In 2015, the Michigan Prescription Drug and Opioid Abuse Task Force was formed to develop a statewide action plan to address a growing public health problem in Michigan - overdose deaths. As opioid painkillers, such as oxycodone, have been prescribed with increasing frequency in recent years, the number of overdose deaths associated with the use of these drugs has risen. The Task Force proposed a multipronged approach to combat opioid use in Michigan. It was suggested that naloxone, a drug that counteracts the effects of an opioid overdose, should also be available in schools, and that school boards that wish to keep the drug on hand should be required to develop a policy regarding its administration to pupils by trained personnel. 

Michigan schools now have the option to have access to the potentially life-saving opioid overdose drug naloxone. Senate Bills 805 and 806, now Public Acts 384 and 385, were signed by the Lieutenant Governor on December 28, 2016. PA 384 and 385 will amend the Public Health Code and the Michigan Revised School Code to allow an opioid antagonist to be prescribed to a school board and administered by a school nurse (or a person trained by a nurse) in case of an opioid-related overdose in the school. 

The amendment to the Michigan Revised School Code (MCL 380.1179b) will allow a school board to require that, in each school it operates, there are at least two employees who have been trained in the appropriate use and administration of an opioid antagonist by a licensed registered professional nurse, beginning in the 2017-2018 school year. It would also provide that a nurse employed or contracted by the school district, immediate school district (ISD) or public school academy (PSA), or an appropriately trained employee, may possess and administer an opioid antagonist. 

What is an opioid antagonist?

An opioid antagonist means naloxone hydrochloride or any other similarly acting and equally safe drug approved by the U.S. Food and Drug Administration for the treatment of drug overdose.

If a school district, ISD or PSA chooses to obtain a prescription for an opioid antagonist, MCL 380.1179b will require the school board to develop and implement a policy by the beginning of the 2017-2018 school year. That policy must:

• Be consistent with the Michigan Department of Education's medication administration guidelines, as amended;
• Provide for the possession of at least one package of an opioid antagonist in each school operated by the school board, which may be administered by a school nurse or a school employee who is trained in its administration and is authorized to administer it under the policy;
• Authorize a school nurse or a trained school employee to administer an opioid antagonist to an individual on school grounds who is believed to be having an opioid related overdose;
• Require school personnel to notify the parent or legal guardian of a pupil to whom an opioid antagonist is administered; 
• Require the school employee to encourage the parent or guardian to seek treatment for the pupil from a substance use disorder services program; and
• Require school personnel to call 911 if a pupil is believed to be having an opioid-related overdose. 

A school district, ISD, and PSA must report all instances in which an opioid antagonist was administered to a student using the school's stock of opioid antagonists to the MDE, at least annually, using the form and manner prescribed by the MDE.

Immunity

Under the current Michigan Revised School Code (MCL 380.1178), a school employee who in good faith administers medication to a pupil or an epinephrine auto-injector (EpiPen) to an individual in accordance with the Code is not liable in a criminal action or for civil damages as a result of an act or omission in the administration of the medication or EpiPen, except for an act or omission amounting to gross negligence or willful and wanton misconduct.

Public Act 385 will amend Section 1178 to extend criminal and civil immunity to a school employee who administered an opioid antagonist to an individual in good faith and consistent with the policies under Section 1179b. 

It will be important for school districts, intermediate school districts and public school academies to determine whether it will allow an opioid antagonist to be prescribed in the event of an opioid-related overdose. If so, this e-alert outlines the requirements of a new policy regarding the use and administration of an opioid antagonist. The new policy will need to be implemented prior to the beginning of the 2017-2018 school year.