Naloxone only works on overdoses caused by opioids. This family of drugs includes prescription painkillers like OxyContin, fentanyl, methadone, and Vicodin, as well as street drugs like heroin. Naloxone will not reverse overdose resulting from non-opioid drugs, like cocaine, benzodiazepines (“benzos”), or alcohol. Given how safe naloxone is, a victim of a non-opioid overdose, or an overdose caused by a mixture of drugs will not be harmed by naloxone. In multiple drug overdoses (e.g., an opioid and a benzodiazepine) it is still worth administering naloxone as it will remove the effects of the opioid and may still reverse the overdose.
Reducing the time between the opioid overdose symptoms and effective intervention is a matter of life and death. Tragically, many victims do not receive timely medical attention. In many cases, witnesses delay calling for help because they do not recognize opioid overdose symptoms or are concerned about getting in trouble with the law. In other cases, emergency medical response may take too long to arrive or the victim may not be discovered until it is too late.
Law enforcement overdose reversal programs are designed to teach law enforcement officers to recognize and reverse an active opioid overdose using naloxone. The idea is that providing law enforcement with the knowledge and the tools to reverse overdoses in the field can reduce the time between when an opioid overdose victim is discovered and when they receive lifesaving assistance. Law enforcement overdose rescue programs are similar to the already widespread efforts to train police in first aid and cardiopulmonary resuscitation (CPR). See a list of existing law enforcement overdose response programs.
Below are a few example law enforcement agencies that have overdose response programs:
Quincy, MA, Police Department
The Quincy, MA, Police Department (QPD) launched its law enforcement overdose reversal program in 2010. Created in partnership with the Massachusetts Department of Public Health, this initiative consisted of training patrol officers how to recognize and reverse opioid overdoses, and equipping them with naloxone. As of October 2015, QPD officers have reversed over 436 opioid overdoses. This program has been widely recognized for its contribution to the fight against the overdose epidemic, and has served as a model for a growing number of law enforcement overdose reversal initiatives across the United States.
Suffolk County (NY) Police Department
Example: In May 2012, the Suffolk County (NY) Police Department began a Narcan Pilot program in conjunction with the New York State Department of Health, initially training 400 officers in several precincts. In the first five months there were 32 opioid overdose (OOD) reversals. Because of this unanticipated success, the Narcan program was quickly expanded to the entire patrol and support divisions. As of October 2015, more than 1,300 officers are certified and there have been 390 successful OOD reversals. In April 2014, the New York State Attorney General, Eric T. Schneiderman, recognized the outstanding success of the Suffolk County Police Narcan Program, which he used as a model for implementation to all law enforcement agencies in the state of New York, an effort currently funded by his office.
Lummi Nation Police Department (WA)
In response to the increase in the number of reported overdose deaths on tribal lands and 20-minute ambulance response times, the Lummi Nation Police Department (WA) requested permission to participate in the overdose prevention program sponsored by the Lummi Nation Tribe. The program trained community members to use naloxone as well as 20 officers in the department and command staff. In the first six weeks of the program, Lummi officers successfully reversed three overdoses. In addition to training the remaining Lummi officers, the Lummi Nation Police Department training is growing to encompass Lummi Housing Security and neighboring First Nations police agencies.
There are a number of collateral benefits to the officers, implementing agencies, as well as to the public at large that are associated with implementing a law enforcement overdose response program. First and foremost, the program can lead to the reversal of possibly fatal overdoses in the community. Additionally, individual officers have cited improved job satisfaction rooted in improved ability to “do something” at the scene of an overdose. Implementing departments report improved community relations, leading to better intelligence-gathering capabilities. Similarly, collaboration between law enforcement, public health, drug treatment, and other sectors on law enforcement overdose response initiatives lead to improved cross-agency communication, and helps take a public health approach to drug abuse.
Some labor unions may consider opioid overdose response and associated training as a change in work conditions or an additional duty, raising the possibility of contract renegotiation. Collective bargaining unit representatives should be consulted early in the process and given the opportunity to address personnel and occupational safety concerns. Agencies concerned about collective bargaining issues can make officer participation in overdose reversal a voluntary activity. Additionally, some union representatives conditioned their agreement on the agency’s explicit policy not to discipline officers if their agency-supplied naloxone kit is lost or stolen.