(BUDA, Texas) — Bandages, ice packs, aspirin and epinephrine have long been staples of nurse Dawn Baker’s public high school medical clinic in Texas.

Now, she also stocks Naloxone to treat drug overdoses — keeping a supply by the door in case she needs to save a life in an instant.

“Schools have had drugs in them forever. It’s just that the drug is so much stronger and so much scarier now, and, you know, the outcome is death,” Baker said.

As the nation’s fentanyl crisis claims a growing number of American teenagers each year, school districts nationwide are scrambling to acquire the opioid-reversing drug, train teachers and students how to use it, and combat stigma from openly acknowledging problems with addiction.

Last year, just two weeks after Hays County gave Nurse Baker six doses of Naloxone, also known by the brand name Narcan, she was called to a classroom where a 16-year-old girl was unresponsive.

“She checked all the boxes of an overdose,” she said. I administered Narcan nasally.” The young woman, who was not breathing, survived but only because an overdose antidote was close at hand, Baker said.

“It’s not the answer to all, but it’s definitely going to help,” she said.

While illicit drug use among teens nationwide has been on the decline, overdose deaths – some of them on school property – have been soaring, according to the Centers for Disease Control.

Around 500 U.S. teenagers died from a drug overdose each year between 2010 and 2019, CDC data shows. But in 2020, the number nearly doubled to 954 deaths; in 2021, more than 1140 teens died from a drug overdose.

“We’re seeing a significant number of kids getting access to highly lethal drugs that are ultimately leading to an increase in deaths,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News medical contributor.

“We know that there is plenty of fentanyl on the market that is tainting products that people really otherwise wouldn’t know is there. Even in a very small quantity – one tenth of a grain of rice – can lead to an overdose death,” Brownstein said.

The National Association of School Nurses has become so alarmed by the trend that the organization now advises schools nationwide to develop a Naloxone policy.

“I’m seeing more receptiveness,” said Kate King, president-elect of the nurses association.

Thirty states expressly authorize the possession and use of naloxone in K-12 schools, according to the Legislative Analysis and Public Policy Association. But only 1 state – Rhode Island – requires all schools to keep it on hand.

Recent FDA approval for over-the-counter sale of naloxone is expected to accelerate interest in the drug and ways to increase its production and availability.

King says unfamiliarity with Naloxone and “stigma” around it are primary barriers to more widespread adoption.

“The fear is that drug users will camp out on the doorstep so that when they use opioids, school personnel will have to run out and save them with naloxone. There’s a fear of danger after administration – that if you administer it, people are going to come up swinging and that you, yourself, are going to be in danger,” King said. “There’s also fear that schools don’t want to get the bad reputation.”

Officials at Hays County Public Schools, just outside Austin, have had to use Naloxone 6 times since the district began stocking the drug in nurses offices. Five students have died off campus in the past year.

“We are being impacted hard. I think what we’re doing differently is we’re hitting it head on,” said Jeri Skrocki, a former county sheriff’s deputy who now oversees safety and security at Hays Consolidated Independent School District’s 26 school campuses with over 22,000 students.

Administrators have produced videos of grieving parents to show students and released surveillance video of student overdose incidents on county campuses.

“Our goal was transparency and really making sure that we were communicating that this is out here, and we wanted them to see those faces,” Skrocki said.

In Montgomery County, Maryland, after a recent rash of student overdoses, administrators are holding community training sessions throughout the year where free doses of naloxone are distributed to parents and children.

“It’s becoming way closer to home,” said high school senior Isabella Juarez Galeas who attended.

Earl Stoddard, a father who joined the session with his daughter Ava, said the dangers need to be talked about openly.

“It’s just important to educate and be aware of what’s going on in your community. She’s going to high school next year. And so I want to have her prepared for that before she gets there,” he sa9id.

Added Ava, “We’ve had strong personal talks at home about drugs, like if you see someone and they’re like, Oh, here’s an Adderall. No, it may not just be Adderall.”

It’s a conversation being had across the country, from Los Angeles, where the nation’s second largest school district is putting naloxone in every K-12 school, to PTA meetings in Arlington, Virginia.

“As a medical professional, if we’re teaching kids to put condoms on bananas, we can teach kids to put Narcan up someone’s nose,” said Dr. Sulman Mirza, a pediatric psychiatrist, during the Arlington meeting last month.

King, who campaigned to get epinephrine and steroid inhalers into the school nurses’ office across Ohio, said the call for naloxone must come with funding for training and education to end stigma.

“Schools already have emergency preparedness plans. We prepare for tornadoes, we prepare for chemical exposures, we prepare for fires, and certainly we prepare for other kinds of health emergencies. This health emergency is no different,” she said.

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(NEW YORK) — A Texas woman said she had to wait until she developed sepsis before physicians could provide her with life-saving abortion care.

Texas has several abortion bans in place that prohibit nearly all abortions, except when a mother’s life is at risk or there is a risk of serious bodily harm. The state has civil and criminal penalties for performing banned abortions.

One of the bans prohibits abortions after fetal cardiac activity has been detected, which meant that doctors couldn’t provide her immediate emergency care, which she would have had access to in states where abortion is not banned or restricted.

Kristen Anaya’s medical records, obtained by ABC News, show she waited 22 hours between when she was admitted to the hospital to when she delivered her baby, despite her spiking a fever and shaking uncontrollably within an hour of arriving.

Anaya said she and her husband Stephen went to see a specialist two years into their marriage, hoping to get pregnant.

After her husband underwent a medical procedure and she went through two rounds of egg retrials for in vitro fertilization, doctors told them they had one embryo, she said.

Anaya said she had the embryo implanted in January and found out she was pregnant nine days later. The couple was elated. Anaya has one 20-year-old son, but this would be her husband’s first child.

Four months later, Anaya said her water broke and she began leaking amniotic fluid — which is essential to keep a fetus alive.

After consulting with her OB/GYN, the couple drove to the hospital and Anaya lost a significant amount of amniotic fluid within the next hour.

An ultrasound confirmed that she had lost nearly all her amniotic fluid, but the baby’s heart was still beating, according to Anaya’s medical records. As she was being examined by a doctor, Anaya began having rigors — shaking uncontrollably — and spiked a fever, both an indication of an infection which could lead to sepsis, the medical records show.

“The pregnant patient has a life-threatening physical condition aggravated by, caused by, or arising from a pregnancy, That condition places the pregnant patient at ‘risk of death;’ That condition poses a ‘serious risk of substantial impairment of a major bodily function’,” doctors wrote in her admission medical records.

It was only a few hours later, when they spoke with Anaya’s OB/GYN, that the couple said they realized their baby girl — who they named Tylee — would not survive.

But the couple had no time to process the devastating news — Anaya’s OB/GYN told her she would “get very sick,” before doctors could help her, she told ABC News.

“So it would have been avoidable — me going into sepsis — if they were able to induce labor. The quicker they could get Tylee delivered, the better chance they had at me not going into sepsis. However, Tylee still had a heartbeat,” Anaya said.

“My husband and I are being told that ‘not only did we lose Tylee, but now you’re gonna go into sepsis and there’s nothing we can do about it other than watch you because of the abortion laws in Texas,'” Anaya said doctors told them.

According to her medical records, Anaya’s physician “initiated contact with the termination committee” — a committee of physicians who must approve any abortion care at the hospital — upon her admission to the hospital, a step which is not required of physicians in states where abortion is legal, according to Dr. Aileen Gariepy, an OB/GYN and assistant professor at Weill Cornell Medical College. Gariepy was not involved in treating Anaya.

If Anaya was a patient in New York, she would have been able to get abortion care immediately. The fever and chills were an indication of an infection and left untreated, sepsis is fatal, Gariepy told ABC News.

“That would be an indication to proceed immediately to start some kind of intervention to end the pregnancy. We can give antibiotics, but the cure is to deliver the pregnancy,” Gariepy said.

“There would be no state laws prohibiting us from giving her the highest level of medical care,” she said.

An ethics committee also had to approve the abortion, Anaya and her husband said.

“As a husband, now I’ve lost my daughter and now I could potentially lose my wife and the doctors kind of have to let it happen. That doesn’t make sense,” Stephen Anaya said.

Kristen Anaya said she then began to get sicker, with a high fever, shaking uncontrollably for hours and vomiting at least 8 times.

“They were going to be monitoring me, doing bloodwork every three hours, monitoring my vitals and ‘building a case’ to prove that my life was in great danger and they needed to induce labor,” she said.

Medical records show that Anaya’s lactic acid reached 2.8 mmol/L before she was induced — the normal range is between 0.4 to 2.0 mmol/L. Her white blood cell count went up to 17.6 k/uL, while the healthy range is between 4.5 to 11 k/uL.

When she was admitted to the hospital, her lactic acid was 1.5 mmol/L and her white blood cell count was 12.3 k/uL, according to her medical records.

“I was crying, asking for help. And I remember them literally not saying anything. [The doctors and nurses] would just literally look at me and look at Stephen and they’re just blank. There’s literally nothing they could do,” Anaya said.

She added, “I’m freezing, shaking so hard that I had body aches for a week after getting discharged from the hospital because my body was so tense and just shaking uncontrollably.”

Once Anaya’s test results met the threshold doctors had set, the hospital approved the abortion. She still had to wait from 30 minutes to an hour until the paperwork was in the system before her labor could be induced, according to her.

Despite a dilation and evacuation procedure being more effective at removing all the fetal tissue and the placenta, according to Gariepy, Anaya said she was only offered a labor induction.

The placenta usually detaches itself once a pregnancy is full term. By inducing labor and not performing the surgical procedure there is a risk the placenta will not be delivered, Gariepy said.

“There’s a 25% chance of still needing surgery [after induction] because the placenta get stuck,” Gariepy said.

Even after receiving four rounds of induction medication, Anaya’s placenta was not delivered, according to her medical records.

She has since needed two dilation and curettage procedures to remove the placenta and stop her bleeding. The first was during her 5-day hospital stay.

Then, Anaya began bleeding heavily in early May and needed a second procedure to remove placenta tissue, her medical records show.

The hospital where Anaya received care, and her physician did not immediately respond to ABC News’ request for comment.

She said she is still having pain and complications and her cervix was still dilated at an appointment last week, despite delivering on April 16. Doctors said her uterus still does not look normal, Anaya said.

“I’m kind of in a gray area, I’m not taking the path of recovery that they would expect. Because I’m still having some complications,” Anaya said. “They’re really unsure as to why I’m still feeling the way that I’m feeling and so we’re kind of gonna wait and see.”

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