Virginia Department of Health (VDH) and the Virginia Department of Behavioral Health and Developmental Services (DBHDS) share the common goal of increasing naloxone access for all Virginians. Due to limited resources, VDH is prioritizing high-priority individuals to receive no-cost naloxone. High priority individuals include people who use drugs (PWUD), family members, friends or coworkers of PWUD and people who work directly with PWUD. VDH continues to support individuals who may not be at highest risk of experiencing or witnessing an opioid overdose by identifying alternative avenues for naloxone access.
Authorized comprehensive harm reduction sites, community services boards, local health departments, first responders (law enforcement agencies, fire service organizations, licensed emergency medical services (EMS) agencies), public schools and high priority community partners (homeless service providers, treatment and recovery centers, rehabilitation facilities, and community-based organizations that serve high-risk populations) are eligible to obtain naloxone at no-cost from VDH. Eligibility criteria are subject to change.
All naloxone nasal spray, including brand Narcan, that has been distributed by the Virginia Department of Health is still a prescription product. If you have received no-cost naloxone from VDH, it is still required to dispense the product in accordance with the Virginia Board of Pharmacy Naloxone protocol, which includes utilizing the Statewide Standing Order for Naloxone.
First responders, including law enforcement, fire service organizations, licensed emergency medical services (EMS) agencies, correctional facilities, and local and regional jails are eligible for no-cost naloxone from VDH.
The Virginia Association of Chiefs of Police (VACP) partners with VDH and DBHDS to provide no-cost naloxone and REVIVE! Opioid Overdose and Naloxone Education (OONE) training to first responders. First responders must complete a REVIVE! for First Responders training in order to obtain no-cost naloxone. Please visit the VACP First Responder Naloxone Webpage for more information about this training and additional resources available to first responders.
Public K-12 schools are eligible for no-cost naloxone through VDH. Private schools may purchase OTC naloxone or email email@example.com for assistance.
Are K-12 schools allowed to possess and administer naloxone to students?
The emergency response and procedures for opioid overdose in the school setting are part of the school division’s School Crisis, Emergency Management and Medical Response Plan. The Code of Virginia § 54.1-3408 (X) provides the framework for schools to develop policy around naloxone possession and administration in the school setting. This legislation pertains to school nurses, health department personnel assigned to schools, and school board employees that provide health services. They may possess and administer naloxone as long as they have completed a training program pursuant to an oral, written, or standing order.
It is important to note that the Code of Virginia § 54.1-3408 (X) does not mandate that schools possess and administer naloxone. School divisions are encouraged to decide whether they want to adopt a naloxone-in-schools policy based on multiple factors including access or location of Emergency Medical Services (EMS) relative to school setting; local data on opioid use/misuse; School Resource Officers (SROs) possession of naloxone; community and school board feedback; and local resources for sustainability.
How do K-12 schools prepare to possess and administer naloxone?
The decision to adopt a naloxone policy in schools is made by the local educational agency (LEA). If an LEA approves naloxone administration by school employees, the Best Practices on Naloxone Possession and Administration in Response to a Suspected Opioid Overdose in the School Setting may be used by school divisions to assist in developing local school policies in response to suspected opioid overdose.
In order to possess or administer naloxone in the school setting, local school boards must develop and implement policies and procedures for the administration of naloxone in schools and ensure the training of relevant school personnel, pursuant to § 54.1-3408.X. The Virginia Department of Behavioral Health and Developmental Services (DBHDS) provides training to school personnel on how to recognize and respond to an opioid overdose emergency with the administration of naloxone.
REVIVE! is the name of the DBHDS’ Opioid Overdose and Naloxone Education (OONE) program for the Commonwealth of Virginia. Schools should document training of school personnel on an annual basis and provide the information upon request to VDH. For further information, schools should refer to the Virginia Department of Education School Health webpage or contact firstname.lastname@example.org.
Do I Need to Report on the Use of Naloxone in the School Setting?
Schools should develop polices for the possession and administration of naloxone and may develop their own reporting form to document naloxone administration.
High-priority community partners include homeless service providers, treatment and recovery centers, rehabilitation facilities, and community-based organizations that serve high-risk populations. High-priority community partners are eligible for no-cost naloxone from VDH to dispense to high-risk individuals. These community partners can apply for a naloxone agreement with VDH using the steps below.
Prior to accessing no-cost naloxone from VDH, high-priority community partners must complete one of the following training requirements:
- Online or in-person training in REVIVE, a course that teaches people how to respond to an opioid overdose and administer Naloxone, or
- Online training in harm reduction education and counseling, which provides techniques for providing education in a short, concise manner and to provide one-on-one harm reduction counseling.
Naloxone and Test Strips Request Process for Eligible Community Partners
Step 1: Apply
if it is the first time your organization has requested naloxone OR if your organization’s agreement with VDH has expired. Once all signatures are obtained and the agreement is executed, the organization is responsible for ensuring the agreement is updated before expiration date.
To renew an existing agreement, please contact email@example.com.
Step 2: Order
after your organization has a fully executed agreement with the Virginia Department of Health for provision of naloxone.
If you are unsure whether your organization has an executed agreement or if an agreement is still active, please contact firstname.lastname@example.org.
Step 3: Return
expired, unused, or damaged naloxone to the Virginia Department of Health. Sites are required to return expired, unused, or damaged naloxone kits and may not distribute them to other organizations.