Center for Health Statistics.

In 2015, the Food and Drug Administration (FDA) approved a naloxone nasal spray that can stop or reverse an opioid overdose. The FDA cited the drug’s safety, efficacy, quality, and potential to save lives. Many K-12 schools, colleges, and universities are considering whether to equip their campus security with this overdose-reversing nasal spray. While your institution might worry about increased liability if naloxone nasal spray is administered, liability is minimal if the spray is properly used.

How Common Is Opioid Use?

Opioids are a class of drugs that include legal pain medications like oxycodone and morphine and illegal drugs like opium and heroin. Student misuse of prescription opioids is more common than administrators and campus security may suspect. One in 12 high school seniors report using oxycodone for recreational use, and half of college students say they can easily get prescription opioids from friends in 24 hours. Significantly, most new heroin users report abusing prescription opioids prior to trying heroin.

Misuse of legal and illegal opioids can result in overdoses. On college campuses, almost one-third of students say they know someone who overdosed on drugs like hydrocodone or heroin. As more overdoses occur in K-12 classrooms, organizations like the National Association of School Nurses (NASN) are encouraging schools and districts to include naloxone nasal spray in their opioid overdose response.

Is Naloxone Dangerous?

Naloxone nasal spray is remarkably safe. It carries no risk of incorrect use or abuse.

Within two to five minutes it can stop or reverse effects of an opioid overdose in adults and children, and it has no effect on someone without opioids in their system. The drug is sprayed into one nostril while patients lay on their backs. This process can be repeated as many times as necessary.

How Can Campus Security Get Naloxone?

Although naloxone is a prescription drug, most states make it available to third parties, such as law enforcement, without a prescription. Consult an attorney about how to equip your campus security with it.

Should Security Be Trained Before Using Naloxone?

While security should receive training about how to provide naloxone, the content and length of training are discretionary in most states. State or local departments of health, community-based organizations, health care organizations, or emergency medical services agencies may provide officer training at no charge. Training may include:

• Recognizing signs of an opioid overdose
• Providing basic life support
• Properly administering naloxone

Do Security Officials Face Liability When Using Naloxone?

Most states have passed naloxone access laws that shield people from civil or criminal liability when administering naloxone. In fact, as long as campus security acts in good faith and within the scope of their training and institutional policies, the risk of liability to themselves or your institution is generally low. Seek advice from a local attorney on the applicability of state naloxone access laws to your institution. For more information on state naloxone laws, refer to the Network for Public Health Law, the National Conference of State Legislatures, and the Policy Surveillance Program.

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Additional Resources

Bureau of Justice Assistance: Law Enforcement Naloxone Toolkit   

Centers for Disease Control and Prevention: Opioid Overdose   

Hazelden Betty Ford Foundation: Confronting America’s Opioid Epidemic   

NASN: Naloxone in Schools Toolkit   

National Institute on Drug Abuse: High School and Youth Trends   

Substance Abuse and Mental Health Services Administration: Naloxone   

FDA: Information About Naloxone