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State updates order allowing schools to administer meds to counter opioid overdoses

The Illinois Department of Public Health (IDPH) has issued an updated standing order allowing schools to keep a supply of medications like naloxone on hand, and also permitting school nurses or other trained personnel to administer them to students in the event of an opioid overdose.

The updated order, signed by IDPH Director Dr. Sameer Vohra, builds upon authority established in 2015 to expand access to naloxone, which can reverse the effects of an opioid overdose. The new order makes clear that schools can obtain a supply of such medications, known as opioid “antagonists,” without a prescription, and that a school nurse or other person who has been trained in their use may administer the medications to someone exhibiting signs of an overdose on school property. Under Public Act 103-0348, which took effect January 1, 2024, public and private schools are now required to keep a supply of an opioid antagonist on hand to be used in the event of an overdose. Illinois is just one of nine states to have this requirement for schools.

The revised order also adds nalmefene as an approved opioid antagonist. In May of 2023, nalmefene was approved by the U.S. Food and Drug Administration for use on persons 12 years of age and older.

“Medications like naloxone save lives,” Vohra said. “This updated standing order will ensure Illinois schools have the authority to use this treatment to prevent tragedies. While we continue to work vigilantly to steer young people away from misuse of opioids and other substances, a public health approach requires us to do everything in our power to reduce harm – preventing the most tragic and permanent consequences of these substances.”


Illinois State Board of Education (ISBE) records show that during the 2022-23 school year, there were ten instances where school personnel administered an opioid antagonist to a student exhibiting signs of an overdose. Each of the incidents happened during regular school hours.

Administration of an opioid antagonist reduces the time to treatment for someone experiencing an overdose. More than one dose of the medication may be required.

Both naloxone and nalmefene are seen as safe and effective in counteracting an overdose. They can be administered safely to persons showing signs of overdose, even if that person has not actually overdosed on opioids. Side effects are considered rare, and usually mimic the symptoms of opioid withdrawal, including fever, hypertension, nausea or vomiting.

Under the standing order, schools can obtain a supply of opioid antagonists without a prescription. The medications can be administered by a school nurse or other personnel who have undergone training in how to recognize an opioid overdose and how to administer treatment. Details of training for school personnel are also outlined in the Illinois School Code.

The revised standing order is in effect through early February 2025.

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