End Overdose

Ending Overdose in Middle and High Schools: California SB 10 and Overdose Response Programs


by Gianna Uy

Aug.14.2024

In 2023, the California Legislature made a significant stride in increasing student safety by passing SB 10, also known as Melanie’s Law. This legislation was born out of the tragic death of a 15-year-old Los Angeles Unified School District (LAUSD) student from a fentanyl overdose on campus. Sponsored by Senator David Cortese (D-15) and cosponsored by the Santa Clara Office of Education among others, SB 10 mandates that the California Department of Education distribute fentanyl awareness and safety education across the state, aiming to prevent similar tragedies in the future.

The youth overdose crisis for Los Angeles County is highlighted by alarming statistics and its large student population. A July 2024 report from the LA County Department of Public Health (LADPH) showed a staggering 70% increase in fentanyl overdose deaths among individuals aged 17 and younger between 2022 and 2023. Projecting to enroll over 100,000 high school students during the 2024-2025 school year, LAUSD is the largest public school system in California and the second-largest in the United States – becoming a priority group for targeted interventions.

A significant aspect of the opioid crisis in Los Angeles County is its disproportionate impact on the Latinx community. In 2023, Latinxs accounted for the largest proportion of fentanyl overdose deaths in Los Angeles County. Given that 37.7% of the county's population speaks Spanish at home, there is a clear need for translated materials and services. End Overdose, a Los Angeles-based non-profit organization dedicated to ending drug-related overdose deaths, has recognized this gap and launched a pilot program that increases accessibility to essential overdose prevention/response education in Spanish. Through this initiative, End Overdose aims to better serve the Latinx community and save lives.

End Overdose’s Pilot Program: A Collaborative Effort with LADPH Wellbeing Centers, Santa Clara Unified School District (SCUSD), CDC Foundation, and National Association of City and County Health Officials (NACCHO)

In their second year pilot project supported by the Overdose Response Strategy (ORS) – a cross-sector public health and safety program – End Overdose expanded its efforts to prevent drug-related deaths among youth. Through partnerships with NACCHO and utilizing the California Naloxone Distribution Project (CA NDP), the targeted intervention provided overdose prevention and response training, naloxone (a medication that can reverse opioid overdoses), and fentanyl test strips to student populations across various schools in California. End Overdose’s program trained peer health advocate students at 39 Wellbeing Center sites in LA County, including 28 located at LAUSD schools. Additionally, End Overdose conducted trainings for students, staff, and parents at three Santa Clara Unified School District (SCUSD) high schools and 12 other schools.

Scaling up the 2023 project into the 2024 was a resounding success:

  • The program reached a total of 63 schools, a 472% increase in outreach from the previous year, including 39 LADPH Wellbeing Center sites.
  • Over 5,900 students, staff, and parents were trained, representing a 195% increase from the previous year.
  • A total of 1,797 naloxone kits and 5,353 fentanyl test strips were distributed, marking a 65% and 346% increase, respectively, compared to the previous year.
Students attended End Overdose’s training at WIlcox High School in Santa Clara, California on February 29.
Parents received naloxone and test strips after participating in End Overdose’s training at Santa Clara High School in Santa Clara, California on February 7.

By focusing on outreach and educational efforts in middle and high schools, End Overdose aims to equip students and their families with the knowledge and tools to recognize and respond to an overdose.

Challenges and Outcomes: Evaluating the Pilot Program

The pilot program highlighted a strong demand for additional overdose prevention and response resources in schools. Staff overwhelmingly agreed that students struggling with substance use disorders need more support on campus. To better understand student perspectives on current school programmed initiatives, End Overdose hosted student listening sessions at two LAUSD high schools: Verdugo Hills High School and Alexander Hamilton High School. The participating students emphasized the need for greater access to online resources, refresher courses, and hands-on training. Some students called for more administrative and leadership responsibility in hosting naloxone training sessions for the entire student body, criticizing past assemblies and programs that focused solely on anti-drug messaging without involving youth voices.

One of the main barriers to implementing the pilot program was school district policies that restrict students from carrying medications on campus, which limits access to this potentially life-saving resource. In SCUSD, while naloxone and test strips were distributed to students with approval from the district, a policy classifying naloxone as a medication prevented students from actually carrying it on campus. These challenges were encountered in multiple school districts, including some in Los Angeles County, where the distribution of fentanyl test strips and naloxone was not approved.

Despite these challenges, the pilot program resulted in significant impacts. Survey data showed that respondents improved their ability to correctly identify the signs of an opioid overdose – such as pinpoint pupils, slow respiratory breathing, and unconsciousness – after completing the End Overdose training. Both students and staff reported feeling more confident in their ability to respond to an overdose following naloxone training.

The graphs show a significant increase in selecting the correct signs and symptoms of an opioid overdose – pinpoint pupils, slow respiratory breathing, and unconsciousness – for students and parents. Additionally, the graph shows a significant increase in school staff correctly selecting pinpoint pupils as a sign and symptom of an opioid overdose.

To address the needs of the Latinx community, three schools – Lynwood, Miguel Contreras, and Adult Chaffey – were offered training in Spanish, ensuring that these crucial resources were accessible to Spanish-speaking students and their families.

Students attended the End Overdose’s training in Spanish at Lynwood High School in Lynwood, California on November 16.

Overall, both students and staff recognized the importance of End Overdose’s training and resource materials, with a majority agreeing that End Overdose was their primary resource for naloxone. End Overdose has been a vital partner to LAUSD, SCUSD, and other school districts in the last two academic years, supplying schools with over 2,800 naloxone kits and more than 5,500 fentanyl test strips, along with the necessary training to prevent overdoses in their communities.

Looking Ahead: Expanding the Impact of End Overdose in Schools

Utilizing student feedback, End Overdose is creating programs tailored specifically for the under-17 age group, which will incorporate interactive digital features to enhance engagement and effectiveness. These expansions will be particularly impactful to ensure content is age-appropriate, relevant, and addresses the unique challenges faced by youth. By incorporating interactive digital features, End Overdose engages with students in a way that resonates with their learning styles. These features can make the training more effective by enhancing understanding, retention, and application of overdose prevention and response practices.

In addition to its digital efforts, End Overdose is focusing on expanding its on-the-ground outreach, bringing training and resources to middle and high schools nationwide through its fifty city and university chapters.

End Overdose's ongoing efforts underscore the importance of targeted initiatives and accessible resources in combating the opioid epidemic. Through continued education, outreach, and partnership, significant impacts are made in reducing drug overdoses and protecting the lives of youth.

Citations

"SB 10 - 2023-2024." Digital Democracy, CalMatters, https://digitaldemocracy.calmatters.org/bills/ca_202320240sb10.

Data Report: Fentanyl Overdoses in Los Angeles County. Health Outcomes and Data Analytics Branch, Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, July 2024.

Los Angeles Unified School District. 2024 Fingertip Facts. LAUSD, https://www.lausd.org/site/handlers/filedownload.ashx?moduleinstanceid=73040&dataid=178843&FileName=2024%20FingertipFacts.pdf.

Data Report: Fentanyl Overdoses in Los Angeles County. Health Outcomes and Data Analytics Branch, Substance Abuse Prevention and Control, Los Angeles County Department of Public Health, July 2024.

U.S. Census Bureau. "Los Angeles County, California." Census Reporter, U.S. Census Bureau, https://data.census.gov/profile/Los_Angeles_County,_California?g=050XX00US06037#populations-and-people.

Partners & Collaborators

ORS: https://orsprogram.org/program-overview/

NACCHO: https://www.naccho.org/

Wellbeing Centers: http://ph.lacounty.gov/pie/Education/wellbeingctrs.htm

CA NDP: https://www.dhcs.ca.gov/individuals/Pages/Naloxone_Distribution_Project.aspx

AUTHOR: Gianna Uy

Gianna Uy is the Director of External Affairs and Programs at End Overdose and is currently pursuing a Master of Public Health in Health Policy and Management at Columbia University in New York, New York.