Changing laws, attitudes of police response to drug overdose may lead to better outcomes

(Press-News.org) PROVIDENCE, R.I. – A recent study from Rhode Island Hospital has found that a change in the way police respond to drug-related overdose emergencies could contribute to improved outcomes of the victims and to the communities where overdoses occur. The study found that while law enforcement officers often serve as medical first responders, there is a lack of clarity as to what police can do, or should do, at the scene of an overdose. The study is published online in advance of print in the journal Drug and Alcohol Dependence.

The study included interviews to better understand and prevent nonmedical prescription opioid use and overdose deaths in areas of Rhode Island and Connecticut that are experiencing overdose "outbreaks."

"Police officers are often limited by available resources or protocol when it comes to responding to overdose," said principal investigator Traci C. Green, Ph.D., a research scientist in Rhode Island Hospital's department of emergency medicine. "While some expressed negative attitudes toward people who use drugs, others were empathetic and simply frustrated with the lack of drug treatment, the cycle of addiction, and the ease with which people can access drugs in their communities."

Green continued, "Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations." Naloxone (also known as Narcan) is the standard antidote used by paramedics to stop overdose and restore breathing in an overdosing victim. Some communities, like Quincy, Mass., have seen expansion of first responder administered naloxone to include police, an effort supported by the White House's Office of National Drug Control Policy as part of addressing the prescription opioid epidemic.

According to the Centers for Disease Control and Prevention (CDC), nearly three out of four prescription drug overdoses are caused by prescription painkillers, or opioids. In fact, there were 14,800 opioid overdose deaths in 2008, more than cocaine and heroin combined. And in 2010, more than 12 million people in the U.S. reported using prescription painkillers either without a prescription, or to get high.

Opioid pain relievers, such as oxycodone, hydrocodone and fentynal, are the most commonly involved type of drug responsible for unintentional drug overdose. These types of overdose have increased significantly in rural and suburban areas, where individuals have less immediate access to emergency medical care. In these areas in particular, providing law enforcement with the tools and training necessary to administer naloxone to reverse a drug overdose could have a significant impact on the death rate from unintentional opioid overdose.

"Educating the public about overdose incidents, the prevalence, and the importance of prevention could go a long way toward aligning public health and criminal justice objectives, and ultimately reducing the number of overdose deaths," Green said.

Green continued, "In addition to saving lives, providing law enforcement officers with naloxone, and proper training for administration may also improve the relationships between law enforcement and their respective communities."

### The study was funded by a grant from the Centers for Disease Control and Prevention (grant number 5 R21CE001846-02). Green's principal affiliation is Rhode Island Hospital, a member hospital of the Lifespan health system in Rhode Island. She also has an academic appointment at The Warren Alpert Medical School of Brown University. Other researchers involved with this study include Nickolas Zaller of The Miriam Hospital and Alpert Medical School; Wilson R. Palacios, University of Southern Florida, department of criminology; Sarah Bowman and Madeline Ray of the Rhode Island Hospital department of emergency medicine; Robert Heimer, Yale School of Public Health; and Patricia Case, The Fenway Institute, Fenway Health, Boston.

About Rhode Island Hospital Founded in 1863, Rhode Island Hospital in Providence, R.I., is a private, not-for-profit hospital and is the principal teaching hospital of The Warren Alpert Medical School of Brown University. A major trauma center for southeastern New England, the hospital is dedicated to being on the cutting edge of medicine and research. Last year, Rhode Island Hospital received more than $55 million in external research funding. It is also home to Hasbro Children's Hospital, the state's only facility dedicated to pediatric care. For more information on Rhode Island Hospital, visit http://www.rhodeislandhospital.org, follow us on Twitter @RIHospital or like us on Facebook http://www.facebook.com/rhodeislandhospitalpage.