Page 10 • DNA Reporter May, June, July 2017 Educating High School Students on the Use of Naloxone Editor’s note: An article by Rose Sarkissian, MSN, RN, was accidently missed in a 2016 issue of the DNA Reporter. We are delighted to include the article on an all important topic in this issue of the DNA Reporter. The Managing Editors of the DNA Reporter would like to apologize for the oversight and any inconvenience it may have caused. Rose T. Sarkissian, MSN, RN Rose T. Sarkissian earned her BSN from Neumann University and her MSN from Wilmington University. Presently, she is a school nurse at Smyrna High School as well as a wife, and mother of four boys. Returning to school after twenty years was life changing and for the past 2 1/2 years it had been a journey for Rose T. Sarkissian which she was forever grateful. Through this learning experience, she has met some of the most amazing people, each sharing a bit of themselves that will forever impact her life. Rose can be reached by email at email@example.com or at her office number at 302-659-1259. Substance abuse disorders, or addiction, have almost tripled in the last decade. The 2013 Partnership Attitude Tracking Study (PATS) stated that almost one in four teens (23%) reported abusing or misusing a prescription drug at least once in his or her lifetime, and one in six (16%) reported doing so within the past year (Felix, 2014). The stigma attached to drug use drives individuals into seclusion, leaving adolescents reluctant to expose their drug use or seek help. In 2014, the CDC added overdose prevention to its top five public health challenges (CDC, 2014). Services should be accessible to young individuals regardless of their age. Since problem drug use mostly starts at a young age, prevention programs should be geared to protecting a young individual’s health and rights using “non-judgmental” approaches. One intervention that has shown positive results is Naloxone, a drug which can be administered during an overdose situation to counteract the negative effects of the drug being used. Naloxone saves lives and with this knowledge, adolescents are now able to recognize signs and symptoms of an opioid overdose and respond appropriately with Naloxone in an emergency setting. Students who participated and completed an educational module at Smyrna High School demonstrated a 28% increase of knowledge. Utilizing the Health Belief Model, a population health education module, provides students with an opportunity to take a positive health action that influences their behavior, while increasing their self-efficiency, confidence, and empowerment. Empowering students with the knowledge of what an opioid overdose is and how Naloxone can benefit individuals in an event of an emergency situation is crucial to saving lives. Most adolescents believe addiction to prescription drugs or heroin will not ever happen to them. However, due to curiosity and peer pressure, most students casually use alcohol or other drugs. The National Survey on Drug Use and Health Report found that over eighty percent of high school seniors have tried alcohol, and over fifty percent have tried other drugs (SAMHSA, 2014). According to the Substance Abuse and Mental Health Services Administration National Survey on Drug Use and Health (SAMHSA), there were 2.2 million adolescents, ages twelve through seventeen, who were illicit users (SAMHSA, 2014). Being an adolescent today often means being exposed to many complex social issues. During this time they are more prone to experiment, defy authority, and to try to impress their peers. Unfortunately, adolescents live in a culture in which drug addiction may be experienced in their own homes. Many adolescents are also preparing for college, an environment which may expose them to heroin or prescription drugs. Delaware is ranked eighth highest in youth overdose death rates (Healthy America, 2015). Given this magnitude of the problem, overdose prevention is the key. Most teens do not comprehend the lifethreatening risks of substance abuse. If students are being offered training in other life-saving procedures, for example, CPR instructions, then why can we not, as educators, inform them about the lifesaving administration of Naloxone? As a high school nurse, health promotion services are essential for improving the health of school populations everywhere. Individuals of all ages can benefit from health promotions care. School nurses are in excellent position to become leaders and are role models for others in our schools. Nurses have the ability to impact students positively by enhancing relationships with our students, families, and community, working towards self-care through education and development. Providing students with the knowledge of what an opioid overdose is and how Naloxone can benefit individuals in the event of an emergency situation is powerful. In multiple studies, death rates from opioid overdoses were decreased in communities where education and Naloxone distribution was implemented in comparison to communities with no implementation. The Project Lazarus public health model is based on the premises that drug overdose deaths are preventable and that all communities are ultimately responsible for their health (Project Lazarus Model). Community members are changing the public’s perception of an addict by educating the individuals about opiate medication and providing tools to prevent overdose deaths from happening. As a result of their initiative, they have seen a forty-two percent drop in overdose in one year. This program has seen growth while creating positive change to communities affected by this disease. In 2014, Delaware Senate Bill Number 219 allows officers, who have completed a state approved training course, to receive, carry, and administer the drug Naloxone. The bill also allows family, friends, and members of the community to obtain naloxone after they have too been trained. This legislation increases the availability of the life-saving drug Naloxone in the community, placing it in the hands of the people who are most likely to witness an overdose leading to the potential of saving more lives. Many lives can be saved by educating people through local programs. An example of this is seen in the results from the Drug Overdose Prevention Education (DOPE) project in San Francisco, California. After a brief ten-minute training session, 2,500 participants received kits. From these, 700 revival attempts were recorded with 95.7% surviving the overdose (Emenalo, 2015). To bring public attention to the use of Naloxone, the National Association of School Nurses (NASN, 2015) has taken a formal position statement supporting the emergency use of Naloxone in a school setting. School nurses work to educate students and families about the risks and potential for life-threatening emergencies that occur, not only in schools, but also in their homes. School nurses realize that they are who adolescents will talk to about situations. Their position has brought much needed national media attention with the goal of creating a conversation between school officials, peers, and family members. Our goal as school nurses working in an adolescent environment is to educate students about the harmful effects of opioid abuse, how to recognize an emergency when occurring, and the naloxone response needed to resolve the life-threatening problem. Naloxone is one of the most important tools in saving someone from an opioid overdose. A recent study at Smyrna High School showed that students who received proper trainings were able to demonstrate how and when to administer Naloxone by using a demonstration kit. This primary prevention provided awareness and education on the dangers of opioid misuse. Addiction to opiates and heroin is not easy to fight. Addict’s families walk an unhappy path that
May, June, July 2017 DNA Reporter • Page 11 is plagued with much frustration and setbacks. Mistakes and pain are inevitable, but so is growth and wisdom if all individuals involved approach addiction with an open mind, a willingness to learn, and acceptance that recovery is a long and complex process. Families should never give up hope for recovery for it can and does happen every day. For many, Naloxone provides families with a second chance of hope and recovery. There is still much to do within our government locally and nationally to aid in this worthy fight. We see results on every level, from small communities to our national government. Providing education and training can mean saving lives and giving individuals a second chance at life. Educational modules work as was evident at Smyrna. It is recommended that such lessons be in common use to educate and guide all middle schools and high school students in Delaware. References Center for Disease Control and Prevention. (2014). Vital Signs: Prescription painkiller overdoses in the US. Retrieved from: http://www.cdc.gov/vitalsigns/opioidprescribing Emenalo, P. (2015). Naloxone: Impacts of Community Distribution Programs. Healthy Students Taking Action Together. Retrieved from: http://www.hastaga.or/ naloxone-impacts-community-distrubution Felix, R. (2014). National study: Teens report higher use of performance enhancing substances. Partnership for Drug-Free Kids. Retrieved from: http://www.drugfree. When Nurses Talk, Washington Listens «DC Bus Trip 2017« Join hundreds of nurses in support of patients and the nursing profession on Capitol Hill. This is an opportunity to experience the power of nursing coming together to advocate for change. June 8, 2017 Wilmington and Dover Pickup/Drop off sites Space is Limited! Visit www.denurses.org org/newsroom/pat-2013-teens-report-higher-use-ofperformance-enhancing-substances Healthy Americans. (2015). Reducing Teen Substance Misuse 2015: Delaware Press Release. Retrieved from: http://www.healthyamericans.org/reports/ youthsubstancemisuse2015/release.php?stateid+de National Association of School Nurses. (2015, June). Naloxone Use in the School Setting: The Role of the School Nurse. Retrieved from: https://www.nasn. org/PolicyAdvocacy/PositionPaperandReports/ NASAPosition Statement Substance Abuse and Mental Health Services Administration: Center for Behavioral Health Statistics and Quality. (2014). SAMHSA: Behavioral Health Trends in the United States: Results from the 2014 National Survey on Drug Use and Health. Retrieved from: http://www.samhsa.gov/data/site/ default/files/NSDUH
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