All New York City public schools, including elementary and middle schools, must soon carry the opioid overdose antidote naloxone under a bill passed by the City Council on Wednesday.

Since this fall, high schools have all either started carrying the nasal spray — often referred to by the brand name Narcan — or been connected with programs that can provide it, according to Jenna Lyle, a spokesperson for the city Department of Education.

The city is following in the footsteps of Los Angeles and a growing number of U.S. school districts that have begun stocking naloxone amid a worsening overdose epidemic. New York City saw 3,026 drug overdose deaths in 2022 — the most on record — with the vast majority involving the powerful opioid fentanyl, city data shows.

Still, local health officials say schools are not at particularly high risk for overdoses and the measure is just a precaution.

“When equipping schools with naloxone, like with EpiPens or defibrillators, the hope is nobody ever needs to use them but it's important that medicine is available in case of an emergency,” said Rachel Vick, a spokesperson for the city's health department, said ahead of the vote.

The bill passed with a unanimous vote and now heads to Mayor Eric Adams for his signature; it would also become law if he doesn't act on it within 30 days.

Implementing the legislation would cost $93,500 in the first year, including equipping elementary and middle school nurses with naloxone and training them to use it, according to a Council cost analysis. Restocking expired kits and training new staff would cost an estimated $126,000 every two years after that.

A spokesperson for Adams’ office didn’t respond to questions about whether he intends to sign the bill.

Since city high schools began stocking naloxone, no doses have been used, Vick said.

In 2021, five New York City youths between the ages of 15 and 18 died of drug overdoses, Jonathan Giftos, then an assistant commissioner in the city health department, said at a Council hearing on the bill in April. The city doesn’t break out deaths of New Yorkers under 18 in its annual overdose data, and the health department didn’t respond to a request for that figure from 2022.

“We’re very fortunate that overdose rates in young people are extremely low in New York City,” Giftos said at the time.

At the hearing, he pushed back against the idea that it was necessary to stock naloxone in elementary and middle schools.

But Councilmember Rafael Salamanca, who represents the South Bronx, disagreed. Salamanca first introduced a version of the naloxone bill in 2017 after a teacher died of an overdose in a public school bathroom in his district.

“We've gotten complaints from schools in the surrounding areas that they're constantly having to pick up needles, that users are using and disposing [of syringes] on school property and playgrounds,” Salamanca said. “The responsible thing to do is to have [naloxone] accessible.”

Earlier this year, a 1-year-old boy died and three other children were hospitalized after ingesting fentanyl at a home-based day care in the Bronx. All were administered naloxone, the NYPD said at the time.

If the bill becomes law, it would take effect 60 days later. Starting in fall 2024, city officials would also have to report on the number of naloxone doses that are used in schools each year.