Despite legislative initiatives to expand the use of the antidote, naloxone to save the lives of opioid overdose victims, many police departments cannot or will not do their jobs.
The United States is in the middle of an opioid and heroin crisis that continues to go unchecked. Governors have called for heroin and overdose task forces to conduct research and make recommendations to curtail the rising overdose death rates. More states are expanding access to naloxone and enacting 911 Good Samaritan legislation that protects the victim and caller during an overdose emergency. Unfortunately, unless there is money budgeted for police training and the opioid antidote, as well as public awareness that law enforcement will carry the antidote and not arrest; death from overdose will continue to rise.
In June, Robert Childs of North Carolina Harm Reduction Coalition presented a report concerning the use and attitudes of naloxone. In part it states that although police may believe that naloxone will save lives, most states do not have enough naloxone training or naloxone available for their departments. In addition, police departments along with other first responders are wary of liability issues that may go unanswered within their state and fail to respond. EMT's( Emergency Medical Teams) question whether giving naloxone to police officers saves lives or is a waste of budgetary dollars. EMT's may claim that police do not have enough training in recognizing an overdose, may use naloxone when not indicated and are not in a position to give follow-up care.
In many parts of the United States, local police arrive on the overdose scene well before emergency personnel and have no tools to address the true needs of an overdose victim. EMT's and ambulances arrive too late and individuals die in route to hospitals. Police are left helpless and families are left in despair. Rural communities where heroin use has yet to peak may be the most vulnerable of all. EMT's may be volunteers, hospitals are miles apart and communities may depend on part time police officers and naloxone is in short supply.
Complicating the overdose response is the complexity of 911 Good Samaritan and Naloxone Laws. Many states have limited protection 911 Good Samaritan Laws that are so difficult to understand that the public is confused as to whether they are protected from arrest when calling 911. Although naloxone legislation may state that naloxone will be made available to first responders, there is confusion as to who actually is included in the definition of "first responder" within state legislation. Police officers, school and college nurses, pharmacists, caregivers and loved ones question if they are liable if they obtain naloxone or administer naloxone in an emergency.
To help distribute naloxone, pharmaceutical companies that manufacture naloxone have made good will naloxone donations to select police departments, non-profits, harm reduction centers as well as community centers; yet that is not a long-term solution. First responders cannot count on arbitrary donations to replace a product that is easy to use, fits in a pocket, and is proven to save lives, it is a good will effort for publicity that can not be sustained. There must be a budgetary line for the antidote that meets the needs of the public.
Although naloxone has been used in hospitals for years, asking for naloxone today comes with the connotation and stigma that follows "drug users." Statements may be heard from first responders that naloxone miraculously revives drug users just so they can go use again, frustrating legislators and the public alike. This frustration is fueling calls of forced drug treatment after naloxone administration and hospital holds. Supporting and providing availability of naloxone has taken on the same stigma and contempt that the public has toward those that use drugs.
Naloxone should not be viewed as a medication that is exclusive for so called "overdosing drug addicts." Proper use of naloxone may be warranted in other emergency situations. Accidents happen; a young child may ingest a parent's or grandparent's medication, a teenager experimenting with drug and alcohol use may not realize what they have taken, college students in transition may think they are fine when partying but are not, adults may mix pain medication with glasses of wine and the elderly may have new pain medication that interacts with other medications. Naloxone should be readily available in these situations.
In addition, drug education and overdose recognition as well as proper CPR and naloxone training should be standard for all first responders and incorporated into every school children's health education class. Parents as well as loved ones need training to recognize a possible overdose, stay calm, call 911 and understand how to administer naloxone if needed. Naloxone should be viewed as standard medicine in first aid kits in every police department, school and home to prevent a possible opioid poisoning.