By Leo Beletsky, Elena Moroz
In Massachusetts, opioid overdose is the leading cause of accidental fatality; it ranks third overall behind heart disease and cancer. In this state, 60% of all poisoning deaths are due to opioid overdoses. Communities just outside of Boston, including Quincy and Lynn have been particularly hard-hit. These areas have three times more heroin-related ER visits than the rest of the country. Heroin, not alcohol, is the most common substance of abuse in Abington, Quincy and Weymouth. Other opioids besides heroin are also abused more frequently in New England than any other region of the United States.
In response to the rising number of opiate overdoses in the area over the past 10 years, the Massachusetts Department of Public Health (MDPH) launched a program to facilitate bystander intervention. The Overdose Education and Naloxone Distribution (OEND) program has reached out to thousands of drug users, their caregivers and other members of the community, distributing naloxone and authorizing bystander administration. The program has also expanded to training non-medical first responders, including fire fighters and police, after a group of drug users’ parents, advocated for increased police involvement in the program.
Nancy is the mother of Brendan, who was a college-bound honor student and an athlete at Boston College High School. It was a shock to everyone when Brendan developed an addiction to his father’s pain medication – OxyContin. The addiction lead Brendan to heroin, homelessness, problems with the law and finally a near-fatal overdose event. Kathy’s son Michael also found his way to opioid addiction through painkillers. When Michael suffered a motorcycle accident, he became addicted to Vicodin and later transitioned to heroin, also surviving an overdose.
After sharing frightening first-hand experiences with their sons’ overdoses, Kathy and Nancy combined their efforts to successfully lobby for first responders in their town to carry naloxone. On request from the Chief, the Quincy, MA Police Department underwent OEND training and now carries naloxone while on duty.
This is the first police department in the state (and one of the first across the US) to carry the life-saving antidote. Such programs carry substantial promise because they expand the reach of emergency response without evoking controversy that sometimes accompanies efforts to distribute naloxone to lay bystanders. According to Lieutenant Patrick Glynn from the Quincy police department, naloxone interventions by members of the Department have been successful 100% of the time. The Quincy police officers have reversed at least 61 overdoses since 2010.
The benefits of this program have the potential to go beyond merely reversing overdoses to actually preventing them. Police often play key roles in community education and prevention efforts through frequent interactions with high-risk groups and educational visits to schools. Involving and training law enforcement in overdose response builds capacity to teach others how to prevent, recognize, and reverse an overdose using naloxone, magnifying the positive impact on the community.
The success of the Quincy department highlights the potential role of law enforcement in lifesaving programs using naloxone. Massachusetts state government is considering rolling out similar programs across the state, but questions about the logistics, funding, and other issues remain. In its 2010 and 2012 National Drug Strategy, the Office of National Drug Control Policy stated interest in naloxone training and access for first responders. The promising outcomes of police pilot programs in MA present an opportunity to learn from and disseminate this innovative model.