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Most Police Still Don't Carry the Drug That Reverses an Opioid Overdose

Due to the high cost of naloxone, only a fraction of the nation’s police departments equip their officers with it.

Police officer holding naloxone.
As the nation’s opioid epidemic persists, it’s become common to hear of police officers carrying and administering naloxone, the overdose antidote often referred to by the brand name of its original nasal-spray version, Narcan. First responders have saved thousands of lives with it.

So it came as a surprise to many when The Washington Post reported in January that not only were District of Columbia police officers not carrying the drug, but that Mayor Muriel Bowser was opposed to the idea, calling it “not the right solution” for the city. The Post report came out as the city council was considering a proposal to equip officers in D.C. wards hardest hit by overdose deaths.

Bowser eventually reversed her position in the face of public criticism, and D.C. police are expected to start carrying naloxone by the end of the year. But the news that such a large police force was not already equipped with the drug highlighted a reality that advocates already know well: Though more police officers in America have started carrying naloxone, it’s still far from the norm.

The North Carolina Harm Reduction Coalition, which tracks police naloxone programs across the country, cites nearly 2,500 of those programs among the nation’s approximately 18,000 police agencies. “More and more departments are carrying every month,” says Robert Childs, the coalition’s former executive director, “but it hasn’t reached a saturation point.” 

Some local governments argue that their emergency medical services are better equipped to administer the drug, making it redundant for police to carry it. But the most frequently cited reason for not equipping police? Costs. Not only do officers need to be trained in opioid reversal, but the price tag for naloxone can be forbidding. While some police departments have managed to get the cost of the nasal spray down to $75 for two doses, a single dose of the newest iteration, an auto-injector, is priced at $4,500 before rebates or discounts. “We’ve seen some departments [in North Carolina] that just can’t afford to equip a thousand officers with it,” Childs says.

Given the high costs, many cities -- even early adopters -- have been strategic in how they roll out naloxone. Seattle police started off equipping only bike-patrol officers, thinking they would be the most likely to encounter someone overdosing in a public area; last year, the city expanded the program to car-patrol officers. Chicago police didn’t begin carrying naloxone until last year, and only in the most at-risk south and west sides of the city.

Beyond the potential to save lives, advocates argue that there’s another reason to expand the number of officers carrying the drug: enhancing community policing. Giving officers the tools for overdose reversal has “changed the way police look at their role,” says Regina LaBelle, program director of Georgetown University’s Addiction and Public Policy Initiative. The officers don’t see it as an extra burden. “Not only is it not a problem, but it can enhance their role in the community.”

And there’s another way to look at costs. As expensive as a dose of naloxone can be, one recent study found that it cost an average of $11,731 to treat an overdose patient admitted to a hospital; for a patient who needed intensive care, that number jumped to $20,500. “It’s incredibly costly to treat someone in the hospital setting, and we know naloxone programs work,” says Childs. “I want all first responders to carry them. We need to do better.” 

Mattie covers all things health for Governing.

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