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Naloxone resources available for school districts

As schools across Colorado look to navigate the current opioid crisis and prevalence of fentanyl, the Colorado Consortium for Prescription Drug Abuse Prevention (Colorado Consortium), in collaboration with the Colorado Department of Public Health and Environment (CDPHE) and Boulder County’s Substance Use Advisory Group, created this school toolkit for accessing, distributing and administering Naloxone, and educating school stakeholders on how to safeguard students and staff from the possibility of an opioid overdose.

Schools and school districts are eligible to receive free Naloxone through the Colorado Naloxone Bulk Purchase Fund administered by the Colorado Department of Public Health and Environment (CDPHE). If your district administrators have not yet approved participation in accessing Naloxone through the Colorado Naloxone Bulk Purchase Fund, please scroll down to the next section of this document titled “Instructions to Prepare Information for School Districts to Consider Deploying Narcan Nasal Spray”.

The toolkit contains:

  • instructions for obtaining free Naloxone;
  • references to the legislation that makes it legal for schools to possess;
  • distribute and administer Naloxone; fentanyl and naloxone fact sheets;
  • educational resources for trusted adults and youth;
  • sample letters to help garner support, if necessary;
  • and a position statement from the National Association of School Nurses (NASN) and the National Association of School Personnel and Administrators (NASPA).

For more information about the toolkit or anything outlined within, contact ers@cuanschutz.edu.

Instructions to Access the Colorado Naloxone Bulk Purchase Fund and Educate School Staff and Students About Opioid Overdose Reversal

Please follow the below guidelines if your school district is ready to access the Colorado Naloxone Bulk Purchase Fund (Bulk Fund). You will also find resources for educating your staff and students about opioids (especially fentanyl), naloxone, and opioid overdose reversal.

1. Instructions for Securing Standing Orders 

All eligible entities must have a current standing order in place prior to submitting an application to the Colorado Naloxone Bulk Fund. Click the link to request a standing order.

If your agency has a medical provider, they can draft and sign a standing order for your organization. Sample standing order documents are available at the above website.

If your organization does not have a medical provider, the medical director for Colorado Department of Public Health and Environment (CDPHE) can provide a standing order for your organization. The above website will direct you to the OpiRescue site to submit this request

2. Instructions for Accessing the Colorado Naloxone Bulk Purchase Fund

Colorado Senate Bill 19-227 created the  Naloxone Bulk Purchase Fund. It allows eligible entities, including schools and school districts to obtain  opioid antagonists, such as nasal naloxone  (Narcan or Kloxxado), at no cost to the school/school district.

The goals of this funding are to:

    • Reduce the financial burden of purchasing naloxone for key partners

    • Promote public health and safety for Colorado citizens

    • Increase access to naloxone, which is used to reverse opioid overdoses and save lives

If you have questions or need additional support accessing the Naloxone Bulk Purchase Fund, you may find the answers to your questions in their FAQ document. If you still have questions after reviewing that document and would like additional assistance, please contact the External Relations Strategist for your region. Their contact information can be found on the Community Engagement page of the Colorado Consortium for Prescription Drug Abuse Prevention’s website.

3. Additional Direction for Schools & Districts

Schools and districts are eligible to receive a standing order for naloxone through the aforementioned options. However, in addition to what is outlined above, school districts, public-private, and charters must have a policy in place regarding the administration of naloxone within the district before submitting their application.

Naloxone policies should address the possession, administration, and maintenance of naloxone. Example policies are provided below.

Colorado School District Policies Addressing Student Access and Administration:

Colorado School District Policies Addressing Naloxone on School Grounds (do not specify student access):

Other State School District Policies Addressing Naloxone on School Grounds (do not specify student access):

4. Colorado Naloxone Legislation

Schools and Naloxone: Colorado Revised Statute (C.R.S) § 22-1-119.1 Policy for employee and agent possession and administration of opiate antagonists.

Allows a school to acquire and maintain a stock supply of Naloxone and protects an employee or agent of a school from civil or criminal liability from administering Naloxone. Allows Naloxone to be placed where AEDs are made available.

Naloxone Prescribing Standing Orders: C.R.S. §12-30-110 Prescribing or dispensing opiate antagonists – authorized recipients – definitions.

Allows a physician—or any medical professional with prescriptive authority—to write an order for an opiate antagonist medication that can be dispensed by other designated individuals including:

    • A family member, friend or other person in a position to assist a person at risk of overdose

    • An employee or volunteer of a harm reduction organization

    • A first responder

    • An individual at risk of an overdose

Naloxone Availability: C.R.S. § 25-20.5-1001 Making opiate antagonist available.

Allows Naloxone to be placed where AEDs are made available and protects persons that furnish or administer Naloxone in the response to an overdose event.

Access Naloxone: C.R.S. §24-1.5-115 Opiate Antagonist Bulk Purchase And Standing Orders.

A unit of local government, harm reduction organization, law enforcement agency, first responder or others as outlined in C.R.S. §12-30-110, may obtain Naloxone through the fund pursuant to a standing order and protocol.

Immunity and Use of Expired Naloxone: C.R.S. § 13-21-108.7 Immunity for persons who administer an opiate antagonist during an opiate-related overdose event.

Extends civil and criminal immunity to a person, other than a healthcare provider or health facility, who acts in good faith to furnish or administer an opiate antagonist, including expired opiate antagonist, such as expired Narcan or expired Kloxxado. Mandates insurance coverage of at least one form of naloxone.

Pharmacist Prescribe Dispense Opiate Antagonist: C.R.S. § 12-280-123 Dispensing opiate antagonists.

Concerning responsibilities of a pharmacist related to opiate antagonists. High-dose opioids or benzodiazepine co-prescription pharmacists can prescribe Naloxone.

Immunity for Naloxone Administration, including expired Naloxone: C.R.S § 18-1-712 Immunity for a person who administers an opiate antagonist during an opiate-related drug overdose event.  Provide immunity for a person who in good faith furnishes or administers an opiate antagonist, including an expired opiate antagonist, during an opiate-related drug overdose event. A person who administers an opiate antagonist to another person is urged to call for emergency medical services immediately.

5. How to Respond to an Opioid Overdose

**IF SOMEONE IS EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY**

Is someone overdosing? The most important thing is to act right away!

It is rare for someone to die immediately from an overdose – it is usually a slowish process that takes anywhere from a few minutes to a few hours. When people survive, it’s because someone was there to respond.

This guide from the National Harm Reduction Coalition provides information on how to respond to an opioid overdose and administer naloxone nasal spray.

Additional training materials are available through the Colorado Consortium and other local community organizations, including a free overdose prevention presentation and facilitators guide. Please contact the External Relations Strategist for your region for more information.

6. Educational Resources: Fact Sheets and Materials for Parents

Below is a list of fact sheets and educational resources for parents and teachers. If you are interested in additional resources or ideas of ways to help educate your staff, students, parents and community members, please contact the External Relations Strategist for your region.  Staff of the Colorado Consortium have supported a number of school districts and community organizations with various educational events from student facilitated panel discussions to in-school presentations and informational movie screening events. We are happy to discuss these events and others as you work to identify what will best meet the needs of your community.

Fact Sheets

Parent Resources

Educational Resources

School Nurse Resources

Instructions to Prepare Information for School Districts to Consider Deploying Narcan Nasal Spray

To help schools adopt the necessary policies and practices to safeguard students and staff from a potential opioid overdose on school grounds or at school activities, experts around the state have created the following resource guide. The below information and sample documents should be used to help district administrators approve participation in accessing Naloxone through the Colorado Naloxone Bulk Purchase Fund to obtain and deploy nasal naloxone in the case of an emergency. This useful toolkit was originally developed by Boulder County’s Substance Use Advisory Group in collaboration with the Consortium and the Colorado Department of Public Health and Environment (CDPHE).

The following documents listed below can be accessed in this Google drive. Documents, which need to be adapted for targeted school districts, are provided in Word so they can be adapted,  as needed.

The order of the documents below aligns with the description of the documents listed in the letter to the district superintendent.  Thus, the order of these documents should be followed unless changes are made to the letter to the superintendent.

1. Letter to a school district superintendent

You will find notes within this letter to enable you to adapt it for your targeted school district.

3. Senate Bill 19-227 

Allows a school to acquire and maintain a stock supply of opiate antagonists such as Narcan. Protects an employee or agent of a school from civil or criminal liability from administering opiate antagonists such as Narcan.  Allows for Narcan or other opioid antagonists to be placed where AEDs are made available.

4. House Bill 20-1065 

Extends civil and criminal immunity to a person, other than a healthcare provider or health facility, who uses an expired opiate antagonist such as expired Narcan.

5. Sample text for four letters of support

Letter of Support #1 – Community Organization

Letter of Support #2 – Substance Use Prevention Coalition

Letter of Support #3 – Treatment or Prevention Organization

Letter of Support #4 – Direct Service Provider

You can provide the text to your county health dept. and other supportive community agencies, which they can put on their letterhead. If you need help identifying other supportive agencies in your community, please contact your local External Relations Strategist with the Colorado Consortium.

6. Position Statement by the National Association of School Nurses

Advocates that the safe and effective management of opioid-related overdoses in schools must be incorporated into the school emergency preparedness and response plans.

7. Position Statement on naloxone in higher education settings by NASPA

Student Affairs Administrators in Higher Education, Colorado Consortium for Prescription Drug Abuse Prevention, and Coalition of Colorado Campus Alcohol and Drug Educators (CADE)

Includes recommendations for campus administrators regarding the use and storage of Naloxone on campus. This statement is specific to higher education but can serve as a reference for talking points.

For more information

If you have any questions, feel free to reach out to the Colorado Consortium for Prescription Drug Abuse Prevention, University of Colorado Anschutz Medical Campus, Skaggs School of Pharmacy and Pharmaceutical Sciences at ers@cuanschutz.edu.