Classrooms: the next frontier in tackling opioid addiction

Classrooms: the next frontier in tackling opioid addiction

(Md.) Maryland schools will begin regular lessons about the dangers of opioids as early as the third grade, under a set of bills set to go into effect on July 1.

The legislation–which also requires that K-12 and college campuses stock up on the overdose-reversal drug naloxone–will be going into effect less than a month after the state Department of Health and Mental Hygiene announced that the number of people who died from drug and alcohol related overdoses reached an all-time high in Maryland last year.

The greatest number of deaths was attributed to the use of illegal opioids.

“Marylanders from one end of the state to the other know the devastation that heroin and opioid abuse can cause,” Gov. Larry Hogan said in a statement. “It’s under the surface of every community, and we decided we were going to shine a spotlight on this, to try to find as many possible solutions as we could. As this crisis evolves, so must our response to it.”

Federal data show that while the opioid epidemic mostly affects those between the ages of 20 and 50, approximately 1,100 teens start misusing pain pills each day, with 521 teens dying of opioid-related causes in 2015. Although teen drug use has long been declining, about 5 percent of high school seniors say they've abused prescription narcotics such as oxycodone, according to an annual federal youth assessment of risky behaviors.

For those ages 12 to 19 who seek rehabilitation and return to traditional schools after treatment relapse within a year, according to the federal Substance Abuse and Mental Health Services Administration. And those who relapse are significantly more likely to drop out.

To address the issue, medical schools including the Stanford University School of Medicine have begun emphasizing addiction medicine and how to avoid over prescribing, after data revealed that the number of Americans overdosing from prescribed opioids had surpassed 14,000 per year, quadrupling between 1999 and 2014.

At least a handful of states including Pennsylvania, Rhode Island, New York, Kentucky, Delaware, Illinois and Vermont allow or even recommend that schools maintain a few doses of naloxone–also known by the brand name Narcan–in case a student does overdose from prescription painkillers or heroin on campus.

Others, such as Ohio, also require interactive, science-based lessons that go beyond the standard “just say no” curriculum often taught in health courses.

In Maryland, a record 2,089 people died from drug and alcohol overdose in 2016, according to state data–a 66 percent increase from 2015, and triple the number from 2010. There were more than 694 overdose deaths last year in Baltimore, more than twice the number of homicides recorded by police.

The greatest number of deaths, both in the city and statewide, was attributed to illegal opioids including heroin and fentanyl–a less expensive and more powerful drug that is commonly mixed into heroin without the user's knowledge.

To combat the problem, state and Baltimore officials have already provided guidance to doctors about limiting prescriptions to addictive painkillers, improved a prescription drug monitoring program and launched hotlines to help connect people with treatment.

The governor also expanded access to naloxone, which reports show has already saved 800 lives since 2015 in Baltimore, and declared a state of emergency in Maryland.

Taking it a step further, Gov. Hogan also signed bills that will create a new felony for individuals who distribute an opioid or opioid analog that cause the death of another; limit opioid prescriptions to a 7-day supply, except prescribed for the treatment of pain associated with a cancer diagnosis or a terminal illness; and allow local fatality review teams to review non-fatal overdose data in order to, among other things, recommend overdose prevention strategies.

Beginning next month, public schools will be required provide drug education that includes examination of the dangers of heroin and other opioids at least once between third and fifth grade, again between sixth and eighth grade and once more between ninth and 12th grade.

Education officials note that while it is important to update the lessons so students understand the dangers of illegal opioids such as heroin, it is even more vital to explain why prescription drugs such as morphine, oxycodone or hydrocodone, as students often hold the misconception that if a doctor prescribes the drug that it must be safe.

The new law, known as the Start Talking Maryland Act, will also require schools to maintain a stock of the overdose-reversal drug naloxone, and have staff trained to use it and report usage to the state.

Additionally, all colleges and universities that accept state funding must also have a heroin and opioid prevention plan that includes education for incoming, full-time students, as well as training in naloxone for campus police and public safety officers.

Schools will have the summer to work on new curriculum.