Naloxone has been available for more than 40 years, and for much of that time, it was largely found in hospitals. But it has become increasingly common outside of them as the opioid epidemic has spread, and is now often found at the fingertips of law enforcement officers. In recent years, laws have changed to allow schools to keep it on hand and administer it to whoever needs it. In New York, for example, public health law was amended in 2015 to authorize school employees to administer naloxone.

Through the state’s program, New York schools can now receive two doses of generic intranasal naloxone in a little nylon bag; the kits cost about $66, the State Health Department said, though schools get them for free. The drug is also available under the brand name Narcan, which is a nasal spray, and Evzio, which is an auto-injector like an EpiPen. Evzio is the most expensive, with a list price of $4,100, according to Kaléo, the company that makes it.

New York City schools are not stocking it because, officials said, they “have not seen the need.”

Many schools have chosen to stock Narcan because they can get it for free. A partnership between Narcan’s producer, Adapt Pharma, and the Clinton Foundation, offers any high school in the country two free doses of Narcan. Adapt Pharma covers the cost of the medication, and the Clinton Foundation does outreach to schools and districts. In an indication of the reach of the epidemic, President Bill Clinton said last year that three of his friends had lost children to opioid overdoses.

An Adapt Pharma spokesman said about 1,300 units have been distributed so far to schools in 15 states, including Pennsylvania, Massachusetts, Kentucky, Delaware and New Hampshire. After the free supply runs out, schools can buy more for $75 a carton, which contains two doses. The list price for that amount is $125, Adapt said.

“I don’t see this as a big land-grab for market share,” said Daniel Raymond the deputy director of policy and planning at the Harm Reduction Coalition, which provides trainings on health issues related to drug use. "Ultimately, schools are going to be a niche market compared to other purchasers of naloxone.”