Concerns Raised About W.Va. Naloxone Bill

May 25, 2015

A law that goes into effect on May 27 allows police officers and those close to addicts to carry the opioid overdose antidote drug Naloxone. While law enforcement officials generally agree that it’s a good idea to carry the drug, there are some questions about safety, training and exactly how the new law will be implemented.

“I totally agree with trying to address the problem at its root but there are a lot of other issues that have to be overcome along the way,” Morgantown Police Chief Ed Preston said. 

 

When Preston found out earlier this year his officers could be asked to not just carry, but also administer a drug that reverses an overdose, he was a little cautious.  

 

“You have to look at it on a much broader scale of how do you implement it, how do you train it, how do you acquire it, how do you pay for it and how do you maintain the program after you get it?” he said.

 

And those same questions are being asked by law enforcement officers across the state. 

 

Naloxone training

Backed by Gov. Earl Ray Tomblin and approved by lawmakers this session, a new law taking effect in West Virginia calls on all first responders — EMTs, firefighters and police — to carry Naloxone. Administered either through an autoinjector or a nasal spray, the prescription medication reverses an opioid overdose and, if followed quickly with more intense medical care, can save a person’s life. 

 

Medical professionals, including Dr. Michael Mills, say if the drug is administered to a person who is not overdosing, there is no harm. Mills is the medical director at the West Virginia Office of Emergency Medical Services. He said that if there is an adverse effect from Naloxone, it's usually caused by an allergic reaction to the preservatives in the medication.

 

“In my 33 years of using this medication, I’ve never had one allergic reaction,” Mills said.

 

But law enforcement officials across the state, like Chief Preston, are still apprehensive. Preston believes there is a risk of cardiac arrhythmia, so he wants to make sure his officers are taught to recognize the signs of a heart attack, as well as how to administer Naloxone.

 

Overcoming Resistance

Gary Tennis said the uneasy feelings some West Virginia law enforcement officials are displaying are common.

 

“Historically across the nation, there has been some resistance on the part of police,” he said.

 

  Tennis is the Secretary of the Pennsylvania Department of Alcohol and Drug Programs. His agency has overseen the distribution of Naloxone to police departments across that state for the past 6 months, police departments that at first also pushed back.

 

“Any resistance on the part of police is overcome when the facts are laid on the table,” Tennis said. 

 

So to curb the concerns in Pennsylvania, his office put together a training course on how to use Naloxone. West Virginia is in the process of doing the same. 

 

Training

Because EMS personnel have been carrying the drug in the state for some time, the West Virginia Office of Emergency Medical Services was tasked with developing the state’s training program.

 

“We will be talking about side effects, we will be talking about what happens when the patient begins to regain consciousness,” Mills said. “We will emphasize that they need to dial 911 as they administer the medication so that more advanced care can arrive and treat other injuries or other aspects of the overdose, complications and then transport the patient to the hospital.”

 

OEMS educators began training contractors how to administer Naloxone on May 18. Those contractors will then go out into their regions of the state, conducting trainings with first responders. 

 

Paying for Naloxone

While the training will cover both forms of Naloxone, West Virginia police departments will be encouraged to carry the nasal spray over the autoinjector, partially because of price. The injectors can cost up to $400, while the spray can cost up to $60. 

 

In Pennsylvania, Secretary Tennis says he is paying for their program by soliciting donations from insurance companies. So far, the state has collected more than $400,000 to purchase Naloxone since November. In West Virginia, the funding part hasn’t been worked out just yet.

 

Chris Stadleman, a representative from Gov. Tomblin’s office, said Tomblin has written to U.S. Department of Health and Human Resources Secretary Sylvia Burwell about potential federal funding, but nothing has been secured. Private funding is something the office is still looking into. 

 

A Police Officer’s Caution

“There’s times you’ll give Narcan, it’ll react with whatever they’ve taken and they’ll become extremely violent, which could pose a danger to the public and other people around,” said Officer Andrew White, of the Whitesville Police Department in Boone County. 

 

He is also an EMT and said he has experienced the violent aftereffects of pulling someone out of an intense high using Naloxone. White calls it by the brand name Narcan.

 

But Tennis said that in the 6 months the program has been in place in Pennsylvania, none of his officers have experienced that type of violence.

"Well, this drug saves lives and that's the most important thing we need to focus on." -Dr. Michael Mills

“I’ll tell you in Delaware County where there have been over 40 saves, the police have had zero instances of people being violent,” Tennis said. “Sometimes they’re agitated, sometimes they’re upset and disoriented, but no instances of violence.” 

 

Storing Narcan

And then there’s the issue of storing Narcan in a police cruiser, which depending on the season, could be extremely hot or extremely cold. The manufacturer recommends the drug be stored between 59 and 86 degrees Fahrenheit. 

 

“So the Troopers have to bring the kit in and out of the vehicle before and after every shift,” said Trooper Adam Reed, who is a public information officer with the Pennsylvania State Police Department.

 

Implementation

With all of the reassurances that West Virginia officials expect to come through proper training, though, there’s still one issue. 

 

The timeline. 

 

The bill was signed March 9, the first training was offered May 18 and the law officially takes effect May 27.

 

“It’s just not going to happen,” Morgantown Police Ed Preston said. “It’s just too quick of a timeframe for an agency like us. And I’m pretty sure that most of the agencies in the state are in the very same boat that we are.”

 

That is one concern the state hasn’t considered yet. But Dr. Mills said the Office of Emergency Medical Services plans to offer its training courses on Naloxone indefinitely.

 

“Well, this drug saves lives and that’s the most important thing we need to focus on,” Mills said.