VANCOUVER, Wash — Outside of her high school, senior Katie Thornton pulled out a plastic bag of supplies.
"This is the kit, it's all smooshed up because I keep it in my backpack — two doses of naloxone, a rescue mask, some gloves and instructions," she said.
A year ago, Thornton didn't know much about fentanyl overdoses and how naloxone, also known by its brand name Narcan, can quickly reverse the effects of an overdose to potentially save a life. Regardless, she was paying attention.
“Watching the news every night and seeing, at least once a week, some report of an overdose or the use of Narcan," she said. "This is something that's frequently happening that I could probably make an impact on.”
After some research, Thornton, then a junior at Henrietta Lacks Health and Bioscience High School, often shortened to HeLa, came up with an idea for her Girl Scouts Gold Award service leadership project.
She set up trainings at seven different southwest Washington schools for students to learn about the signs of an opioid overdose and how to administer Narcan.
"Teaching to high schoolers, it's information that's useful for them either currently in their lives or in the future," Thornton said. "Because I'm within the school system, I can see what's happening and have a stronger (impact) than someone who's outside the school system."
That influence could be much-needed, as a statewide survey shows Narcan usage in Washington schools increased by 600% over the last two school years.
Narcan is already available in many Washington schools. In 2019, state lawmakers passed a bill requiring most high schools to have Narcan on hand — a response to the growing fentanyl crisis. School nurses or security officers often carry it with them.
Since then, the threat of fentanyl has only worsened.
This year, Oregon and Washington have reported the two largest increases in fentanyl overdose deaths of any states across the country, according to CDC data.
With the rates of overdoses increasing, some school districts have decided to expand Narcan to all schools. Micki Moss, a school nurse at Prairie High School in the Battle Ground School District, said nurses like her need to prepare for the worst.
"We're seeing (overdoses of) infants, toddlers, people that are not necessarily trying to ingest drugs and they're being exposed and overdosing," Moss said.
At Prairie High School and other Battle Ground schools, a Narcan kit is stored on the wall right next to an AED — even though BGSD has yet to report a use of Narcan.
"It's a little (sobering), especially if you've had any experience with someone who has overdosed," Moss said. "You have to treat every situations as though it's a potential overdose."
The reality is — more and more — Narcan is being used at school.
The school nurse corps asks each Washington school district to take a voluntary survey each year. For the 2021-2022 school year, school officials reported they used Narcan six times.
For the 2022-2023 school year, they reported using it at least 42 times.
That increase is likely an undercount, as schools are not required to report their data and not every school district participates — plus there are other gaps in the reporting process.
In May of 2022, a teenage girl died after overdosing in a bathroom at Hudson’s Bay High School – a story that KGW uncovered. School officials used Narcan to try and save her life. However, Vancouver Public Schools officials reported on the survey that they didn’t use Narcan in the 2021-2022 school year.
A district spokesperson told KGW there’s a simple explanation for that — the survey was sent out and returned in April, while the overdose happened in May. But the incident further emphasizes how schools are using Narcan more frequently than we know.
Katie Thornton said that the trend is concerning on its surface, but the increase in Narcan usage also shows some growth in how schools are ready to respond.
“It shows that it is accessible and people do know where it is to save people's lives," Thornton said.
Thornton's HeLa High School is part of the Evergreen School District, which reported two uses of Narcan last school year. The district has expanded Narcan to all schools and school buses, while some staff members now carry it with them.
KGW asked to see and take video of these Narcan supplies, but an Evergreen School District spokesperson declined, saying they don’t want to show where the Narcan is because high school students could potentially steal it.
The Longview and Vancouver school districts also each reported using Narcan one time last school year.
A Vancouver Public Schools spokesperson said the district has rolled out new "Go Kits" for medical emergencies that include Narcan. Typically, a school nurse, an administrator and other staff members who are first aid and CPR-certified would be the ones to respond with Go Kits.
In light of recent overdoses, Thornton said she believes students and families should be more willing to talk about fentanyl and Narcan.
“I think that it is important that people are talking about it and that it is an open conversation and it's not something that should be shunned and hushed away," Thornton said.
Katie Thornton directed seven trainings this spring, talking to hundreds of students, parents and teachers about Narcan. She gave out 80 kits with life-saving materials.
“High school students, we definitely know that fentanyl is out there and that it's a big, dangerous thing," she said. "So part of what I was looking to do is make sure that they also know there is a way to save their life."