Opioids and Texas Schools

The opioid epidemic in the U.S. impacts people of all ages, but those between the ages of 15 and 24 make up a significant number of opioid-related deaths. An opioid antagonist can be used to block the drug’s effects. This article answers questions about laws requiring Texas school districts to adopt a policy for opioid antagonists.

Q: What is an opioid overdose?

A: An opioid is a drug that produces morphine-like effects. Opioids include prescription painkillers, like oxycodone, as well as heroin. People may become addicted to opioids with continuous use and may build up a tolerance to the drug’s euphoric effects, thereby increasing amount and frequency of use.

In an overdose, the person’s bodily functions begin to slow, including the impulse to breathe. The person may become nonresponsive or exhibit blueness around the fingertips or eyelids. An opioid overdose can lead to brain damage or even death.

Q: What is an opioid antagonist?

A: An opioid antagonist blocks the effects of the opioid. Naloxone is the opioid antagonist’s generic name, but its common brand name is Narcan. Naloxone may be administered by an autoinjector or a nasal spray. Improperly administering naloxone does not typically result in a medical emergency. Side effects include flu-like symptoms.

Q: Can a school district obtain a prescription for an unassigned opioid antagonist?

A: Yes. An opioid antagonist may be issued under an unassigned prescription, meaning the prescription does not specify the name of one person but authorizes use under certain circumstances. For example, emergency medical service personnel are authorized to administer the antagonist if the person they are assisting shows clinical symptoms of an opioid overdose. Tex. Health & Safety Code §§ 483.101-.106.

A physician or person who has been delegated prescriptive authority under Chapter 157, Texas Occupations Code, may prescribe opioid antagonists in the name of a school district through an unassigned standing order. Tex. Educ. Code § 38.225.

Q: Does a school district need a policy for administering an unassigned opioid antagonist?

A: Yes, depending on the grades served. In 2023, the 88th Texas Legislature amended the Texas Education Code to require school districts to adopt and implement a policy regarding the maintenance, administration, and disposal of opioid antagonists at each campus in a district that serves students in grades 6 through 12. Districts may also adopt and implement such a policy at other campuses in the district, including campuses serving students in a grade level below grade 6. The law requires districts to have adopted a policy before Jan. 1, 2024. The policy must:

• Provide that authorized and trained school personnel and volunteers may administer an opioid antagonist to a person who is reasonably believed to be experiencing an overdose;
• Require campuses subject to the policy to have present one or more authorized and trained school personnel members or volunteers to administer an opioid antagonist during “regular school hours”;
• Establish the number of opioid antagonists that must be available at each campus at any time; and
• Require that the supply of opioid antagonists at each campus be stored in a secure location, easily accessible to authorized and trained school personnel and volunteers. Tex. Educ. Code § 38.222.

Q: Which employees or volunteers should be trained to administer an opioid antagonist?

A: This is a local decision. The National Association of School Nurses has issued a written position statement emphasizing the importance of the school nurse facilitating access to naloxone for the management of opioid-related overdoses in the school setting. Schools may need to train additional personnel to ensure an authorized individual is available.

Q: When does a trained and authorized person need to be available to administer an opioid antagonist?

A: A district’s policy must require one or more authorized and trained employees or volunteers to be present “during regular school hours.” Tex. Educ. § 38.222(c). The law does not define the meaning of this phrase or how it may apply to off-campus or after-school activities.

Q: What needs to happen after an opioid antagonist is administered?

A: No later than 10 business days after a school employee or volunteer administers an opioid antagonist, the school must report certain information about the incident to the district, the physician or other person who prescribed the opioid antagonist, and the commissioner of state health services.

Q: What sort of training must a district provide?

A: Each district that adopts a policy is responsible for training school personnel and volunteers. The training must be provided annually in a formal training session or through online education and includes practicing with an opioid antagonist trainer device. Tex. Educ. Code § 38.224; 25 Tex. Admin. Code 40.86.

Q: Does the law protect a school district employee or volunteer who administers an opioid antagonist?

A: Yes. A person who in good faith takes, or fails to take, any action under laws requiring an opioid antagonist policy is immune from civil or criminal liability or disciplinary action. In addition, the district and school personnel and school volunteers are immune from suit resulting from an act, or failure to act, including an act or failure to act under related policies and procedures. Tex. Educ. Code § 38.227.

Q: Where can districts find the required policy?

A: A district’s Policy FFAC(LOCAL) includes decisions that the district has made regarding storing and administering medication at schools.