School boards contemplating whether or not to introduce high school naloxone programs now have a new way to help determine whether it would be a cost-effective step.
Western University researchers developed a spreadsheet tool that would show a board whether the overdose-reversing medication initiative would be the best use of their limited resources.
“We created this tool, not because the program is costly, but because targeting overdose fatality prevention for a low-risk population has an unclear value,” said Lauren Cipriano, who co-authored the study with Gregory Zaric, both cross-appointed in Schulich Medicine & Dentistry and the Ivey Business School. “The Public Health Agency of Canada reports that there were 80 overdose fatalities in 2017 for people under the age of 19, but there are no public reports of opioid overdoses, fatal or otherwise, happening in a school.”
The study used the Toronto District school board, which announced earlier this year it would supply naloxone kits to more than 100 of its high schools, as an example. Researchers then looked at costs and health effects of naloxone programs, compared to existing public health and emergency resources currently available.
They determined that, for the program to be cost-effective, there would need to be at least one overdose per year across the whole school board's 112 high schools. The program would also need to reduce mortality by about 50 per cent, according to the study.
The cost to establish a school naloxone program is estimated to be $50,000, with the bulk of the costs going to train staff on how to properly administer the medication.
Using the evaluation tool, school board officials anywhere in the world can download the spreadsheet, plug in their information and instantly see whether the program is fiscally responsible for their jurisdiction.
“Each school board can tailor the inputs for their own situation. They may decide to put naloxone kits in high schools anyway, but I would hope that they would do so informed by solid evidence,” said Zaric.
Researchers stressed that, if the risk of an overdose in a high school is low, students would be better served by board investments in other public health initiatives.
“Because the budget for a school board is limited, it is about using that limited budget in the best possible way,” said Zaric. “There are a lot of public health interventions for high school students around mental health, diet, and sex education that might have a better incremental cost per health benefit or per quality of life years gained.”
The study was published in the November edition of the journal Drug and Alcohol Dependence.