Dept. of Ed. Distributing Narcan to NYC Public High Schools But Rollout Lags

Nearly one third of public high schools that should have been stocked with naloxone for the first time at the start of the school year were still waiting to receive their supplies when the school year started, Straus News has found. It comes amid a wave of youth overdose death that accompanied the Covid-19 pandemic, exposing gaps in services for New York City’s youngest substance users and leaving officials scrambling to catch up.

The Department of Education said New York City public schools for the first time were going to be stocked with naloxone, an opioid overdose reversal drug more commonly known by its brand name Narcan, according to DOE spokesperson Jenna Lyle. The announcement was first reported by CBS News in June after an investigation revealed the city lagged behind neighboring school districts in stocking the lifesaving drug. But approximately 130 schools began the school year earlier this month without a stock of the medication, administered as a lifesaving nasal spray, Straus News has learned.

“We are working closely with [the Department of Health and Mental Hygiene] to ensure that every high school has naloxone stocked in the building and school nurses are trained on administering the drug by fall of 2023,” Lyle wrote in an email to Straus News.

New York City lags behind other major school districts like Los Angeles and Miami-Dade, which moved to fully stock their public schools last fall and this spring, respectively.

According to DOE, on September 15, approximately 270 public high schools (out of over 400 across the five boroughs) had received a 2-dose kit of naloxone. The first day of school was September 7.

In 2021, the last year age data is available, 78 people aged 15-24 died in New York City, down from a peak in 2020 but 1.5 times higher than pre-pandemic levels. Overall, overdoses across all ages continued to rise in the first half of 2022 as compared to the same period the year before, part of a four year increase driven by a surge in opioid-related deaths, according to the most recent data published by the city Health Department.

DOE did not have data on the use of naloxone in city schools but will track it going forward, Lyle said in response to a Straus News inquiry.

This month, the death of a 1-year old in a Bronx daycare highlighted the dangers of fentanyl—a chemical often found in opioids that can be lethal even in minuscule doses—and renewed calls for stronger drug policies. While 15-24 year olds are the only age group that saw a decline in overdoses from 2020 to 2021, youth drug abuse remains high. According to one treatment provider, the number of people under the age of 22 entering emergency rooms in a drug-related crisis has shown no signs of returning to pre-pandemic levels.

“It’s the same serious issue. The curve hasn’t gone down,” said Norwig Debye-Saxinger, a veteran policymaker and the executive director of the Therapeutic Community Association of New York, a network of residential treatment providers. “Either what’s been done to date isn’t working, or the new approaches haven’t been around long enough to make a difference yet,” he told Straus News.

The state’s approach to overdose prevention in recent years has focused on “harm reduction,” a term that includes a range of low-barrier interventions with an emphasis on medications to treat opioid dependency, like buprenorphine and methadone. Both Mayor Eric Adams and Governor Kathy Hochul have praised the method in their mental health plans, each key planks of their first-term agendas.

Harm Reductions

In March, Adams unveiled a three-part plan focused on severe mental illness, drug abuse, and youth services. It set a goal of reducing overdose death in New York City 15 percent by 2025.

“We’re going to increase the availability of overdose reversal drugs, especially in high-risk areas, provide more medication for opioids use disorder, as well as clean syringes and other safety supplies, and reduce the risk of overdose by expanding the distribution of fentanyl test strips that will alert users to dangerous levels of the drugs before it’s too late,” Adams said at a March press conference when he announced the plan.

According to the latest Mayor’s Management Report, released in September, New York City is on track to meet or exceed the number of buprenorphine patients in 2022, topping 15,000 individuals, after a slight decline over the previous two years.

Inpatient and Outpatient Treatment

The Department of Education also employs dedicated substance abuse specialists to provide in-school intervention in the form of counseling, training and, when necessary, referrals to outside service providers, including residential services. But according to Debye-Saxinger, who is a member of the state’s Advisory Council for the Protection of People with Special Needs, those referrals are rarely used by the Department of Education, in part because relying on outside services could mean a loss of state and federal funding to cash-strapped city schools.

Even for the most serious cases, the number of adolescent treatment beds around the state has diminished significantly over the last decade. There are 240 residential adolescent treatment beds (known as Part 817 beds) around New York State, according to Evan Frost, a spokesperson for the state Office of Addiction Services and Supports (OASAS). While Frost could not verify bed counts in previous years, Debye-Saxinger estimated the number is roughly a third of what it was in the early 2010s. “There are very few treatment beds in New York State designated specifically for adolescents,” he told Straus News.

In total, OASAS is providing just $117.3 million of its $1 billion-plus budget for youth services in the current fiscal year. New York City is expected to receive $49.3 million of that sum, according to Frost. Another $4 million from the state’s Opioid Settlement fund will go to youth engagement in eight school districts with above average opioid use.

For her part, Hochul has placed a premium on outpatient services, while struggling to restore psychiatric beds that had closed during the pandemic. “We are taking an all-hands-on-deck approach to addressing the opioid crisis across New York State, including in underserved areas that are lacking addiction services and supports,” she said in a March statement as part of an announcement of funding for public education and engagement. “The street outreach services funded through these grants will help marginalized populations access the life-saving care they need to break the vicious cycle of addiction.”

In addition to the treatment beds, Frost touted the statewide network of substance abuse providers OASAS oversees, as well as youth “clubhouses” — drop-in centers that offer peer-led, wrap-around services in each borough. A list on OASAS’s website of treatment programs designated for adolescents, shows only three in New York City, including none in Brooklyn or Staten Island.

A telehealth platform for teen mental health is also part of the city’s overdose prevention plan, according to a health department spokesperson. At a forum in June with Adams, City Health Commissioner Dr. Ashwin Vasan said the platform would be launched “this calendar year.” A spokesperson in September told Straus the technology was still going through the procurement process.