Described below are successful programs in Quincy, Mass., and Suffolk County, N.Y., whose police officers have been using naloxone hydrochloride, also known as Narcan, to counter the effects of opiates and save lives.
One program that has garnered much attention is in the Quincy Police Department. In 2010, under a pilot program, Quincy began requiring officers to carry Narcan, which is used to reverse overdoses from opiates. Opiates include heroin and prescription painkillers such as oxycodone and Percodan. Naloxone can be administered through injection, but police carry and administer the nasal spray form and are trained in its use.
Police are often the first on the scene of an emergency, and in Quincy, police respond to every medical emergency call. Prior to Quincy police carrying nasal Narcan, the communities of Quincy, Braintree and Weymouth experienced a surge in heroin use and had 99 overdose deaths due to opiates in an 18-month period, 47 of which were in Quincy. At the urging of citizens to address the problem, police and the Massachusetts Department of Public Health joined forces and established the pilot program.
Between October 2010 and early December 2013, Quincy police reversed 202 opiate overdoses using nasal Narcan, according to Lt. Detective Patrick Glynn, a veteran narcotics officer who heads the program. The first 18 months of the program reduced the overdose death rate by 66 percent. There have been 27 opiate overdose deaths in the past three years.
“We realized we could not arrest ourselves out of the situation,” Glynn says. “People need help.”
The success of the pilot led to all 200 officers in the Quincy Police Department being required to carry nasal Narcan, whether they are in a police cruiser, the booking unit, the marine unit or community police officers on bicycles. The program has not only saved lives but has eased the relationship between the police and the community. The outreach has paid off in citizen trust of police officers and a more open perception of law enforcement.
“Once the program caught on, the public saw us in a different light and it reduced their fear of calling 911,” Glynn says. “Slowly, we were able to change the perception of the public. The officers represent a chance of a future life without drugs.”
For example, Glynn adds, “A police cruiser was driving down Main Street and a driver behind it was flashing his lights and essentially pulled the police over because a friend was overdosing in 2 the back seat, and the driver knew the police would help. The perception of police has changed dramatically since inception of this program.”
Massachusetts, 13 other states and the District of Columbia have laws to encourage Good Samaritans to summon aid in the event of an overdose (California, Colorado, Connecticut, Delaware, Florida, Illinois, New Jersey, New Mexico, New York, North Carolina, Rhode Island, Vermont and Washington). The laws protect from prosecution overdose witnesses who call 911 or seek help; they won’t be charged with possession of drugs.
In addition, Massachusetts law protects from liability physicians prescribing naloxone and individuals with prescriptions who administer it.
Quincy, with a population of a 93,000, is a shore community that sits about 10 miles from Boston. Any initial misgivings by Quincy officers about the Narcan program were allayed once they began administering it on the street.
“You can see results in 60 seconds, they see immediate results,” Glynn says. “That was the catalyst for the officers to embrace it.”
Glynn says his department has had a number of inquiries from other jurisdictions in Massachusetts and around the United States interested in starting similar programs (e.g., Columbus, Ohio; Portland, Maine; Raleigh, N.C.; Chicago; New York City; and small towns in Kentucky and Mississippi).
“The interest really blossomed once the results began to roll in.”
The Quincy program caught the attention of federal officials, and Glynn received an Advocates for Action citation in 2013 from the Office of National Drug Control Policy.
Narcan blocks the effects of opiates to the brain. Each Narcan dose costs about $22 and is paid for by the Massachusetts Department of Public Health. The Quincy program thus far has cost about $8,000.
“We have received countless letters from people who have been reversed from overdosing,” Glynn says. “Drugs affect the user, family members, everyone in some way so we had to do something, and hopefully the end result is that we get someone into treatment. We have to keep chipping away; we can’t quit.”
For more information, contact Lt. Detective Patrick Glynn at email@example.com or (617) 745-5750.
Suffolk County, N.Y.
An intranasal Narcan program in the Suffolk County Police Department has seen success similar to that experienced in Quincy, Mass.
“We began the program because opiate overdoses on Long Island and in Suffolk County are epidemic,” says Dr. Scott Coyne, medical director and chief surgeon for the Suffolk County Police Department.
Suffolk County’s overall drug overdose deaths (not just opiates) totaled 189 in 2010, 269 in 2011 and 279 in 2012. Heroin overdose deaths rose from 38 in 2010 to 83 in 2012. Oxycodone overdose deaths totaled 58 in 2010, 90 in 2011, and dropped to 62 in 2012. Coyne attributes the drop in oxycodone overdose deaths to the effectiveness of the Narcan program.
Suffolk County, with a population of approximately 1.5 million people, is the easternmost county in the state, surrounded by water on three sides.
The pilot program in the police department, which was sponsored by the New York State Department of Health, was designed to test the ability of emergency medical technicians (EMTs) to recognize the symptoms of opiate overdose and effectively administer intranasal Narcan. The program required anyone administering Narcan to be certified as an EMT. All Suffolk County police officers have been trained as EMTs and are typically first on the scene of medical emergencies following 911 calls.
The police department rolled out the pilot program on Aug. 1, 2012 in three of its seven precincts and in the Marine Bureau, and saw immediate results. The department initially trained 460 officers during the pilot and placed Narcan in sector cars throughout those precincts
“The program was immediately successful,” Coyne says. “In the first month we had five or six documented saves of people experiencing life-threatening effects of an opiate overdose, unconscious and barely breathing.”
At the end of 2012, citing the number of successful nasal Narcan overdose reversals, Coyne recommended that the Narcan program be expanded throughout the department, which was completed in January 2013. Officers are now trained in all precincts, the Marine Bureau and the Emergency Services section. The police department has 2,500 officers, and training has been provided throughout the Patrol Division. The program has trained and certified almost 1,100 officers.
As of early December 2013, the department had recorded 159 documented overdose saves.
“I was totally surprised. The number of opiate reversals is substantially more than we had ever expected. At this point, we are recording several saves each week,” Coyne says. “It’s been a remarkably successful program.”
Officers have embraced the program.
“There has been no resistance. I think the police officers feel great pride and increased confidence to effectively assist victims in these situations. It makes such as difference.”
Coyne notes that nasal Narcan is easy to administer and only acts on the opiate molecule and does no harm if no opiates are present. Administered directly into a person’s nostrils, it is absorbed in the nasal cavity. How quickly results are seen depends on the general physical condition of the overdose victim. “We generally teach our police offices to expect to see significant effects in three to four minutes.”
Coyne notes that the Department of Health attempts to follow up and contact all overdose victims to get them into a treatment program. Although not always successful, the department makes every attempt to follow up.
For information, contact at Dr. Scott Coyne at Scott.firstname.lastname@example.org.