A new practice

Sept. 05--Perhaps as early as this fall, law enforcement officers around Alamance County will be in the business of administering life-saving medication, at least to patients who have overdosed on opiates.

There's a quick -- and fairly easy, and mostly effective -- fix to reverse the sometimes fatal effects of overdoses from drugs like heroin or prescription pain medications. It's called Naloxone, often referred to as Narcan, and is among the drugs given by Emergency Medical Services to unconscious patients in case they've overdosed on an opiate.

"We all are CPR-certified," Burlington Police Chief Jeffrey Smythe said. "We have been trained to, and routinely do, put hands on people in live-saving circumstances. I think this is an extension of that same type of training, where we're instantly effective in saving people's lives."

Smythe acknowledged that there's a good chance an officer on patrol may arrive at the scene of an overdose call before paramedics do -- not to mention, those officers could find an unconscious person in need of the drug before it's reported.

The Burlington Police Department was the first in Alamance County to jump on board and agree to participate in the local initiative for officers to administer Naloxone, largely initiated by Karen Webb, director of Alamance Citizens for a Drug-Free Community. Several law enforcement agencies in surrounding counties carry Naloxone, including the Guilford County Sheriff's Office, which reversed an overdose in June, according to the N.C. Harm Reduction Coalition, and the Carrboro Police Department, which has reversed overdoses twice this year.

So far, police departments in Elon, Gibsonville, Graham, and most likely Mebane, according to Chief Terry Caldwell, also plan to move forward with training that Alamance County EMS has agreed to provide to officers this fall.

Tracey Saunders, training officer for Alamance County EMS, said training for the police officers is simple and could be done essentially in minutes.

Officers will insert a tool to the end of the vial of Naloxone, allowing it to be used as a fine mist, and spray it into each of the patient's nostrils, at which time it's "delivered across the mucus membrane of the nose, where it's rapidly absorbed and it can reverse the effect of the overdose," sometimes within seconds, said Chuck Mancillas, director of Alamance County EMS.

"If it's not an overdose, there's no harm whatsoever," Mancillas said.

Smythe said when Webb initially approached the department about having officers trained in giving Naloxone, he didn't want to rush into it.

"We're talking about giving medicine to people in the field without being a doctor," Smythe said. "And that's a little tenuous proposition, to say the least."

Page 2 of 3 -- But after doing more research, he learned "there literally isn't a downside to this particular medicine," he said. "When you look at the totality of the circumstances, it's a pretty easy decision to get on board."

At least some of the other law enforcement agencies aren't convinced the perceived benefit is worth the risk of having police officers give out medicine.

Haw River Police Capt. Toby Harrison acknowledged that the fire department and EMS "get on the scene about the same time we do."

"They have more medical training, and it just makes more sense to let them administer it," Harrison said. "We're a small town."

Sheriff Terry Johnson said he has "given it a lot of thought," but has decided not to have his deputies trained in administering Naloxone.

"It's a lot different than in the cities, in that (city) law enforcement is closer when calls come in," Johnson said, adding that if he were a city police chief, he might consider it. "Usually when we arrive, the EMS is already there, and I don't want to look at the liability factor of our officers getting involved and wind up getting sued."

BUT LIABILITY ISN'T much of a concern to most of the rest of the chiefs, or to Burlington's city attorney David Huffman, who cited references to state law protecting those acting in good faith who have been trained in using the drug.

Huffman said he received from the county this week a copy of a memorandum of understanding for the local Naloxone program, and was still looking over it and G.S. 90-106.2, which specifically addresses people treating overdose patients with Naloxone.

The statute "is basically to encourage people to help those that are overdosed," Huffman said. "That would include law enforcement folks and EMS folks, provided they've been trained. And of course that's what we're doing."

Webb said a $9,000 grant from Community Care of North Carolina's Project Lazarus would cover the cost of the officers' initial supply of Naloxone, which Smythe said may come in small kits about the size of a sunglasses case and have an approximately two-year shelf life.

Under the agreement, any time an officer uses one of the vials, once EMS arrives on scene, he or she will be given a replacement kit by EMS.

"It's a use the EMS folks would've had (if we) had not been there," Smythe said. "Their costs are going to be level with what they were before."

Page 3 of 3 -- Mancillas said each vial costs $46, and the atomizer for the officers is only a couple dollars, though EMS primarily administers the drug intravenously or intramuscularly.

And they give it out to patients fairly often.

"Here recently, we're seeing it more and more," Mancillas said. "There have been more than a handful of calls I've been on personally in the past several weeks where we've administered Narcan."

So far this year, Alamance County EMS has given Naloxone to 115 patients.

In a lot of cases, they're administering it to elderly people who aren't illicit drug users.

Naloxone "is not just for someone who's recreationally overdosing on an opioid, but it could be someone in a nursing home or a person at home that's gotten confused or taken too many medications," Webb said.

THOUGH NONE OF the police departments described fatal drug overdoses as being a major problem in their cities, the chiefs on board with the initiative indicated they would rather be prepared should something happen, than have the means to intervene and not be able to.

Just on Friday, N.C. Department of Health and Human Services announced the state was among 16 selected by the Centers for Disease Control to receive funding for preventing overdose deaths from prescription opioids.

North Carolina is receiving $939,000 to stop the increase in overdose deaths, which numbered more than 1,000 in 2014, according to DHHS, "driven by prescription opioid medications and increased heroin use."

"I'd hate to see someone lose their life where we were in a position to do something about it," Gibsonville Police Chief Ron Parrish said.

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