MONTVILLE, CT — An effort to equip Montville’s police officers with the overdose reversal drug naloxone has revealed a tension among law enforcement and medical professionals over how much training police officers should have and the extent to which they should be responsible for medical care.
The drug, more commonly known by the brand name Narcan, blocks the effects of opiates like heroin and can revive people who have overdosed.
Several area police departments and members of two of Montville’s three fire departments, in addition to the Mohegan Tribal Fire Department, already carry individual doses of naloxone, and use them regularly to revive people who have overdosed on heroin and other opiates.
A state law that goes into effect Oct. 1 requires each Connecticut town to equip its first responder agencies with naloxone.
State Police Sgt. Mark Juhola, who is stationed as Montville’s resident state trooper, has been working for months to create and enact a policy to bring the drug to Montville’s police officers as well.
But Robin Salvatore, a Montville officer and the president of the department’s union, said she has expressed multiple concerns about the proposed policy to town officials and has threatened to file a grievance with the department if the policy is enacted without a discussion about the implications of giving police officers the responsibility of medical care.
Salvatore, who leads the American Federation of State, County and Municipal Employees Council 4 Local 2504, said even with the training required to administer naloxone, police officers may not feel comfortable with administering the drug, which carries with it additional medical implications.
“We’re not medical people,” she said. “If we wanted to be EMT’s we would be EMT’s.”
People who have overdosed often vomit or become angry when they are revived, Salvatore said.
“It’s an officer safety concern,” she said.
“You’re over the top of the patient sticking something up their nose,” she added.
All officers who have recently graduated from the state police academy are trained as emergency medical responders, but the certification expires after several years.
The emergency medical response training is not required for police officers using the drug — and some departments have equipped their officers with doses and permitted them to use it on overdose victims without the certification.
But the co-chairman of the Connecticut EMS Medical Advisory Committee said providing police officers with Narcan without certifying them as emergency responders might be short-sighted, and has advised the Montville department to recertify all its officers before they start using the drug — despite cost and time requirement the training requires.
The emergency medical response training empowers officers to correctly identify an overdose, administer CPR, and keep the overdose victim breathing in the minute it can take for Narcan to take effect, said Kyle McClaine, who is also the emergency medical services director at The William W. Backus Hospital in Norwich.
“If the police have stepped up and helped the dying teenager on the street (by administering Narcan) and didn’t breathe for them in that minute…you’ve really not helped,” McClaine said.
Departments that equip their officers with Narcan without requiring them to re-certify their officers in emergency medical care may be moving too soon to use the newest tool in the arsenal against the region’s opioid addiction epidemic without considering the medical and ethical consequences, he said.
Groton City Police Chief Thomas Davoren, who oversaw one of the first efforts in the region to equip officers with naloxone, said his officers are all required to maintain their emergency medical certification because the police department is the city’s primary first responder for medical calls.
The certification requirement means Groton officers are comfortable with administering naloxone, and do it often when they are the first people to arrive at the scene of a possible overdose.
The department paid about $700 for an outside consultant to train the officers specifically in administering naloxone, and $50 per dose to equip department’s 29 officers with the nasal spray, Davoren said.
“It was a little bit of money…and it was actually not a lot of hassle,” he said.
In Waterford, officers let their emergency medical certification training lapse once it expires because the re-certification process is too costly, Chief Brett Mahoney said.
The naloxone training alone has proved sufficient for Waterford officers, who have carried the drug with them since the town approved it almost a year ago.
“I’ve had no pushback whatsoever from our officers,” he said. “They took this as any other assignment.”
He said the officers have been eager to use any tool available to them — including Narcan — to combat the opioid overdoses that have become increasingly common across Connecticut and New England.
But McClaine said he would prefer to see departments pushing for emergency medical training beyond just learning how to administer the naloxone itself.
In some cases, he said, prioritizing CPR or other emergency medical procedures may be more helpful for an overdose victim than emphasizing getting Narcan in them first.
“That’s going to capture more lives than the ‘something is better than nothing’ approach,”‘ he said.
He said he understands officers’ reluctance to take responsibility for overdose victims’ medical care when they have not been sufficiently trained.
“The whole world has found that Narcan is a nice buzzword to help solve the epidemic,” he added, but “when you start walking up to someone and giving them medication, you really are entering in to the treatment of someone as a patient.”
“You’re going to save lives better if you do it the right way,” he said.
Juhola, who first proposed the policy in March, said he’s following McClaine’s advice. He’s trying to get all of Montville’s officers re-certified as emergency medical responders before presenting the policy to the town’s public safety commission.
He said in June that twelve officers are already emergency medical responders, leaving ten to get their certifications.
Salvatore said she’s wary of the cost of that training when the town’s other emergency responders are already accustomed to using naloxone and usually respond to overdose calls before the police department arrives.
“We have four paid fire departments in town…and if you look at the families who have addicted kids, most of them already have Narcan kits in their house,” she said. “It’s a duplication.”
But Davoren said the investment in paying for the kits and training for Groton City police has already paid off in cases that officers can revive an overdose victim before EMS personnel arrives.
“A lot of the times we are the first ones there…and when this began, we used to wait for the ambulance,” he said. “If you’re the first one there and EMS or fire is five or six minutes behind you, that could be a tragedy.”
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