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Opioid overdoses are an important public health concern. Concerns about police involvement at overdose events may decrease calls to 911 for emergency medical care thereby increasing the chances than an overdose becomes fatal. To address this concern, Washington State passed a law that provides immunity from drug possession charges and facilitates the availability of take-home-naloxone (the opioid overdose antidote) to bystanders in 2010. To examine the knowledge and opinions regarding opioid overdoses and this new law, police (n = 251) and paramedics (n = 28) in Seattle, WA were surveyed. The majority of police (64 %) and paramedics (89 %) had been at an opioid overdose in the prior year. Few officers (16 %) or paramedics (7 %) were aware of the new law. While arrests at overdose scenes were rare, drugs or paraphernalia were confiscated at 25 % of the most recent overdoses police responded to. Three quarters of officers felt it was important they were at the scene of an overdose to protect medical personnel, and a minority, 34 %, indicated it was important they were present for the purpose of enforcing laws. Police opinions about the immunity and naloxone provisions of the law were split, and we present a summary of the reasons for their opinions. The results of this survey were utilized in public health efforts by the police department which developed a roll call training video shown to all patrol officers. Knowledge of the law was low, and opinions of it were mixed; however, police were concerned about the issue of opioid overdose and willing to implement agency-wide training.
A fairly robust research literature that addresses training those at risk for witnessing an overdose in how to recognize and intervene during an emergency exists. However, much less is known about law enforcement officers’ experience and perspectives on overdose. Engaging police in opioid overdose response is critical because they are often the first to arrive at the scene and can provide or enhance effective emergency response, especially in rural and poorly resourced areas. The police also routinely interact with many individuals at high risk for overdose and can facilitate primary and secondary prevention. Law enforcement institutions routinely engage in raising awareness and educational outreach on drug issues, including in schools with a young population that is exposed to prescription opioid use and abuse. Thus, law enforcement professionals and institutions are key stakeholders in building a comprehensive response to the overdose epidemic and should be partners in providing education substantiated by research findings. Among heroin users, research indicates fear of police response as the most common barrier to not calling 911 during overdoses. In a Baltimore study, 37 % of injection drug users who did not call 911 during an overdose endorsed concerns about police as the most important reason they did not call. Several states have enacted laws, commonly called Good Samaritan laws, to encourage calling 911 during overdoses on controlled substances; these laws are in part modeled on college campus alcohol Good Samaritan policies.14 Overdose Good Samaritan laws had been adopted in ten states as of the end of 2012, but they have not yet been evaluated. Generally, the laws include provisions that provide immunity from criminal prosecution for drug possession to overdose victims and to those who seek medical aid. Eight states have passed laws that ease access to take-home-naloxone by allowing the prescription of naloxone (an opioid antagonist or antidote) to persons at risk for having or witnessing an overdose, enabling bystanders to quickly respond in the event of an overdose. Previous research suggests that police are sometimes under-informed, and often ambivalent to public health laws, especially those based in a risk reduction framework.
In June 2010, Washington State became the second state to enact legislation to address these issues (Revised Code of Washington 69.50.315).18 The law included both a Good Samaritan immunity provision for overdose victims and bystanders who seek medical aid, as well as allowed for naloxone to be prescribed to those at risk for having or witnessing an opioid overdose. The law also explicitly allows naloxone to be carried and administered by lay persons. Clearly stated in the law is “The protection in this section from prosecution for possession crimes… shall not be grounds for suppression of evidence in other criminal charges.” Given the persistent concern that interactions between police and people at the scene of an overdose may influence proclivity to call 911 during future overdoses, we examined the experiences, attitudes, and beliefs of Seattle police officers and paramedics with regard to overdose and the 2010 law. Paramedics were included in surveying to triangulate police officers’ responses and also to help address an often contentious point—“Should police be at the scene of overdoses?” We also describe how study findings were used by police to motivate and inform an overdose training video for patrol officers.
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