ReviewHarm reduction journal2026
National review of state laws on opioid antagonists in Kindergarten-12th grade schools across the United States.
Review in Harm reduction journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Authors and funding
9 authors.
Funding
Abstract
backgroundOpioid overdoses have surged among United States (US) youth, who face high risk of morbidity and mortality. Opioid antagonists (OAs), like naloxone, are life-saving medications that can reverse overdoses. For youth, schools can be key venues for harm reduction. As states enact laws governing OAs in schools, it is important to understand how states permit schools to manage and respond to emergencies with this medication. This study's objective was to examine statutes on OAs in Kindergarten-12th grade schools to identify and compare key legislative components across states.
methodsThis national review analyzed US state laws on OAs in K-12 schools enacted by December 31, 2024. A search of statutes was conducted using Nexis Uni. Team members iteratively reviewed each statute to identify components and extract relevant language. Discrepancies were resolved through discussion. Findings were summarized and reviewed with experts in school health, addiction, and harm reduction for validity.
resultsThirty-eight states have laws on OAs in K-12 schools. Nine states (24%) mandate a supply of OAs to be available in schools, while eight states (21%) require policies to be adopted for school systems to have OAs. State laws vary in terms of components. State laws commonly define OA (n = 24, 63%) and specify school types and/or levels (n = 35, 92%). Most states detail individual(s) who may administer OAs in school settings (n = 34, 89%) and training on OAs (n = 25, 66%). More than half of states detail acquisition (n = 22, 58%) and inventory logistics (n = 21, 55%). Few state laws include incident response post-administration (n = 9, 24%), reporting of administration (n = 8, 21%), and parental involvement (n = 5, 13%). Lastly, most states include immunity (n = 32, 84%) protecting school systems and/or individuals who provide or administer OAs.
conclusionThis study found most states have laws on OAs in K-12 schools with variation in specific language. Such variability in state legislation contributes to varied implementation in school, which may affect accessibility to OAs and response to overdose emergencies in schools. If implemented effectively, such legislation has potential to promote harm reduction and reduce opioid overdoses among youth.
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