LAW ENFORCEMENT FAQ ON NALOXONE PROGRAMS
Why can’t we rely solely on EMS to respond to overdoses?
We can and should continue to rely in EMS to respond to overdoses—but not to the exclusion of others who may be the first on the scene. Every second counts in an overdose. It is a medical emergency. With appropriate training, administering naloxone is relatively simple. Having trained individuals in the community makes saving lives easier for EMS. The NC Office of EMS and most local EMS are extremely supportive of law enforcement naloxone programs.
Why are we training law enforcement officers?
Law enforcement personnel are often the first to arrive on the scene of an overdose. Sometimes they are responding to an EMS call; and sometimes, in the course of their work, they just happen to encounter someone who has overdosed. We want to ensure that these officers have the training and the necessary tool, naloxone, to make a difference when it matters most. Many law enforcement officers are already trained in using AEDs (automated external defibrillators) or in administering CPR (cardiopulmonary resuscitation). Adding naloxone to their set of tools will help save lives.
How does one get trained to save the lives of people who have overdosed?
A simple, single session generally lasting less than one hour is all that is necessary for an officer to be trained in recognizing and responding to an opioid overdose. The training is likely to be a joint effort between the North Carolina Harm Reduction Coalition, your law enforcement department, and your local EMS. A standard curriculum has been developed to guide these trainings.
Does my agency need to do anything special so that my colleagues and I can get naloxone?
Yes. Your agency should develop policies and procedures that address its officers intervening in overdoses and administering naloxone. The NC Harm Reduction Coalition is prepared to help your agency by sharing recommended policies and procedures for the administration of naloxone.
How do I get naloxone?
Although naloxone is not a controlled substance, it is a prescribed drug. However, a new law in North Carolina, SB20: 911 Good Samaritan/Naloxone Access law, allows naloxone to be distributed under a standing order model, which means that a medical provider does not need to be present in order to issue a prescription for naloxone. NCHRC can work with your department to order naloxone and to secure a medical provider who can issue a standing order for law enforcement officers in your department to carry and administer naloxone. In most NC law enforcement departments, the naloxone is ordered through the county EMS.
How should naloxone be maintained?
As a general rule, naloxone should be kept as close to room temperature as possible. It should also be kept out of direct sunlight. Your agency’s policies and procedures should address the maintenance of naloxone. However, naloxone maintains 89% concentration even when exposed to extreme hot and cold temperatures for extended periods of time, such as in a car.
How long can naloxone be kept?
Naloxone should be within the expiration date that appears on its packaging. Your agency’s policies and procedures should address maintaining naloxone consistent with its expiration date (usually about 2 years from the date of issue).
Will I have to use a needle to administer naloxone?
No. Naloxone is available in an intranasal form that can be sprayed up the nose and requires no needle. Naloxone can also be found in auto injector form (Kaleo’s Evzio). Naloxone is also available an intramuscular form that does come with a syringe. Intramuscular is significantly less expensive, so it depends on your agency’s budget and preferences. You will receive hands-on training on how to administer both forms.
Can the naloxone harm me or others around me?
No. Naloxone has no side effects and causes no harm even when administered in error to a person who is not overdosing on opioids.
How do I get refills?
Generally the refills are provided by your department.
What is North Carolina’s Overdose Prevention Project?
Since August 1, 2013, the North Carolina Harm Reduction Coalition (NCHRC) has had a program that provides training to individuals in the community on how to recognize an overdose and how to respond to it appropriately. The applicable law is SB 20: 911 Good Samaritan/Naloxone Access law. The appropriate responses to an opioid overdose include calling 911 and administering naloxone (Narcan), an opioid antagonist which reverses the potentially life-threatening consequences of an overdose.
Is this program successful?
NCHRC has distributed over 50,000 kits between August 1, 2013 and October 1, 2017. The distribution includes training on how to recognize and reverse and opioid drug overdose. As of October 15, 2017, the individuals receiving the kits have successfully administered naloxone more than 8500 times according to reports that have been submitted to the NCHRC. The actual number of reversals these responders have been responsible for is likely to be substantially higher.
How many Law Enforcement Departments in the US carry naloxone?
Currently over 1200 US departments carry naloxone. Quincy PD is the most successful program, which has reversed over 500 overdoses. In North Carolina over 180 departments carry naloxone.
Law Enforcement FAQs on Legal Syringe Exchange Programs in North Carolina
What are syringe exchange programs?
Syringe exchange programs collect used syringes from people who inject drugs and exchange them for sterile syringes and access to social services, including substance addiction treatment.
When did syringe exchange programs become legal in North Carolina?
Syringe exchange programs became legal in North Carolina on July 11, 2016, the day Governor McCrory signed House Bill 972 into law (G.S. 90-113.27). House Bill 972 also regulates the release of law enforcement body camera footage.
What services are syringe exchange programs required to provide?
Syringe exchange programs operating in North Carolina are required to provide the following:
(1) Disposal of used needles and hypodermic syringes
(2) Needles, hypodermic syringes, and other injection supplies at no cost and in quantities sufficient to ensure that needles, hypodermic syringes, and other injection supplies are not shared or reused
(3) Reasonable and adequate security of program sites, equipment, and personnel. (Written plans for security shall be provided to the police and sheriff’s offices with jurisdiction in the program location and shall be updated annually)
(4) Educational materials on all of the following: Overdose prevention; the prevention of HIV, AIDS, and viral hepatitis transmission; drug abuse prevention; treatment for mental illness, including treatment referrals; treatment for substance abuse, including referrals for medication assisted treatment
(5) Access to naloxone kits or referrals to programs that provide access to naloxone
(6) For each individual requesting services, personal consultations from a program employee or volunteer concerning mental health or addiction treatment as appropriate
Programs should also provide written verification to all participants that they have received syringes and other injection supplies from the exchange. This can be in the form of a letter or a program identification card.
Who can start a syringe exchange program in NC?
Any governmental or nongovernmental organization “that promotes scientifically proven ways of mitigating health risks associated with drug use and other high risk behaviors” can start a syringe exchange program. This includes, but is not limited to harm reduction organizations, health departments, AIDS Service Organizations and community based organizations (CBOs).
Where will the syringe exchange programs be located?
The location of each program will vary depending on the geographic area and resources of the host organization, but there are several common locations for syringe exchanges. Also, the exact location will be stated in the security plan that each exchange is required to provide to law enforcement prior to implementation.
1) Fixed site exchanges – exchange is located at a fixed site such as a storefront, local nonprofit, church, or public health department
2) Mobile exchange – exchange is run out of a vehicle that travels to various locations to deliver syringes and other services
3) Peer based or home delivery exchange – syringes and other services are delivered to people’s homes or other agreed upon locations
4) Integrated exchange – exchange is integrated into the existing structure of an organization such as a pharmacy, a drug treatment center, an AIDS service organization, etc.
What is the role of law enforcement in syringe exchange programs
Under H972, no employee, volunteer or participant of the syringe exchange can be charged with possession of syringes or other injection supplies, or with residual amounts of controlled substances in them, obtained from or returned to a syringe exchange. Syringe exchange programs will supply a card, letter, or other documentation to each participant stating that they obtained their syringes from the exchange.
Also, organizations that intend to start a syringe exchange program must provide a copy of the security plan to local law enforcement prior to implementation and update it every 12 months thereafter.
What information will be contained in the security plan?
This will depend on the size, location, and resources of the program, but the plan should detail how the exchange will secure syringes and others supplies and take reasonable steps to protect the health and safety of employees, volunteers, and clients.
How can I find out more information about syringe exchange programs?
For more information contact Hyun Namkoong at firstname.lastname@example.org at the North Carolina Harm Reduction Coalition.
For a free training resource on syringe exchange, download the powerpoint made by NCHRC for law enforcement here.