LANSING, N.Y. — A handful of teens gather in the basement of the Lansing Community Library one evening in June. On a folding table in front of them sits the pink rubber head and torso of a demonstration dummy, similar to the type used to teach CPR.
The students are here to learn a different type of life-saving action: how and when to administer the opioid overdose reversing drug naloxone, often known by the brand name Narcan.
The event, organizers say, is likely the very first naloxone training in Tompkins County open to and specifically aimed at teenagers.
About 10 teenagers have signed up to take the class. One student enrolled because he has a summer job as a lifeguard at a local swimming pool; another is taking it as part of a scout project.
Jasmine Myrick works at local harm reduction medical clinic REACH, where she has taught hundreds of people how to recognize and reverse an opioid overdose. But this is her first time teaching middle and high school students how to administer naloxone.
Organizers say the event is not meant to promote drug use, but to prepare students for a world where opioid-related overdoses are increasingly common. The evening opens with a half-hour presentation from a local school district employee — complete with a quiz game — advising students of the risks of opioids as well as other substances like cannabis, alcohol and electronic cigarettes.
During the training itself, Myrick describes the telltale signs of an overdose — changes in skin tone, pinpoint pupils and gurgling or choking sounds, among others.
Myrick distributes empty vials of the nasal spray as training devices and shows students how to push down the plunger properly.
“Press down once, firmly,” Myrick said, prompting a chorus of soft clicks as students practice with the plastic vials. “[The plunger] will actually lock into place and that’s how you know that you’ve used the entire dose.”
Much of the training is also applicable in other emergency medical situations too: Myrick advises students to call 9-1-1 as soon as possible. She uses the dummy to show them how to place the person on their side to avoid asphyxiation.
“To me, this is just education in first aid. We have been teaching students how to do CPR and things like that for years,” Myrick said. “Health is evolving and [an overdose] is something that is not as out of the realm of possibility as I think people think it is.”
National and county-wide data show that intentional opioid misuse in high school and middle school students remains uncommon, but Myrick said it’s become increasingly likely that teens have someone else in their lives who might be at risk of an overdose.
“There’s students that have parents or family members that might be using opioids or other drugs,” Myrick said. “A lot of [other] drugs now are laced with fentanyl too.”
Julia, who will enter the ninth grade this fall, attended the training with her mother.
“At [my school] we’ve never really talked about overdosing or anything like that,” she said. “But just because you’re in high school or middle school, I still think that it’s helpful to know how to use [naloxone].”
Julia said she’s more familiar with naloxone than her peers because her mother works in the mental health field and carries the medication with her in case of emergency.
Despite the training, Julia will not be able to do the same when she is at school. State law prohibits students from possessing virtually any medication while on school grounds. The law isn’t specific to naloxone — it covers all prescription and over-the-counter medications in all but a handful of situations.
Dr. Melissa Dhundale, medical director for the six school districts in the Tompkins-Seneca-Tioga BOCES (TST-BOCES) cooperative, said the law effectively prevents interested teens from accessing overdose first aid training at school, where they spend the majority of their time.
In part, that’s because state law dictates where medications — including naloxone — can be kept when they are not being administered.
“New York State has pretty strict rules about what [students] can and can’t carry on school grounds,” Dhundale said. “So [students are] really not even supposed to carry, say, ibuprofen on school grounds.”
At the training, each attendee received a supply kit with two doses of naloxone, a test kit to detect fentanyl and a disposable face shield that can be used to prevent disease transmission during mouth-to-mouth resuscitation. Under current state law, these supplies could not be distributed to trainees if the training was held on school premises. Students also cannot bring the supplies to school.
The medication does not contain any opioids. It is not addictive, side effects are rare and if administered by mistake, has minimal effect on someone who is not experiencing opioid-related overdose.
Schools aren’t barred from keeping naloxone on the premises — the TST-BOCES campus and Ithaca, Lansing and Trumansburg school districts are all registered as Opioid Overdose Prevention Program Sites.
Districts designated under the program can keep naloxone on hand and offer interested adult employees training on how to administer the medication, but only those trained adults and the school nurse can actually administer it in an emergency. Like most other medications, naloxone must also be stored in a “secure but accessible location” such as a nurses’ office or in a locked emergency medical kit when not in use, which can delay response in case of an emergency.
Dhundale said she and other educators are working with state elected officials to make it easier for schools to offer the training to interested students. She said that while local school leaders and school boards have expressed interest in offering the training, it’s taken almost a year to put together the event due to legal constraints.
“I think the state hasn’t quite caught up yet,” Dhundale said. “And it takes a while to change laws.”
Dhundale and other organizers said they had to abandon early plans to host the student-oriented training on-site, instead hosting it in Lansing’s public library.
Lansing Central School District Superintendent Chris Pettograsso worked closely with Dhundale to organize the training. Pettograsso said they hope to eventually integrate overdose prevention education into the classroom so more students can access it.
“It’s really just about preventing harm and saving lives and getting as much information as we can out to the community and to the students,” Pettograsso said. “We knew that it’d be hard to get people here tonight, but it’s a start. And we have to start somewhere.”