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Divisions Faculty Featured Pharmaceutical Outcomes and Policy Research, Delesha Carpenter
Grayson Mendenhall
October 17, 2017

Delesha Carpenter
Delesha Carpenter, Ph.D., M.S.P.H.

Many school nurses in North Carolina and South Carolina are contending with prescription opioids at school but very few have access to naloxone, which can reverse an opioid overdose, according to a new study from the University of North Carolina at Chapel Hill. The nurses also said they would welcome more training in dealing with opioids.

Many school nurses (40 percent) said they had encountered a student with an opioid prescription, but less than 4 percent had naloxone available in case of an overdose despite an agreement between Adapt Pharma and state departments of education to provide naloxone nasal spray to high schools free of charge. The National Association of School Nurses has endorsed school nurse access to naloxone for the emergency treatment of opioid overdose.

The majority of school nurses (84 percent) were interested in opioid-related training. Almost 70 percent, especially those in rural schools, said they believed students would also benefit from opioid education.

“Few studies have looked at opioids in schools even as more children are coming to school with prescription opioids that the school is responsible for administering,” said Delesha Carpenter, Ph.D., M.S.P.H., the study’s senior author and an assistant professor at the UNC Eshelman School of Pharmacy. “The responsibility for storing, monitoring and administering students’ medications falls on school nurses, and they are asking for more resources to help them deal with these powerful drugs.”

The study was published in the Journal of Addictive Diseases.

Opioid deaths and prescription sales in the United States have nearly quadrupled since 1999. Between 1994 and 2007, the number of opioids prescribed for adolescents nearly doubled. This has been associated with an increase in nonmedical opioid use among youth. Between 1997 and 2012, opioid-related hospital admissions of adolescents ages 15 to 19 increased 175 percent, and pain relievers were the largest category of misused prescription drugs among teenagers in 2013.

Students were most commonly prescribed opioids for broken bones, dental procedures, and pain after surgery. Examples of opioids are oxycodone, hydrocodone, codeine and morphine.

Researchers sent a request to nearly 2,500 school nurses in North Carolina and South Carolina asking them to participate in an online survey. They received responses from 633 between November 2016 and January 2017.

Naloxone was approved by the U.S. Food and Drug Administration for treating opiate and opioid overdoses in 1971. Originally the drug could only be administered by injection, but a nasal spray delivery system was approved in 2015 for use without a prescription. Opiates are derived from opium. Opioids are synthetic drugs that act like opiates in the body and are typically used to relieve pain.


The authors of this study are

  • Ella Pattison-Sharp, doctor of pharmacy student at the University College London School of Pharmacy;
  • Robin Dawson Estrada Ph.D., University of South Carolina College of Nursing;
  • Alice Elio, M.S.N., Mountain Area Health Education Center Asheville, North Carolina;
  • Melissa Prendergast, Director of Nursing, Charleston County School District, South Carolina; and
  • Delesha M. Carpenter Ph.D., M.S.P.H. University of North Carolina, Eshelman School of Pharmacy.



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