Washougal to stock schools with opioid overdose-reversal medication

School board OK’d new policy in October, will train staff to use naloxone

Contributed photo courtesy Washougal School District Washougal School District assistant superintendent Aaron Hansen (left) and Washougal High School principal Mark Castle (right) display a dose of Narcan, a medication used to assist people who have experienced an overdose of opioids. The Washougal School Board recently approved a policy that states that Narcan will be placed in every one of the district's schools.

Contributed photo courtesy Washougal School District According to the Center for Disease Control and Prevention, 107,622 Americans died of drug overdoses in 2021, with 66 percent of those deaths related to synthetic opioids like fentanyl.

Alexander Cook’s older brother, Daniel, passed away earlier this year as a result of an opioid overdose. Cook was devastated, of course, but at the same time, he had long since come to terms with the fact that in some ways, the person that he knew and loved had already been gone for some time.

“It’s heartbreaking because (addiction) really changes people,” said Cook, the youth engagement coordinator for Unite! Washougal, a nonprofit organization that supports youth and guides healthy choices. “When people are using substances, you know how they are when they’re not (using), and they really do seem like different people when they’re on the substances. There was a sense of loss before he passed away — a loss of who he was … who we hadn’t seen in a long time. It was a heartbreaking sense of loss, a sense of helplessness, in a lot of ways, with wanting to be there, wanting to help, but not knowing how.”

That’s why Cook works every day to make sure that nobody else has to feel the grief, anguish and sense of helplessness that he felt for so many years. And that’s why he’s proud to work for Unite! Washougal, which is partnering with the Washougal School District to implement a variety of educational activities and prevention measures to combat youth opioid misuse, which has increased locally and nationally in the last several years.

“This is a big problem, and big problems require big solutions,” Unite! Washougal Margaret McCarthy told the Washougal School Board in June. “They require all of us to work together. It’s about partnerships.”

The Washougal School Board approved a policy in October that states the district will seek to obtain and maintain at least one set of opioid overdose reversal medication doses in every one of its schools.

“Four or five nurses had already been trained and had the (medication),” WSD assistant superintendent Aaron Hansen said. “Now we’re planning to have the nurses train other staff members. We’re identifying which staff members will receive the training and have the naloxone available just in case it is needed.”

Board president Cory Chase said that the medication should be placed in all of the district’s schools and not just Washougal High School, as the first draft of the policy stated.

“It’s unfortunate that we’re talking about this,” he said during an October board meeting, “but it’s reality.”

The district is using naloxone, a medication that can reverse an overdose from opioids, including heroin, fentanyl, and prescription opioid medications. Often given as a nasal spray, it can quickly reverse an overdose by blocking the effects of opioids and restore normal breathing within 2 to 3 minutes in a person whose breath has slowed or even stopped.

“Just in case something was to happen, we now have a product in all of our buildings that can save a life,” Hansen said. “If we get to a point where we need to use this medication because of a potentially life-threatening situation, we have it.”

The district has “not had any students, staff or visitors on campus who were suspected of an opioid-related overdose at any school,” according to Les Brown, the district’s director of communications and technology.

“I did hear that the Washougal Police Department may have (responded to) a suspected overdose in a community member near one of our schools, but I don’t have any other details since school staff were not the ones responding,” Brown said.

Fentanyl is a synthetic opioid that is 50 times more potent than heroin and 100 times more potent than morphine. Just two milligrams of fentanyl, which is equal to 10 to 15 grains of table salt, is considered a lethal dose. It remains “the deadliest drug threat facing this country,” according to the news release from the Centers for Disease Control and Prevention (CDC).

“There are people who are just using a recreational drug for recreational purposes, and then there’s also the people who are using it as a coping strategy, a dependency,” Cook said. “I think what we’re really facing is this lack of understanding that someone can take something one day and then take it the next day, and it has a little more fentanyl in it than it did the day before, and it’s a lethal dose when it wasn’t the day before. Just because you were able to do it one day doesn’t mean you can do it safely the next day.”

Fentanyl-related deaths in Clark County tripled from 13 in 2019 to 39 in 2020, and then climbed again to 57 deaths in 2021, according to the Washington State Department of Health. Eleven Clark County youth ages 19 and younger died as a result of opioid overdose between 2016 and 2022, according to Clark County Public Health.

“You don’t have to work very hard to search (for the numbers) and see the impact this is having in communities in the state of Washington,” Hansen said. “When you see the graphs that show the impact, the change that has occurred in the last few years with opioid overdoses and deaths, (you realize that it) is hitting close to home.”

Fentanyl may be added to illicit drugs during their production without the drug user’s knowledge.

“Anyone who uses powdered drugs or takes pills that were not given to them by a pharmacy should assume they contain fentanyl,” Alan Melnick, Clark County’s health officer and public health director, said in a news release. “Drugs purchased online, from friends, or from regular dealers could be deadly. There’s no way to know how much fentanyl is in a drug or if it’s evenly distributed throughout the batch.”

Unite! Washougal has access to several national platforms, including the Washington State HealthCare Authority’s Starts With One campaign, the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Opioid and Naloxone Education Program (ONE), that it’s planning to leverage within the WSD ecosystem in the coming months.

“And Margaret and I have been talking about what we can do as far as (setting up) a meeting for our community to get some more information,” Hansen said. “We’re also working in the schools to share grade-level, specific, age-appropriate presentations around what can happen (when someone takes opioids), the potential (ramifications), and making healthy choices. We’re helping our students deal with these types of situations, supporting them, and making them aware about the availability of fentanyl and what it could look like.”

‘A very unfortunate case’

Cook believes his brother “probably had early onset schizophrenia, a mental health disorder that wasn’t properly diagnosed early on.”

“And as a result there was a substance use disorder — sort of like addiction, I guess,” he said. “And (that led to) self-medication that continued to impact him his whole life, and he wasn’t really ever able to, despite lots of efforts on our end, rehab. He wasn’t really able to get through that.”

Daniel participated in a Narcotics Anonymous program earlier this year and was seemingly “on the path to getting better,” according to Cook.

“(And then in April he) took a substance that was more potent than what his body was ready for,” Cook said. “There was there no indication of attempting suicide. This is just a very unfortunate case. I know Narcan was administered, but maybe it wasn’t enough.”

Daniel was 34 years old when he died.

“I think in the beginning there was a lot of judgment, not understanding the issue, making it feel like he needed to change, like he needed to decide for himself. At some point, I felt like there was almost nothing I could do, and I just had to wait for him to hit rock bottom,” Cook said. “As I learned more and went through this process more with him and talked more about how to deal with these issues, I realized maybe I was a little na?ve.”

Cook decided to pursue a career in youth drug prevention largely due to his experiences with his brother. Before joining Unite! Washougal, he worked as a national trainer for Community Anti-Drug Coalitions of America, a Virginia-based nonprofit organization dedicated to creating and maintaining safe, healthy, and drug-free communities globally. And now he’s using all that he’s learned to help young people in east Clark County.

“Me not wanting that for other people is a huge, huge part (of my work),” he said. “A lot of what I do now is a way to sort of make me feel like I’m able to make a difference for somebody, even if it’s not my brother. It’s really important to me. Maybe I can do something for other people before they have to go through (what my brother went through).”