As state and local officials voice growing concern about the fentanyl crisis — and the U.S. attorney general says the Justice Department is focusing “enormous urgency” on the deadly drug — high schools in nearly a dozen Bay Area districts are still not prepared to save an overdosing student, according to a survey by the Bay Area News Group.
The news organization found 36% of the 33 districts that responded said they have yet to train teachers and staff to recognize the signs of fentanyl overdoses. About 27% have not made the lifesaving drug Narcan readily available in schools, even after Bay Area educators and school nurses have used the nasal spray to revive students at least four times this school year.
But there also was encouraging news: Many schools have stepped up their preparedness in recent months, the survey showed. At least nine districts have followed through after this news organization conducted an earlier survey in December, and have now trained their staffs and are stocking up on Narcan. In one of those districts, the Milpitas Unified school board president prodded the district’s superintendent in an email — “Where are we on fentanyl?”– after reading stories by the Bay Area News Group about schools taking action to save overdosing students.
Chris Norwood, the board president, recognizes that his district, like most, is still dealing with widespread learning loss from COVID school closures and other chronic issues around poverty that can consume teachers’ and administrators’ time.
“We’re dealing with those things,” Norwood said, “but before you even get to that, you’re talking about kids dying.”
Fentanyl was behind a staggering one in five California youth deaths in 2021, according to a Bay Area News Group analysis published in October. That month, San Jose’s Overfelt High principal Vito Chiala and his safety team found themselves saving an overdosing teen in the school conference room. Only two days later, a school social worker who had just been trained used Narcan to revive a student at Oak Grove High in San Jose. And in January, a week after returning from winter break, a school nurse at Acalanes High School in Lafayette used Narcan to save a 17-year-old girl overdosing in a school bathroom.
One of the most unnerving things about fentanyl, a powerful synthetic opioid that is 50 times more potent than heroin, is that teens often don’t know they are consuming it. It is being laced into less lethal drugs that young people can buy online, such as illicit painkillers and stimulants. Last week, testifying before Congress, Attorney General Merrick Garland blamed Mexican drug cartels for fueling the epidemic and acknowledged current efforts are failing to stop it.
That’s why schools are under pressure to respond.
In 2021, 77 Bay Area youth ages 15 to 19 were rushed to emergency rooms after acute opioid poisonings, according to data from the California Department of Public Health. A staggering number of those visits, 34, were in Santa Clara County.
But notably, San Jose Unified is the only school district in Santa Clara County that has not signed up for the county’s Narcan training program or begun providing school staff with a supply of the lifesaving drug. One county official, fed up after months of pushing the district to take action, is now expressing her fury publicly.
“It’s amazing. They are the biggest and largest school district in San Jose, and they are absolutely refusing to have Narcan on campuses,” said Mira Parwiz, director of Addiction Medicine Services at Santa Clara Valley Medical Center and one of the leaders of the county’s overdose prevention program that’s helping train schools. “They just say, ‘Oh, we just don’t have time for this.’ … What they are waiting for is for a student to die.”
San Jose Unified spokesperson Jennifer Maddox shot back, saying that “obviously we are not waiting for a student to die.” She said most, but not all, of the middle and high schools in the district have campus police officers who are equipped with Narcan. Those officers are on campus “most of the time,” she said. The district has also trained nurses on how to spot the signs of an opioid overdose but has not trained them to use Narcan.
The San Jose high schools that have used Narcan to save students were in East Side Union High School District.
Three other districts — Pleasanton Unified, Fremont Unified and South San Francisco Unified — responded to the Bay Area News Group’s latest survey that they do not plan to acquire their own stock of Narcan or train their staffs on how to use it within the next two months.
Like San Jose Unified, Pleasanton and Fremont say they rely on school resource officers to carry Narcan. Fremont will provide training for school principals next month. Pleasanton’s school nurses have been trained to identify signs of fentanyl overdoses, but are not armed with Narcan, said the district’s communications officer Patrick Gannon. In the meantime, the district is distributing information to students about the dangers of the opioid as part of a broader campaign to address students’ “negative choices.”
Many districts are now taking a more aggressive approach.
Oakland Unified School District recently trained all its nursing staff on how to administer Narcan and is in the process of getting additional staff trained, according to the district’s spokesperson John Sasaki.
In Milpitas, at least 40 staff members have now been trained, including health clerks, district nurses, high school and middle school administrators, and 16 staff members at Calaveras Hills High. In a presentation to the school board Tuesday, student services manager Jillian Valdez said that dozens of Narcan doses were sent this past week to high schools and middle schools, along with eight doses to each elementary school. Presentations to families on fentanyl awareness start this week.
Anyone in California can get Narcan from their local pharmacy, according to the California Department of Public Health. The drug, also known as naloxone, is safe even when administered unnecessarily, according to the National Institutes of Health.
Norwood, the school board president, said he is pleased with his district’s progress and anxious to expand training. “Whatever it takes to minimize the possibility of a kid in Milpitas overdosing. … We have the ability to save them.”
San Jose Unified, meanwhile, has no imminent plans to start training staff or acquiring Narcan. But in the wake of criticism, the district now says it would like to move toward acquiring its own stock of Narcan — eventually.
“We don’t just say, ‘Hey, this is great. Let’s just get a bunch of Narcan and give it to everybody.’ That’s just not our approach,” Maddox said.
One of the district’s concerns, Maddox said, is that teachers and other school staff may not want to be responsible for responding to a fentanyl overdose. And she says they may not be best equipped to respond to an emergency situation.
According to the California Education Code, just as staff members can’t be required to administer Epinephrine injections (EpiPens) for students having allergic reactions, they can’t be required to administer Narcan.
But Patrick Bernhardt, president of the San Jose Teachers Association, pointed out that San Jose Unified teachers have already gone through training on how to use EpiPens and defibrillators. “It’s hard for me to envision anyone who would object to that training,” he said referring to Narcan.
Santa Clara District Attorney Jeff Rosen, whose office works with the county’s fentanyl task force, said he hopes more school districts will embrace Narcan before tragedy strikes.
“I think it may be controversial for some schools, a combination of, ‘We don’t have a problem’ … and then there’s a sense that somehow this is just going to encourage kids to use” drugs, Rosen said. “Having said that, once a child at your high school has died from this, and you didn’t have Narcan, you will” get it.
Staff Writer Harriet Blair Rowan contributed to this report.