Child development centers should be enabled and encouraged to stock emergency naloxone HCl, supported by policies that parallel those already in place for epinephrine (8VAC20-781-40 Required policies and procedures. 16. Stock epinephrine; references § 22.1-289.059). We are in the midst of a fentanyl overdose epidemic that continues to intensify as stronger varieties of the chemical are developed. It only takes the tiniest bit of fentanyl for a child to be affected, and it takes only minutes for them to die of respiratory failure before their caregivers’ eyes if naloxone is not administered in time.

Naloxone is available as an intranasal spray that requires minimal training for proper use. VDH advises that it is considered safe for application to infants and children because even if the cause of the emergency turns out not to be fentanyl, it does no harm. But if breathing has stopped, naloxone can be lifesaving if the issue is fentanyl exposure, and VDH recommends administering the spray even before calling 911. 

My children’s child development center does supervised field trips on a regular basis to places that are normally considered safe, like our city’s public parks. Yet there have been cases of young children in other states unexpectedly encountering, and ingesting or inhaling fentanyl, hidden in the grass in public parks (CA) or even contaminating the mats in their childcare center (NY). Our police department has reported fentanyl is very much present in our city. There have also been documented cases in other states in which fentanyl patches have been mistaken as bandaids and fentanyl tablets have been mistaken as candies or as other OTC medications. I have asked my children’s teachers to stock naloxone in the school’s first aid kit in case of emergency, but they have said that current policies disallow them from doing so unless I request an individual prescription for each child. Even they carried it for my children, in an emergency situation they would be legally unable to administer it to another child who might have been exposed.

Even the White House recommends that schools consider stocking naloxone: https://www.whitehouse.gov/wp-content/uploads/2023/10/Letter-to-Schools.pdf 

The White House letter addresses schools serving older students, and it may seem like the children in early childhood education centers are too young to need this kind of protection, but we need to remember that our communities are connected: there are sibling connections from the high school to the middle and elementary schools to the preschools, and sadly, accidents happen. Kids love to share special things that they bring from home. Please don’t wait until a child dies in care. Update our legislation to help protect our children in these troubled times.