Opiate painkiller overdoses are at epidemic levels in the United States, but the public health and public safety systems have not adapted sufficiently in response. A simple, inexpensive and life saving reform would be to have police, firefighters and other first responders carry naloxone (aka Narcan) as standard equipment.
Naloxone is a medication that reverses the effects of opiate overdose for about 30 minutes, which can be the difference between getting someone to the hospital and needing to get them to the morgue. There is some medical risk in its administration, but certainly less than letting an overdose persist. Because it is available as an intranasal spray formulation, no training in injection is needed in order to administer it. Naloxone administration should be accompanied by some basic life support (e.g., putting people in the recovery position, checking for airway blockage, doing CPR if necessary), but first responders already have those skills. They can therefore be trained to add naloxone administration to their clinical repertoire at little marginal cost.
Police in Quincy, Massachusetts have started carrying naloxone and the Boston Globe reports that they are reversing about one opioid overdose every 10 days. Disappointingly, firefighters have thus far refused to do so, even though they have had the training. I hope they change their minds before someone dies needlessly on their watch.
I have been working with my home state of West Virginia on this issue, after testifying about naloxone in front of a committee chaired by a legislator who is also fortunately enough a physician (Senator Ron Stollings, M.D.). The Senator is lead sponsor on a bill to equip first responders to carry and administer naloxone; it passed the senate unanimously last week.
Relative to other things I have advocated for over the years, it wasn’t hard to get elected officials interested; I think the lack of naloxone availability in the U.S. stems less from strong opposition to it (though there is some of that, as the Quincy firefighters demonstrate) and more from most people not having heard of the medication or understanding how it can enhance public health. I hope therefore that everyone who lives in a city or state with an opiate overdose problem will spread the word to their elected officials. Their ears may be more open than you imagine.