The opioid epidemic showed no signs of slowing down in Maine last year. In the first nine months of 2015, 174 Mainers died from drug overdoses, putting the state on track to record 230 to 250 total overdose deaths for the year.
Often, and particularly in rural areas, law enforcement are the first on scene to deal with overdoses. So more and more police departments across the country have started equipping their officers with the overdose antidote naloxone to reduce overdose deaths.
In Maine, the Legislature passed the first in a series of bills in 2014 to make naloxone more accessible to law enforcement, other first responders and the family members of people at risk of an overdose. But nearly two years later, only a handful of police departments across the state have opted to equip officers with the overdose antidote.
Maine has fewer police departments equipped with naloxone than most other New England states.
In February 2015, the Kennebec County Sheriff’s Office became the first law enforcement agency to provide its deputies with naloxone kits to prevent overdoses.
The York Police Department is the only other department that equips officers with the medication. It started its naloxone program in May 2015.
Elsewhere across New England, it’s more common for police departments to equip officers with naloxone. Officers from 44 agencies in Massachusetts, eight in Connecticut, eight in Rhode Island, two in Vermont and one in New Hampshire carry naloxone with them, according to the North Carolina Harm Reduction Coalition, an advocate of national access to naloxone.
Why do so few departments use naloxone?
Naloxone, known commonly by its brand name Narcan, has been used in emergency rooms for decades, but its use outside hospitals has long been limited to paramedics. And this hasn’t changed much — even in recent years, as the number of overdose deaths has increased.
Paramedics across the state last year administered more than 1,500 doses of naloxone to reverse overdoses in 1,133 patients, according to data from Maine Emergency Medical Services, a unit of the Department of Public Safety. The number of doses paramedics have administered has steadily climbed in recent years, from 659 in 2012 to 1,128 in 2014.
Many police departments located in municipalities with full-time fire and ambulance crews choose not to use naloxone because paramedics often arrive at the scene of an overdose sooner than police, according to Robert Schwartz, executive director of the Maine Chiefs of Police Association.
While more populated parts of the state can rely on the quick response of paramedics to prevent an overdose death, law enforcement — often a sheriff’s deputy or a state police trooper — often reach the scene first in a more rural area. But with few rural law enforcement agencies equipped with naloxone, some Mainers may not be able to get help in time.
Some hospitals are trying to close this gap by arming police with naloxone.
In 2014, MaineGeneral Medical Center in Augusta began a program to equip law enforcement who patrol rural areas with naloxone and train them to handle overdoses from heroin and prescription pain pills, according to Laura St. John, program manager for the harm reduction program at MaineGeneral.
The training program is funded by a one-year $100,000 grant from the federal Office of Rural Health Policy to support the purchase of naloxone for use in rural communities. It’s a small start, but four sheriff’s offices — Aroostook, Kennebec, Sagadahoc and Waldo — have signed up for training. Deputies will learn to recognize the signs of an overdose, identify at-risk individuals and administer naloxone.
(The Somerset County Sheriff’s Office also is set to begin a naloxone program.)
The Kennebec County sheriff’s deputies originally received training in 2014 using a grant from the Maine attorney general’s office. They’re now getting a refresher course through MaineGeneral with the other departments.
In addition to the training, each department will receive 15 naloxone kits for free. Each kit contains two doses of the medication and two atomizers to turn the medication into a nasal spray. A dose of naloxone has a one- to two-year shelf life.
While MaineGeneral is picking up the tab for now through the federal grant, the departments will need to secure their own funding for future naloxone purchases if they decide to keep equipping their deputies with the kits.
Maine police could be in for sticker shock because naloxone is getting expensive.
Amphastar Pharmaceuticals Inc., which manufactures the naloxone used by most public health agencies and police departments, raised the price of the medication more than 60 percent in September 2014, according to the U.S. Food and Drug Administration. Addiction treatment advocates and state and federal lawmakers widely criticized the move, which Amphastar said was necessary to offset a rise in manufacturing costs, in particular for raw materials, energy and labor.
The price for naloxone in Maine varies by hospital. Current per-dose prices range from $32 to $55, according to Maine Emergency Medical Services. The two-dose naloxone kits MaineGeneral is providing the sheriff’s agencies will cost about $75 each this year, up from $62 a year ago, according to St. John, the MaineGeneral program manager.
Several states have taken steps to secure affordable access to naloxone for first responders. For example, attorney generals in Vermont, Ohio and New York negotiated with Amphastar to secure a $6 per dose discount on state agency and municipal government purchases.
In Massachusetts, a bulk naloxone purchasing fund managed by the state attorney general’s office and Department of Public Health allows police and other first responders to buy the naloxone at the discounted rate of $20 per dose. Until the state created the fund, first responders paid anywhere from $33 to $66 per dose, according to the Massachusetts attorney general’s office.
In Maine, a bill sponsored by Rep. Sara Gideon, a Freeport Democrat and assistant House majority leader, proposed to create a similar bulk purchase fund. Gideon, however, withdrew the bill last week.
But the high sticker price for naloxone is unlikely to deter police.
Already, Kennebec County Interim Sheriff Ryan Reardon plans to purchase more naloxone kits for his department after MaineGeneral stops picking up the tab.
“We’ve saved one person, who we saved in October, and for me that makes it all worthwhile,” he said.