Below are several sample resource documents related to liability.
The Bureau of Justice Assistance’s Law Enforcement Naloxone Toolkit is a clearinghouse of resources to support law enforcement agencies in establishing a naloxone program. The U.S. Department of Justice vows to work closely with law enforcement to help combat the opioid epidemic, including expanding access to drugs, such as naloxone, that can help reverse opioid overdose. The Law Enforcement Naloxone Toolkit provides law enforcement with the knowledge and tools needed to reduce opioid overdoses and help save lives.
In the toolkit you will find answers to frequent questions about naloxone and sample documents and templates, such as data collection forms, standard operating procedures, training materials, press releases, community outreach materials, and memoranda of agreement (MOA) between first responders and medical directors. These templates can be downloaded and customized for your own agency.
On November 1, 2017, the White House announced the release of the Fentanyl Safety Recommendations for First Responders. The Recommendations provide first responders with unified, scientific, evidence-based recommendations to protect themselves when the presence of fentanyl is suspected. The recommendations are the result of a Federal Interagency Working Group coordinated by the White House National Security Council. The U.S. Department of Justice served on the Federal Interagency Working Group and is pleased to support the release of these recommendations as a critical first step in keeping first responders safe in the field. Stakeholder associations and organizations representing the medical, public health, law enforcement, fire, emergency medical services (EMS), and occupational safety and health disciplines provided invaluable input to inform the Interagency Working Group’s efforts, and their feedback helped ensure the recommendations are operationally relevant, appropriately tailored to first responders, and conveyed in a user-friendly one-page format. In addition to the recommendations, U.S Customs and Border Protection has produced a companion training video, Fentanyl: The Real Deal, to help first responders protect themselves when the presence of fentanyl is suspected or encountered on the job.
Download the Fentanyl Safety Recommendations for First Responders, watch the first responders' companion training video Fentanyl: The Real Deal for more information.
Providing first aid to an opioid overdose victim carries the same general occupational risk inherent to other first aid activities that are part of policing. Universal precautions should be taken when coming into direct contact with the overdose victim, including moving them into the recovery position, providing rescue breathing, and any other manipulation. Given that a substantial proportion of opioid overdose victims are people who inject drugs, law enforcement officers should be aware of the high likelihood that hypodermic needles may be present on the victim’s person and elsewhere on the scene.
Injection of intramuscular (IM) naloxone carries a remote risk of an accidental needle stick injury (NSI). If the officer experiences an NSI after administering the drug, there is a risk of contracting a blood borne infection, such as Hepatitis C or HIV. Aftermarket atomizers enable intranasal administration of naloxone without using a needle. Most law enforcement agencies have determined that the added expense of purchasing atomizers is worth the occupational safety gains from not having to use needles to administer the drug. The retractable needle system of the EVZIO® naloxone auto-injector is designed to prevent needle stick injury.
Overdose victims rescued by naloxone may experience opioid withdrawal symptoms. In very rare instances when such symptoms are severe, the victim may become combative. This is reported in about one percent of all rescues. There are no reported cases of injuries to law enforcement officers or the victim in the context of law enforcement overdose response programs.
Generally, no. In most states, a legal concept called the Public Duty Doctrine blocks such lawsuits. This means that officers have no legal duty to assist others, even when they are in a position to do so. These protections do not apply to any administrative discipline for violating standard operating procedures.
Many communities across the country have come together to develop strategic plans to address opioid abuse, including the City of Baltimore, the State of New Jersey, the State of Pennsylvania, and the State of Wisconsin. Samples of these plans can be found on the Prescription Drug Monitoring Program Training and Technical Assistance Center website.
See the Community Outreach Letter below for one example of you can highlight partnerships in your community.
Yes, in January 2017, BJA released two funding opportunities as part of the Comprehensive Addiction and Recovery Act (CARA), which is the first major federal substance abuse disorder treatment and recovery legislation in 40 years. The Comprehensive Opioid Abuse Program (COAP) Training and Technical Assistance (TTA) Program and the Comprehensive Opioid Abuse Site-Based Program support CARA’s goals to address the opioid epidemic by encouraging comprehensive, cross-system, data-driven, and evidence-based planning and collaboration among stakeholders from the criminal justice field and substance abuse treatment and recovery system. Under the Comprehensive Opioid Abuse Site-Based Program there is support for overdose outreach projects, which can connect overdose survivors with treatment and recovery services, including naloxone, and educate communities on overdose prevention. The deadline for both of these solicitations is April 25, 2017.
Additional funding is available through the Harold Rogers Prescription Drug Monitoring Program (PDMP).
Each state and territory offers information and support regarding substance use disorders through a state substance abuse agency. The role of a state substance abuse agency is to plan, carry out, and evaluate substance use disorder prevention, treatment, and recovery services provided to individuals and families. Specifically, they oversee treatment centers and counselors in their respective states and, in many cases, supply funding to providers, track state trends, and ensure residents receive the services to which they are entitled.
Examples of promising programs include:
Programs to encourage opioid overdose witnesses to seek help:
Many opioid overdoses are witnessed, but bystanders do not call 9-1-1 because they do not recognize the signs and symptoms of an overdose, or because they are concerned about legal repercussions.
To remove barriers for witnesses of opioid overdoses to call 9-1-1, a growing number of states have passed overdose Good Samaritan laws. These laws shield those who seek help and witnesses from certain criminal charges for drug or alcohol possession. Even in the absence of Good Samaritan laws, arrests at the scene of an overdose are rare in most jurisdictions. Law enforcement agencies are in a unique position to make the public aware of these life-saving policies. However, failure to follow stated policies about arrest or prosecution can detrimentally impact the willingness of drug users, their families, and others to seek help in an emergency.
Example: In Washington State, research suggested that the vast majority of drug users were not aware of the new Good Samaritan law a year after its passage. The State Attorney General was featured in a press conference when the law took effect and he and the medical director of the Poison Control Center appeared in a radio public service announcement to share information about the law. The launch of the video was accompanied by a wide-ranging media campaign to educate the public about the provisions and benefits of the Good Samaritan law. The Seattle Police Department also created a video to be shown at roll call to all patrol officers that featured the narcotics captain, a county prosecutor and the medical director of public health. The video addressed what the law does and does not cover, the basics of what naloxone is, and the fact that public health programs would be distributing naloxone. To address their concerns, community members receiving naloxone were informed that police have received education about the Good Samaritan law and naloxone distribution efforts.
Veterans, residents of rural and tribal areas, recently-released inmates, people completing drug treatment/detox programs, and some young adults are at an especially high risk of opioid overdose. Law enforcement and correctional officers are uniquely positioned to engage in initiatives targeting these high-risk groups, thereby helping prevent fatalities by engaging in outreach initiatives. Individuals re-entering society after a period of incarceration are especially vulnerable. In the first two weeks, formerly incarcerated individuals are approximately 30 times more likely to die of a drug overdose than members of the general public. A number of programs engage law enforcement and correctional staff in educating this population about overdose risk, how to avoid and respond to overdose, and any provisions covering criminal liability of those who seek help.
Example: In Rhode Island’s “Staying Alive on the Outside” program, state prisoners are shown a video about overdose risks as part of the pre-release process. Another example is a program at the Allegheny County, PA, jail, where public health and corrections officials present overdose prevention trainings to inmates prior to discharge. At the jail in Kent, Washington pharmacists train inmates and naloxone is placed in their possession for pick up upon release.
Example: In Indiana, local law enforcement worked in partnership with the Drug Enforcement Administration to revise the drug education curriculum delivered in schools to include key information about overdoses. This includes content covering signs and symptoms of overdose, the substances that are likely to cause overdose, and the considerations involved in calling 9-1-1.
Some law enforcement agencies found it helpful to develop pocket cards or brochures that can be easily distributed. Sample pocket cards and brochures are included in the resources below.