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Stopping the overdose on the front lines

Narcan (naloxone) is now being carried by Hastings police officers. The kit is pictured here, including the nasal spray for the patient and gloves for the first responder. (Star Gazette photo by Katrina Styx)

For first responders, finding a person in the throes of an opiate overdose can be stressful, to say the least. Among the effects of opioids (including prescription painkillers and heroin) is the slowing of a patient’s respiratory system; an overdose can shut down a person’s breathing and heart completely, resulting in death.

“Unfortunately, by the time a person having an overdose is reached and treated, it is often too late,” wrote Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), in a 2014 blog post.

Now Hastings police officers, who are often the first ones to arrive at the scene, are equipped to bring a person away from that brink and help them recover from an overdose. Their tool is a small package containing an opioid antagonist drug called naloxone (Narcan). Once administered, naloxone can make it possible for an overdose patient to breath on their own within just a couple minutes.

“It’s a lifesaving tool,” said Hastings Fire and EMS Director Mike Schutt

Naloxone works by blocking opioid receptors in the brain. Even in cases where the drugs have already entered the brain, naloxone displaces it “and thus counteracts the use of the drug,” explained Sgt. Rod Risch at the Hastings Police Department.

“This medication definitely saves lives and the sooner it can be administered, the better,” Schutt said.

That’s exactly why police officers are adding the drug to their standard set of equipment.

“Last year, the Hastings Police Department responded to over 1,600 medical calls, and many times we were the first to arrive,” said Chief of Police Bryan Schafer.

And when responding to overdoses, it’s seconds – not minutes – that can mean the difference between life and death, Schutt said.

Not a new drug

Naloxone is not a new drug. It was invented in 1961 and approved for use by the Food and Drug Administration to treat overdoses in 1971. The Hastings Fire Department, which operates its own ambulance service, has been using it since 1995.

But until 2014, first responders and police officers in Minnesota weren’t authorized to administer naloxone. That year, the state passed “Steve’s Law,” which allows doctors to prescribe naloxone to police and others who might be first to arrive in an opioid overdose situation. Prior to that, only paramedics or physicians were allowed to administer naloxone.

The drug went through another evolution; last November, the FDA approved a version of naloxone that can be administered via nasal spray rather than the traditional intravenous method. That, Risch explained, lowers the risk for police, as there are no needles involved.

The Dakota County Sheriff’s Office also has its deputies equipped with naloxone and completed its own training program.

Local efforts

Hastings police got up to speed on how to treat people using naloxone through the Hastings Fire Department. The fire department’s Captain Jamie Stevens led all the training for Hastings police, using both classroom sessions and hands-on practice using mannequins.

Dr. Lawrence Erickson, the department’s medical director, worked with police to create a protocol for the drug’s use.

That protocol is a quick one. Officers first have to determine whether or not an opioid was used, Risch said. They can do that by looking for nearby evidence, such as discarded materials or leftover substances, by observing the symptoms of opioid overdose and recording vital signs. Once opioids are confirmed, they can spray the naloxone into the patient’s nasal cavity.

Risch stressed that, while naloxone is “an amazing drug” that can produce incredible results, responders still need to provide basic life support to help a patient survive an overdose. Naloxone allows a patient who might be struggling to breath or not breathing at all to breathe on their own, and that makes for a better situation than an officer trying to ventilate them.

“The patient still needs to be assisted,” Risch said.

Drug use on the rise

Luckily for Hastings, first responders and emergency medical crews don’t have to use naloxone too often. Schutt said that last year, the fire department responded to seven calls involving a drug overdose, and naloxone may not have been used on all of those. Risch said that, anecdotally, police might respond to a handful of cases each year.

That doesn’t mean it’s not valuable for police to carry.

“It’s one drug we can administer that has a dramatic effect on one’s health and welfare,” Risch said.

He likened it to the defibrillators on squad cars and throughout the community. Although they’re not needed often, when they are needed, they can save lives.

And, across the nation, opioid overdoses are increasing.

Across the state and the region, “we’re seeing a rise,” Schutt said.

According to NIDA statistics, deaths from prescription opioid pain relievers and heroin have been increasing each year on a national level.

“And we’re not immune,” Schutt said.

That’s why he’s happy to see naloxone added to police and sheriff squads.

“Our goal is to have a good outcome for the patient,” he said.