AMA Backs Making Overdose Reversal Meds Accessible in Schools

The AMA is encouraging states, communities, and schools to adopt policies that allow naloxone and other overdose reversal medications to be readily accessible to teachers and school staff.

Additionally, the AMA is urging states, communities, and schools to “remove barriers to students carrying safe and effective overdose medications.”

The policy sponsored by the AMA Section Council on Psychiatry, was adopted in June at the Annual Meeting of the House of Delegates, where AMA’s advocacy policies are formulated. It was one of five resolutions sponsored by the section council that were adopted by the House.

Alexis Geier-Horan/AACAP

The Section Council on Psychiatry comprises delegates from APA, the American Academy of Child and Adolescent Psychiatry (AACAP), the American Academy of Psychiatry and the Law, the American Association for Geriatric Psychiatry, and the American Academy of Addiction Psychiatry (AAAP).

As a part of the resolution on overdose medications, delegates also asked the AMA to conduct a study on the safety of allowing student access to effective overdose reversal medications and related issues.

“Just as students carry prescription inhalers to treat an asthma attack, we must destigmatize substance use disorders and treat naloxone as a lifesaving tool,” Bobby Mukkamala, M.D., chair of the AMA Substance Use and Pain Care Task Force, said in an AMA press release.

The resolution to make overdose reversal medications more accessible in schools was widely supported, though the inclusion of a recommendation to allow students to carry such medications—as originally called for in the section council resolution—elicited concern among some delegates about safety and about local rules that might prohibit students from carrying naloxone or similar medications.

Speaking on behalf of the section council on the floor of the House, Warren Ng, M.D., president of AACAP, proffered the revised language calling for the AMA to “encourage states, communities, and educational settings to remove barriers to students carrying safe and effective overdose reversal medications.” The amended resolution was adopted by the House.

Ng said that allowing students to carry overdose reversal medications can be lifesaving. He cited a 2022 study by the U.S. Centers for Disease Control and Prevention showing that among youth aged 10 to 19 years old, overdose deaths increased 109% between July 2019 and December 2021. For many of these deaths, there were people nearby who might have been able to intervene had they had access to lifesaving medication, Ng said.

“The AMA needs to support school districts that are trying to save students’ lives right now,” he told delegates. “Overdose reversal medications including nasal inhalers are safe and easy to use.”

He recounted for delegates the story of a 14-year-old boy found unresponsive earlier this year in the bathroom of Wakefield High School in Arlington, Va. He died at a hospital a short time later of an apparent overdose. As a result, students in the school district are now allowed to carry naloxone with them, he said.

“Our school districts need the help of our AMA to enable students to carry overdose reversal agents and not rely on it being with a teacher or a school nurse,” Ng said. “It needs to be where the students are and with them. … We know that adults do not always know what the students are doing, but the students often know before others.”

Kenneth Certa, M.D., an APA delegate to the section council, told Psychiatric News that the adopted resolution “will embolden school boards to make this change so students will not die on school campuses because no one has the necessary medication to keep them alive until EMS gets there.”

Jerry Halverson, M.D., chair of the section council, said the successful passage of the resolution speaks to the effectiveness of the psychiatric delegation at the AMA. “This resolution was produced by psychiatry, and it took the psychiatrists in the House working together to educate other delegates,” he said. “Now we have a policy that will allow school districts to do something that will save lives.”

Other Actions Related to Substance Use

The House of Delegates also approved a resolution, sponsored by the section council, that asks the AMA to advocate against the use of any psychedelics or entactogenic compounds (such as psilocybin or MDMA) to treat any psychiatric disorder for which the medication has not received FDA approval or has not received approval in the context of investigational studies.

During testimony on the resolution, Alena Balasanova, M.D., a delegate from AAAP, read the APA position statement on hallucinogens. That statement asserts: “There is currently inadequate scientific evidence for endorsing the use of psychedelics to treat any psychiatric disorder except within the context of approved investigational studies. … Clinical treatments should be determined by scientific evidence in accordance with applicable regulatory standards and not by ballot initiatives or popular opinion.”

Referencing the APA statement, Certa told delegates, “Unfortunately that is what’s happening—popular opinion is dictating care that is being done in ways that are quite harmful.”

Also approved by the House of Delegates was a resolution advocating that substance use history be recorded in electronic medical records as medical history, not as social history.

“Treating substance use history as part of the social history is a historical relic from an earlier time when substance use was considered a moral failing and a social problem, and it should have no place in modern medicine,” said Balasanova, director of addiction psychiatry education at the University of Nebraska Medical Center. “We know better now. Social history is for social things—relationships, employment, hobbies, education—none of these relate to the ingestion of a biologically active substance resulting in physiological changes in the body and brain. Continuing to endorse substance use history as social history perpetuates the stigma that claimed over 100,000 lives to overdose in the last year alone.”

Balasanova is a member of the APA Council on Addiction Psychiatry.

Finally, the House also approved two other resolutions sponsored by the section council—one calling for a study on the effectiveness of physical activity on depression outcomes and another advocating that the need to address child mental health issues should be regarded as a national emergency. ■