Engaging Law Enforcement in Overdose Reversal Initiatives: Authorization and Liability for Naloxone Administration

Davis, Corey S.; Carr, Derek; Southwell, Jessica; Beletsky, Leo

doi:10.2105/ajph.2015.302638

Cited by 69 publications

(62 citation statements)

References 47 publications

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“…289 Bystanders who have used drugs may also be reluctant to contact the police or medical emergency personnel for fear of being arrested themselves. 290 …”

Section: Drug Policy and Death From Overdosementioning

confidence: 99%

Public health and international drug policy

et al. 2016

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Executive summary In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Johns Hopkins-Lancet Commission is concerned that drug policies are often colored by ideas about drug use and drug dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug abuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, found it important to emphasize that “[d]rug use is neither a medical condition nor does it necessarily lead to drug dependence.” The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, alcohol for which the goal of social policy is to reduce potential harms. Health impact of drug policy based on enforcement of prohibition The pursuit of drug prohibition has generated a parallel economy run by criminal networks. Both these networks, which resort to violence to protect their markets, and the police and sometimes military ...

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“…289 Bystanders who have used drugs may also be reluctant to contact the police or medical emergency personnel for fear of being arrested themselves. 290 …”

Section: Drug Policy and Death From Overdosementioning

confidence: 99%

Public health and international drug policy

et al. 2016

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“…Deaths involving opioid pain relievers and heroin increased 200% between 2000 and 2014 (Rudd, 2015). Training and equipping professional first responders (police officers; firefighters; Emergency Medical Technicians or EMTs), who are often the first to arrive at an overdose emergency, has been advocated widely (Office of the Attorney General, 2014; Davis et al, 2014; 2015; Rando et al, 2015; Childs, 2016). Research has consistently demonstrated that training increases overdose-related knowledge and appropriate use and administration of naloxone (Wagner et al, 2016; Saucer et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Implementation of online opioid overdose prevention, recognition and response trainings for professional first responders: Year 1 survey results

Simmons

Rajan

Goldsamt

et al. 2016

Drug and Alcohol Dependence

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Background This article reports on the first web-based implementation of an opioid-overdose prevention, recognition and response training for professional first responders. The training was disseminated nationally over one listserv in November, 2014. The same year, following Act 139, which mandated the provision of an online training for police officers in Pennsylvania, the Pennsylvania Department of Health approved the training. It was subsequently adopted as the primary training tool for police and other first responders in Pennsylvania and has been used as a training tool by first responders nationally. Methods Analyses employed descriptive statistics to report characteristics of a sample of 387 professional first responders who completed a survey about their experience with the online training. Z-ratios were used to compare independent proportions related to overdose, naloxone, and satisfaction with the training between key subgroups, and paired t-tests were used to compare participant responses to a range of items pre- and post-participation in the training. Results Between January – October 2015, 4,804 first responders took the training; 1,697 (35.3%) agreed to be contacted; of these, 387 (22.8%) completed a survey about the training and subsequent overdose response experiences. The majority (86.4%) were from Pennsylvania, with police representing over half of the sample. Analysis of the post-training survey indicates high satisfaction with content, format and mode of delivery, and high satisfaction with items related to confidence and overdose reversal preparedness. Conclusions This study demonstrates the feasibility and acceptability of implementing online training for first responders in overdose prevention, recognition and response.

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“…Some programmes have additionally factored in around US$10 for staff time per kit (Coffin & Sullivan, 2013). More recently even higher prices have been reported (for example US$60-$80 for a 2 dose rescue kit) (Davis, Carr, Southwell, & Beletsky, 2015), though even at much higher prices naloxone supply to heroin users has been demonstrated to be cost 'What is known about community pharmacy supply of naloxone': A scoping review.…”

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confidence: 99%