Naloxone Toolkit for Schools

Keeping Our Students Safe

As of July 1, 2023, all Minnesota school districts and charter schools are legally required to have nasal naloxone (commonly known as NARCAN®) in every school building. With increasing rates of substance use among 13-18 year-olds, this is an opportunity to make an impact in the community.

This toolkit provides information about naloxone, as well as guidance for creating a Naloxone Policy.

Policy and Procedure

A naloxone policy is a systemic guide to the storage, administration, and maintenance of the life-saving medication. Common elements of a naloxone policy include:

Position Statement
What is the purpose of the policy? Include background information like definitions of important terms.
Storage and Maintenance Plans
Where will the medication be stored and who will have access? Who will be responsible for tracking the medication’s expiration date(s) and placing orders? Take into consideration optimal storage conditions and accessibility.
Training
Who is required to be trained in naloxone administration, and how will this training be provided and tracked?
Emergency Procedure
What are actions are to be taken in an overdose emergency? Who should be notified in a case of naloxone use?
Reporting
How should the incident be documented?

Per law, schools have flexibility in what they include in their policies, and may choose to not have one at all. We recommend a policy to ensure clarity and preparedness among district staff. See sample policies below:

Sample Policies:

For questions related to implementing a naloxone policy, contact: health.school.health@state.mn.us

What is a Condition Specific Protocol?

A condition specific protocol is a set of criteria which outlines when naloxone should be administered by a nurse in a school setting. It does not reference a specific patient, but instead determines circumstances (like symptoms) when a drug can be prescribed/administered. It must be reviewed and signed by a licensed prescriber.

Why does our school need a Condition Specific Protocol?

While laymen can administer naloxone through the standing orders possessed by community groups and OTC availability, Registered Nurses (RN) and Licensed Practical Nurses (LPN) need an additional mechanism to administer naloxone in a school setting. Since schools typically do not have licensed prescribers on-site, this protocol allows nurses to administer naloxone.

How do we get a Condition Specific Protocol? Where do we find a prescriber to sign?

Minnesota Department of Health (MDH)
MDH can provide a condition specific protocol to schools enrolled in the Minnesota Statewide Naloxone Distribution Program. All MN schools (public, charter, private) are eligible for this program and can register by filling out this form.

Create your own
Districts and schools can implement their own condition specific protocols if they have a relationship with a licensed prescriber. See the links below for additional guidance:

An emergency procedure is a set of action steps that detail what should be done in response to an overdose event. A procedure is an important part of a naloxone policy, or can exist without a formal policy in place.

Example of an emergency procedure:

Assess the person for responsiveness, pulse, and breathing and attempt to wake them up.
If the person is unconscious/unresponsive, call 911 immediately and tell the operator there is a medical emergency.
Access the school’s naloxone kit and follow the kit instruction card.
Continue to follow steps including but not limited to:
- Performing rescue breaths
- Administering additional doses of naloxone
If/when the person wakes up – be aware of your surroundings and place the person in the recovery position (on their side, body is supported by a bent knee)
Continue to monitor and repeat any necessary procedures until EMS arrives.
After the individual is in the care of EMS, continue to follow any emergency procedures including notifying any identified personnel (reference notification procedure below).
Log the use of the naloxone kit and replace it.

Additional Resources:

SRHN Nasal Naloxone Instruction Card

Minnesota Department of Health (MDH) Portal

MDH, in partnership with the Minnesota Department of Human Services (DHS), have developed a portal which allows mandated groups (including schools) to order naloxone and register for the state’s Standing Order and Condition Specific Protocol. Once your portal account is approved, you’ll receive instructions from Emergent BioSolutions to set up a Narcan Direct account and place your order.

There is no cost to this program.

MDH Naloxone Portal

For questions related to the naloxone portal and standing order, contact: health.naloxone_admin@crm.mn.gov

Note: Through this program, naloxone can only be ordered by the case (24 doses). While the state encourages districts to place a single order for all schools to minimize surplus, we recognize the reality of administrative hassle may be a deterrent and schools may end up with a surplus of naloxone. In the face of escalating opioid emergencies, the risk of inefficiency can mean life or death. We urge schools to redirect surplus naloxone doses directly to community organizations, to ensure the medication is utilized effectively before expiration.

For more info or further discussion, please reach out to:

Alicia House, Executive Director
ahouse@rummlerhope.org
(612) 217-4212

Emergent BioSolutions

Emergent BioSolutions, the manufacturer of NARCAN®, has a program which allows high schools to receive two free units (1 unit = 2 doses) of NARCAN®. Email EmergentGives@ebsi.com for more info on their program.

Additional Resources:

Relevant Legislation

121A.224 OPIATE ANTAGONISTS.

(a) A school district or charter school must maintain a supply of opiate antagonists, as defined in section 604A.04, subdivision 1, at each school site to be administered in compliance with section 151.37, subdivision 12.

(b) Each school building must have two doses of nasal naloxone available on-site.

(c) The commissioner of health shall identify resources, including at least one training video to help schools implement an opiate antagonist emergency response and make the resources available for schools.

(d) A school board may adopt a model plan for use, storage, and administration of opiate antagonists.”

151.37 LEGEND DRUGS; WHO MAY PRESCRIBE, POSSESS.

Subd. 12. Administration of opiate antagonists for drug overdose. (a) A licensed physician, a licensed advanced practice registered nurse authorized to prescribe drugs pursuant to section 148.235, or a licensed physician assistant may authorize the following individuals to administer opiate antagonists, as defined in section 604A.04, subdivision 1:

(1) an emergency medical responder registered pursuant to section 144E.27;

(2) a peace officer as defined in section 626.84, subdivision 1, paragraphs (c) and (d);

(3) correctional employees of a state or local political subdivision;

(4) staff of community-based health disease prevention or social service programs;

(5) a volunteer firefighter;

(6) a nurse or any other personnel employed by, or under contract with, a charter, public, or private school; and

(7) transit rider investment program personnel authorized under section 473.4075.

(b) For the purposes of this subdivision, opiate antagonists may be administered by one of these individuals only if: (1) the licensed physician, licensed physician assistant, or licensed advanced practice registered nurse has issued a standing order to, or entered into a protocol with, the individual; and (2) the individual has training in the recognition of signs of opiate overdose and the use of opiate antagonists as part of the emergency response to opiate overdose.

(d) Notwithstanding section 148.235, subdivisions 8 and 9, a licensed practical nurse is authorized to possess and administer according to this subdivision an opiate antagonist in a school setting.

148.235 PRESCRIBING DRUGS AND THERAPEUTIC DEVICES.

Subd. 8. Prescription by protocol. A registered nurse may implement a protocol that does not reference a specific patient and results in a prescription of a legend drug that has been predetermined and delegated by a licensed practitioner as defined under section 151.01, subdivision 23, when caring for a patient whose condition falls within the protocol and when the protocol specifies the circumstances under which the drug is to be prescribed or administered.

604A.04 GOOD SAMARITAN OVERDOSE PREVENTION.

Subdivision 1. Definitions; opiate antagonist. For purposes of this section, “opiate antagonist” means naloxone hydrochloride or any similarly acting drug approved by the federal Food and Drug Administration for the treatment of a drug overdose.

Subd. 2. Authority to possess and administer opiate antagonists; release from liability. (a) A person who is not a health care professional may possess or administer an opiate antagonist that is prescribed, dispensed, or distributed by a licensed health care professional pursuant to subdivision 3.

(b) A person who is not a health care professional who acts in good faith in administering an opiate antagonist to another person whom the person believes in good faith to be suffering a drug overdose is immune from criminal prosecution for the act and is not liable for any civil damages for acts or omissions resulting from the act.

Subd. 3. Health care professionals; release from liability. A licensed health care professional who is permitted by law to prescribe an opiate antagonist, if acting in good faith, may directly or by standing order prescribe, dispense, distribute, or administer an opiate antagonist to a person without being subject to civil liability or criminal prosecution for the act. This immunity applies even when the opiate antagonist is eventually administered in either or both of the following instances: (1) by someone other than the person to whom it is prescribed; or (2) to someone other than the person to whom it is prescribed.

Naloxone Training

Steve Rummler HOPE Network can help train school staff on overdose response and naloxone administration. We offer many convenient training options in both virtual and live formats.

Learn More

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