1,400 Second Chances: Narcan’s Potential to Reduce Overdose Deaths in Virginia

In 2016, 1,400 Virginians died from an opioid overdose. This was a 38% increase from 2015’s death rate. There is a way to lower this figure, and that is through outfitting all Virginia police forces with the overdose reversal drug called Narcan. Narcan is safe, easy to use, and consistently saves lives, and it is not being adequately deployed by Virginia Police Officers.

Narcan is an overdose reversal drug made of naxalone hydrochloride. It works to combat the most lethal effect of an overdose by helping victim breathe again. While Naxalone has been available since 1996, it initially could be only administered by a doctor because it has to be carefully dosed and injected. But in 2015, the FDA approved a nasal spray version of the life saving drug. Now Narcan can be effectively administered by a lay person. According to the Virginia Department of Behavioral Health and Developmental services, Narcan is not addictive, has no potential for abuse, and has no ill effects even if given to a person who is not experiencing a drug overdose. There is also a standing order for Narcan in Virginia, meaning a physician has issued a statewide prescription so that anyone from a civilian to a police officer would be able to purchase and possess Narcan without seeking an individual prescription.

Narcan’s life-saving potential has not been lost on police forces across the country and many have begun to carry Narcan. Even here in Virginia, an eight police forces have adopted Narcan. Still, that leaves several hundred other forces in the state without this powerful tool.

Why hasn’t Virginia police adopted Narcan statewide? The first reason can be attributed to a common misconception. Some have argued that having the police carry Narcan is redundant, as emergency medical vehicles already carry it. In reality an overdose victim begins to have serious brain damage 3-5 minutes after they stop breathing. In Virginia’s rural communities, the time difference between when one emergency vehicle arrives and another can be well over this range. Not only do police need Narcan for when they arrive first to an overdose scene, minutes that are a matter of life and death, but they increasingly need to use Narcan themselves due to accidental exposure to fentanyl. This issue has become so great that the Drug Enforcement Agency issued a warning in June to first responders specifically about fentanyl exposure.

According to the CDC, Fentanyl is a synthetic pain medication that is often used to cut heroin to intensify the feeling. Fentanyl, even in miniscule doses, can be lethal. An amount of fentanyl the size of a grain of rice can kill a grown man whether ingested, inhaled, or even absorbed through skin. A first responder could easily come into contact with fentanyl while helping an overdose victim who has overdosed on heroin cut with fentanyl, or while gathering evidence from a scene. Thus police carrying Narcan not only allows them to help overdose victims, but can be vital to protecting first responders from lethal exposures.

The second component that has slowed statewide adoption is the search for funding. An individual kit of Narcan can cost between $75 and $150 depending on the brand and whether the kit contains one or two doses. Outfitting every single police officer in Virginia would only cost 2 million dollars, less than 1% of Virginia’s annual budget. While this cost is small in comparison to the budget as a whole, obviously this money would still need to come from somewhere. The state could apply for a grant from the Substance Abuse and Mental Health Services Administration, a federal agency that manages 1.82 billion dollars to distribute to states, territories, and tribes to fund substance abuse and harm reduction initiatives.

A slightly more controversial, but perhaps more financially sustainable, way to fund this program would be through instituting an opioid tax. This could take the form of some of the bills that are being considered in California and Alaska, which would propose a tax that is “1 cent per milligram at the drug’s first point of sale.” The money raised would then fund substance abuse prevention initiatives. The slightly increased cost for the consumer would hopefully also shift Doctors towards prescribing non opioid pain management options. Either the tax path or a grant would successfully fund the program.

Training for Narcan use is already offered through a Virginia Department of Health program. While it is not large enough to train the entire state’s police forces, it also has a trainer training program that is only three hours long. Thus a member of each force could come to this training, and then go back and provide a one hour long training course on Narcan use to the rest of their force. This system would allow for training to happen quickly and at a low cost to the state by making us of resources it already has in place.

Narcan is a powerful tool to save lives. It is only one component of ending the epidemic of opioid addiction in our country, but it is a clear first step. While we do need to work on lowering the amount of opioids prescribed and providing more effective drug education in schools, neither of those initiatives will help those who are already addicted. Narcan is that help. Particularly in this case, as Narcan is administered by the police, this means the overdose survivor would already be heading to serve a sentence for drug possession where they would have access to rehabilitory services. This means that if they live long enough to go through this process, they will have the chance to get into recovery and rejoin society. Narcan offers them that second chance.