Schools confront the heroin crisis

Overdoses force administrators to shift tactics, stock emergency medicine
By: | Issue: May, 2016
April 11, 2016

The number of districts and states rushing to stock an emergency antidote that can revive students suffering heroin overdoses shows the severe degree to which the nation’s latest drug epidemic has disrupted schools.

Students who in the past might have abused marijuana, painkillers and other prescription drugs have turned to heroin, which is now cheaper and easier to buy. Dealers also often mix heroin with powerful drugs like fentanyl, a painkiller administered in operating rooms that’s extremely dangerous if used incorrectly.

Traditional programs like D.A.R.E. haven’t solved drug abuse problems in the past and are even less likely to work this time, district leaders and school health experts say.

Heroin overdose deaths in the United States increased by 286 percent between 2002 and 2013, according to the “Reducing Teen Substance Misuse” report released in November 2015 by the Trust for America’s Health.

“Don’t tell schools to teach another drug-free curriculum—we’ve been teaching that for years” says Corinne Cascadden, superintendent of Berlin Public Schools, a small New Hampshire district where two students overdosed in the past year. “Treatment and recovery is what we need, but nobody has any dollars for that.”

Spot risk factors

Berlin’s school board earlier this year approved the district’s use of Narcan, the opiate antidote also known as naxolone, which can be administered via inhaler or injection to reverse a user’s overdose shortly after it starts to affect the body.

The northern New Hampshire city’s recent struggles have filtered down into the schools, Cascadden says. Berlin’s population has declined over the past 10 years since a paper mill closed. Vacated housing has been partially filled by outsiders who were offered low rent by real estate agents and who are less likely to take advantage of hiking, fishing and other outdoor activities Berlin’s region offers, she says.

The students become bored and disillusioned with the rural lifestyle and seek solace in drugs. Plus, dealers who face stiff competition in urban and suburban centers can relocate to small cities like Berlin and make money. “We never had hard drugs on the scale that we have now” says Cascadden, who has worked in the district for nearly 40 years. “We’re seeing younger kids having access and getting addicted.”

Nearly 6 percent of Berlin’s students reported using heroin in 2013—nearly double the state average. Since the beginning of 2015, a 19-year-old student overdosed in a dugout during baseball practice and a 15-year-old student OD’d.

“The kids [who also take drugs] all grieve but they don’t get out of dangerous situations” Cascadden says. “It doesn’t scare them enough, and I’d like them to be scared.”

The district has actually shortened the number of suspension days for students caught using drugs or alcohol. Like many court systems, it now requires the students to attend drug and alcohol counseling. Behavioral health teams have been added to provide mental health care at each of Berlin’s four schools. But Cascadden says the district doesn’t have enough money to hire a sufficient number of therapists.

Counselors and therapists are crucial because they can help identify the students most likely to experiment with drugs. Those at greatest risk include students who are being bullied, have difficult home lives or are suffering mental problems like anxiety and depression, says Beth Mattey, president of the National Association of School Nurses.

Nurses, in fact, likely see the first warning signs, such as students who come to the school clinic with frequent headaches or stomach aches. The complaints may be a student’s way of getting away from uncomfortable situations.

“Nurses are trusted, kids will tell us things they might not tell other people” Mattey says.

Nurses and counselors can steer students toward athletics or other extracurricular activities, which lowers the risk of potential drug use.

Students can also be referred to community health providers for more intensive counseling. “Supportive adults in a child’s life make a difference” she says. “Just saying no does not work.”

‘Problem is everywhere’

The number of ninth-graders in the Harford County Public Schools in Maryland who had tried heroin at least once nearly tripled in 2013, to just over 5 percent, according to a youth behavior survey.

It’s above the Maryland state average, driving the district of about 37,500 students to work even more closely with police, the county health department and other agencies on initiatives to reverse the alarming trend, says Ginny Popiolek, district supervisor of physical education and health curriculum.

“We’re not going to arrest ourselves out of this problem” Popiolek says. “We want to be working smart, using all our resources, instead of each entity having its own agenda.”

Police, for instance, have told students that under Maryland’s Good Samaritan law, they won’t be arrested if they report that a friend is overdosing. Students also learn that calling authorities is the best way to get help for friends who are abusing drugs, she says.

Offering students data about the large majority of students who never try drugs can help steer others away, adds Joe Ryan, director of the Harford County Office of Drug Control Policy.

Ryan’s office has provided funding and expertise to help students use school production equipment to make anti-drug public service announcements for their classmates. One of those videos, posted on an internal school website, tells parents how to search a child’s room. “The way we’ve addressed these problems before was with canned programs” Popiolek says. “We ‘scared students straight.’ But we really want them to be the ones turning to their peers.”

Students—beginning in elementary and middle school health classes—should be taught “refusal skills” to use when offered drugs, she says.

But not all districts offer the same level of health instruction as Harford County provides—in fact, it lags in many places, says Becky King, an executive committee member of the National Association of School Nurses.

Most states require a certain number of hours for health instruction, but the rules are rarely enforced, adds King, who also works as a school nurse at St. George’s Technical High School in Delaware.

First, school administrators need to be willing to admit their school or district has a problem and then have teachers cover serious topics like addiction, mental health, suicide and bullying prominence in health classes, she says.

“It is a problem that is everywhere right now” King says. “Administrators need to look at this from a public health perspective and see the predicament that we’re truly in—and not say ‘This doesn’t happen in my school.'”

‘Handle with care’

On back-to-school night, parents in one rural eastern Pennsylvania district conducted mock drug searches in bedrooms set up by the county District Attorney’s office. Authorities show parents how drugs can be hidden inside the labels of soda bottles and what heroin looks like.

A few years ago, four young adults, though not students, died of overdoses in the community of the Brandywine Heights Area School District. Last spring, a student suffered a non-fatal overdose in a classroom. The student had taken heroin in the bathroom and was resuscitated by a guidance counselor who is a certified EMT. In rural areas, boredom can drive some students to try hard drugs, Superintendent Andrew Potteiger says.

“There’s not a lot of things to do here, we don’t have a huge park or area for people to go to” Potteiger says. “The hub of the community is the school district. So we were the lead on this, and we decided to take a stand.”

The dis