As of January, police departments in 38 states nationwide are now carrying naloxone (brand name Narcan) to use in narcotic overdoses. Naloxone has long been an arsenal in paramedic drug boxes everywhere; it’s sad to say but a lot of our calls for service have to do with some kind of substance abuse.
But with the recent spike in opioid abuse and overdose, Narcan has found its way into the hands of basic life support providers, police and even civilians. There is even a call for it to be placed in schools, for nurses to dispense if need be.
The opioid drug class includes heroin, oxycodone, hydrocodone (Vicodin, Norco), morphine, fentanyl, and the newest deadly player, carfentanil. Opioid effects include respiratory depression to the point of respiratory and cardiac arrest, pallor, sweating, vomiting, and usually render the user unresponsive. And while most of these drugs have clinical indications and therapeutic effects, opioids are the most abused drug class in the nation.
It’s no secret that Americans have a love affair with opioids, especially prescription narcotics. At the end of 2016, several news agencies reported that 80% of the world’s opioid production was consumed in the United States. Considering that we make up only about 5% of the earth’s population, that’s a frightening statistic. What’s more frightening is that more than 99% of the hydrocodone manufactured in the world is being used by Americans.
Over 300 million pain prescriptions were written in 2015, a $24 billion boon for big pharmaceutical. Prescription opioids kill more people in the U.S. than every other drug combined. I think it is pretty safe to say that we are in a pandemic-level crisis with opioid consumption. (You can read more here.)
Naloxone (Narcan) works quite simply. It enters the system quickly, binds to the opioid receptors in the brain, booting out any other narcotic present, and reversing the potential deadly effects. And, it has zero risk associated with its administration. If it isn’t indicated, giving it to an overdose won’t hurt them. The body just excretes. But when it works, it works immediately and lasts anywhere from 30 to 60 minutes.
If you’ve ever worked in EMS and given naloxone to an unresponsive drug overdose that looked dead, you know exactly what I’m talking about. Within less than a minute, the patient s awake, breathing, talking, sitting up, and usually very surprised to see a room full of uniforms staring back at them.
So, the movement to provide it to law enforcement agencies, given these statistics, is a logical one. The officers receive special training in recognizing the signs of an opioid overdose and carry kits that allow them to administer it nasally as a spray, rather than dealing with needles (paramedics usually give Narcan intravenously). That way, the life-saving drug is on board until EMS can take over.
And with EMS/FD resources being stretched thin these days due to high call volume and shrinking budgets, getting LEOs involved in first responder medical care is a positive thing. Most agencies already carry AEDs (automated external defibrillators), perform CPR and can render basic first aid like bleeding control.
The U.S. Department of Health and Human Services is calling the opioid overdose death rate an epidemic. And the American Society of Addiction Medicine (AMSA) cites more than 52,000 opioid overdose deaths since 2015. And the numbers are growing. More than 20.5 million Americans are reported to have an opioid addiction. The Washington Post reported in December that the Centers for Disease Control and Prevention confirmed that opioid overdose deaths now outnumber gun homicides in the country.
Of course, there will be dissenting opinions on whether or not cops carrying Narcan is a good thing or a dangerous one. In EMS, we are slow to adopt change in industry that is in constant flux, but us dinosaurs are quick to buck any deviation in protocol rather than embrace it.
Of the EMS personnel I have discussed this with, the opinions are split down the middle. Some feel it’s great that law enforcement will have another tool to help save lives, especially considering some of our longer response times. Others think the police need to stick to crime fighting and leave the medical stuff to the attending clinician.
Here’s my take: if law enforcement is willing to go through this training, carry the drug and be ready to use it, fantastic. A local deputy has already used his, and helped a patient survive until paramedics could take over. It’s another weapon in their arsenal. I’ve always appreciated police involvement no matter the call. When things get serious, all hands on deck is my favorite thing.
Here’s a list of the states carrying naloxone (Narcan) right now:
- New York – 201 departments
- New Jersey – 148 departments
- North Carolina – 92 departments
- Illinois – 64 departments
- Pennsylvania – 61 departments
- Ohio – 50 departments
- Massachusetts – 49 departments
- Michigan – 49 departments
- Oklahoma – 33 departments
- Georgia – 32 departments
- Indiana – 30 departments
- Rhode Island – 26 departments
- Colorado – 19 departments
- Wisconsin – 18 departments
- Connecticut – 13 departments
- Maryland – 12 departments
- Washington – 9 departments
- Delaware – 8 departments
- Kentucky – 8 departments
- Virginia – 7 departments
- Maine – 6 departments
- California – 5 departments
- West Virginia – 5 departments
- New Mexico – 4 departments
- Oregon – 4 departments
- South Carolina – 4 departments
- Florida – 3 departments
- Minnesota – 3 departments
- Tennessee – 3 departments
- Missouri – 3 departments
- New Hampshire – 2 departments
- Vermont – 2 departments
- Arizona – 1 department
- Mississippi – 1 department
- Texas – 1 department
- Utah – 1 department
With the national opioid abuse crisis showing no signs of stopping, you can expect to see more law enforcement agencies adopt this program as well.
Disclaimer: The content in this article is the opinion of the writer and does not necessarily reflect the policies or opinions of US Patriot Tactical.
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