Narcan Policy for Law Enforcement
What you need to implement an overdose reversal program.
- What is Narcan?
- The importance of Narcan policy and training.
- Helpful resources and sample policies.
Law enforcement officers have long responded to incidents related to substance abuse and addiction.
But in the last few years, a new problem is on the rise – drug overdoses.
According to the Centers for Disease Control and Prevention, more than half a million people died from drug overdoses between 2000 and 2015.
Opioid use specifically is increasing, with heroin deaths tripling in the same time period. Every day, 91 Americans die from an opioid overdose.
In September 2016, the U.S. Office of the Attorney General issued a memorandum calling the opioid epidemic a “public health crisis.” The memorandum called for the use of a prescription medicine called naloxone (also known as Narcan) to prevent overdose deaths.
Police officers increasingly end up serving as first responders in drug overdose situations.
Law enforcement agencies need to equip officers with the proper policy and training to respond to these incidents.
In response to the rise in heroin and opioid use, police departments across the country have implemented Narcan programs.
What is Narcan?
Narcan is the brand name of the medical drug naloxone, which essentially serves as an antidote to opioid overdose.
When someone takes too much of an opioid, their breathing slows down and can stop completely.
Narcan blocks the effects of opioids and reverses overdose symptoms.
It works on overdoses of heroin and prescription painkillers such as oxycodone, hydrocodone, and morphine.
According to the Bureau of Justice Assistance, most opioid overdoses are accidents. People may accidentally take too many painkillers or mix drugs with alcohol or other substances.
It can take up to 90 minutes for the person to stop breathing after overdosing.
When used correctly in this window, Narcan can restore breathing within two to five minutes, preventing brain injury and death by overdose.
In the past few years, government and law enforcement leaders have pushed for the expanded use of naloxone.
Law enforcement officers and first responders started carrying the drug, which was usually administered via injection.
In November 2015, the Food and Drug Administration approved a nasal spray version of the drug.
The spray made Narcan much easier to administer.
Since the release of the nasal spray, many more police departments have started using Narcan.
As of December 2016, the North Carolina Harm Reduction Coalition(NCHRC) estimated that 1,214 law enforcement agencies across the U.S. have implemented Narcan programs.
How do law enforcement agencies use Narcan?
Since police officers are often the first people on the scene of an overdose, many law enforcement agencies have started training officers to use Narcan.
These “overdose reversal programs” aim to train officers to recognize an opioid overdose and use naloxone to intervene.
The training often goes hand in hand with CPR training, the idea being that law enforcement may be able to take life-saving action before medical aid arrives.
According to the Bureau of Justice Assistance (BJA), “Law enforcement agencies that have implemented an overdose reversal program report improved community relations, leading to better intelligence-gathering capabilities.”
Reports show that law enforcement Narcan programs have already saved thousands of lives across the U.S.
The NCHRC reports 403 rescues in North Carolina alone as of February 2017.
In January, Pennsylvania Governor Tom Wolf requested that lawmakers set aside $10 million in the state budget to make sure law enforcement has access to Narcan.
He said that law enforcement officers had saved more than 2,300 lives using Narcan.
What are the risks of Narcan?
Narcan has no harmful effects on people who haven’t used opioids.
For people who have overdosed, Narcan may cause withdrawal symptoms, including nausea, chills, and body aches.
Some have argued that this may prompt addicts to seek out another fix after Narcan wears off.
Other critics worried that making naloxone widely available could encourage drug users to push the limits.
However, most law enforcement leaders argue that the potential to save a life far outweighs these potential risks.
In an article on EMS1, Michael Gerber warns against using Narcan reflexively in every potential overdose situation.
“The primary danger with naloxone is that law enforcement officers … sometimes jump to use naloxone without fully evaluating their unresponsive subject.
With the rising cost of the drug, other medical options may be just as effective and more practical.
However they choose to use Narcan, law enforcement agencies need to remember that it is not a cure-all for substance abuse.
Narcan can save lives, but it doesn’t cure addiction. Officers may find themselves using naloxone on the same person over and over again.
True community policing requires agencies to work to address the root problems of addictions.
Police departments need to work hand in hand with other organizations to help with addiction education, prevention, and treatment.
The importance of Narcan policy and training
Like any law enforcement program, overdose reversal should be governed by thorough policy and training.
Most U.S. states now allow law enforcement officers to administer Narcan, but a handful of states don’t.
Departments should make sure policy about overdose response complies with state and local laws. This should include Good Samaritan laws that protect overdose victims or bystanders who administer naloxone from prosecution.
The Bureau of Justice Assistance suggests training officers in naloxone use at least annually.
Narcan policy and training will differ between departments. But law enforcement agencies can collaborate with local health care organizations, EMS agencies, or departments of health to provide Narcan training to officers.
Narcan policy and training should address issues including:
- A basic overview of drug abuse and addiction
- How to recognize the symptoms of overdose
- When and how to administer Narcan
- What dosage of naloxone is necessary
- How to work with people coming out of an overdose
- What to do once the subject is stabilized (how to follow up with emergency medical services, addiction referral programs, etc)
Narcan training should include some sort of hands-on opportunity for officers to practice administering the drug.
It can typically be completed relatively quickly – the BJA estimates that naloxone training usually lasts anywhere from 40 to 90 minutes.
At the end of the training, officers should walk away with the proper documentation authorizing them to possess and use naloxone.
The International Association of Chiefs of Police recommends that law enforcement agencies collect data on all uses of naloxone.
Recording the success of treatments can help researchers study the drug’s benefits and risks.
The IACP also stresses that police departments should continue to emphasize education, treatment, and other law enforcement methods to combat addiction and drug use.
Resources for Writing Your Agency’s Narcan Policy
The Bureau of Justice Assistance’s Law Enforcement Naloxone Toolkit:
The BJA’s toolkit is the best place to start when crafting Narcan policy for your law enforcement agency. The toolkit includes helpful resources about how police departments can obtain and use naloxone.
Sample training materials:
- Massachusetts Department of Public Health – Opioid Overdose Education
- New York State Division of Criminal Justice Services – Opioid Overdose and Intranasal Naloxone Training for Law Enforcement
- NCHRC’s Overdose Prevention Program Guidelines