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Poor policy penetration and implementation gaps observed here have been identified in a previous research. It is not atypical for police officers to exhibit substantial gaps in knowledge of the law related to public health interventions.16 Similarly, research among drug users and other at-risk groups has identified pervasive lack of clarity about the law.27–30 Our findings underscore the critical role of policy evaluation to evidence-based tailoring of public health laws in order to guarantee their positive impact.
The results of this survey were utilized in public health efforts. Survey results were shared with Seattle Police Department commanders, county prosecutors, and health department staff. The police department training unit produced a training video that includes the narcotics commander introducing the law; the prosecutor describing the Good Samaritan component; and the medical director for public health describing the nature of opioid overdoses, how naloxone works, and the research evidence demonstrating the impact of distributing take-home-naloxone on public health. The video has been shown at Seattle Police Department roll calls, and the narcotics commander has also shared it at national law enforcement conferences. It may be viewed at www.stopoverdose.org. In addition, potential bystanders receiving overdose trainings in the Seattle area are informed that police have been trained on the Good Samaritan law and the legality of take-home-naloxone. At this stage, we do not know whether these efforts have led to a change in perceptions, 911 calls, or the rate of overdoses.
Engaging police is a critical component in a comprehensive strategy for curbing the US opioid overdose epidemic. Law enforcement activities, such as searches, questioning, and arrest at a scene of an overdose, represent an important, but by no means the only aspect of the possible role of police in overdose prevention. Given their routine contact with high-risk groups and central role in school-based and other drug education, police are also uniquely situated to promote opioid overdose awareness and response in the community. Law enforcement policies and outreach can encourage help-seeking during overdose events by mollifying concerns about legal repercussions to victims or witnesses.5 Emergency dispatchers—often police department employees—are uniquely positioned to instruct bystanders on lifesaving measures that can substantially reduce the risk of death of injury from opioid overdose before professional help arrives. Equally critical, police officers provide key security coverage for paramedics, as reflected in our findings.
This study is limited by several factors including the reliance upon self-report by respondents; however, we did triangulate information about arrest with paramedics and heroin users. We also surveyed half of each first responder type strengthening the representativeness of the results. This was an exploratory study, and therefore we conducted descriptive analyses. Generalizability is limited by the single city evaluated. Social, political, drug-using, and demographic factors might yield different results in other settings. Nonetheless, the approach to evaluating public health law may be readily transferable to other localities and healthcare topics.
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