As with any new initiative, officers should be trained in the proper handling and use of the medication. The length and content of the training are discretionary in most states. The vast majority of law enforcement overdose reversal programs are administered in collaboration with state or local departments of health, community-based organizations, healthcare organizations, or EMS agencies that provide officer trainings at no charge.

In the case of dual-role officers holding additional medical response certifications (e.g. EMTs), existing training and certification could be sufficient to carry and administer naloxone.

Several options exist for providing training to law enforcement overdose response program participants.

One model is for the training to be provided by the staff of the local hospital, another health facility, health department, or EMS service. In these situations, the same medical organization often acts as a liaison for the naloxone supply. Some law enforcement agencies have an existing emergency response training infrastructure to maintain required first aid and first responder certifications. Depending on the organization’s internal capabilities, this training may be provided by a designated training officer, who often has additional medical training, or provided by staff of the external health agencies. Opioid overdose response training can be incorporated into this existing training infrastructure.

Another option is for a community-based organization providing naloxone access to members of the public to provide such training.

A third option is for the training to be organized at the state or county level using a distance learning or train-the-trainer model. E-learning tools may be especially useful for rural and tribal agencies.

By including presentations from law enforcement professionals in opioid overdose trainings, agencies can take advantage of the benefits of peer-to-peer learning, thus improving uptake and retention.

There are currently no legal requirements for retraining in law enforcement overdose response programs. Just like with any other law enforcement activity, annual or other periodic re-training may be needed to ensure effective and compliant practices. In some jurisdictions, refresher trainings have become part of the annual training programs.

Law enforcement overdose response program trainings typically last from 40 to 90 minutes. At the very least, such training includes three basic elements: 1) information on how to recognize signs of an opioid overdose, 2) information on how to provide basic life support and proper administration of naloxone, and 3) an applied component providing trainees an opportunity to practice their skills. Trainings also typically include time for the completion of requisite documentation to authorize naloxone possession and administration by law enforcement officers.

Most trainings also cover some combination of the following content:

  • Drug abuse basics, including the chronic nature of addiction
  • Mechanisms by which opioids can cause overdoses and the reversal properties of naloxone
  • Occupational safety considerations
  • Legal considerations, including naloxone authorization and applicable Good Samaritan laws or policy provisions covering overdose victims and bystanders
  • Standard operating procedures for the administration of naloxone
  • Overdose education and naloxone distribution programs available to community members
  • Substance abuse treatment resources available in the jurisdiction

Programs that meet best practices cover information and skills that equip officers to engage in prevention and treatment program referral. The particular mix of training content and delivery channels depends on local needs and circumstances. Employees who hold existing medical response certifications such as CPR or basic life support may require an abridged training.

There are a number of existing resources to help agencies design their own law enforcement overdose response training. Sample training curriculum can be found below.

Resources:

High Intensity Drug Trafficking Area (HIDTA) Training

Indianapolis (IN) Metropolitan Police Department Training Presentation

Massachusetts Department of Public Health Core Competencies

New York City Train the Trainer

Norfolk County (MA) Naloxone Training

Opioid Overdose and Intranasal Naloxone Training for Law Enforcement - Trainer's Guide

Rhode Island Law Enforcement Officer Toolkit

Suffolk County, NY, Police Department Training Presentation

In June 2014, the Association of State and Territorial Health Officials administered a survey to collect information about activities and policies to address prescription opioid abuse and overdose. Individual profiles were created for the 48 states, two U.S. territories, and one freely associated state that responded to the survey. The profiles provide an understanding of the current environment of state activities to address prescription drug abuse, ranging from prevention strategies to surveillance and monitoring (PDMPs), law enforcement, and treatment and recovery. See the 2014 Policy Inventory: State Action to Prevent and Treat Prescription Drug Abuse resource. 

While not legally required, it is strongly encouraged. Each agency should establish standard operating procedures (SOPs) for law enforcement overdose response activities. These procedures should be drafted in consultation with the governing laws of the jurisdiction and any applicable collective bargaining units. If applicable, policies should integrate the provisions of relevant 9-1-1 Good Samaritan laws, as well as the department’s policy on information gathering, searches, arrests, and other activities at the scene of an overdose. Any triage plans developed with EMS and fire agencies can also be reflected in the department’s SOP.

A list of sample procedures from a variety of jurisdictions are available for download below.

Resources:

Lorain Police Department Policy and Procedure

New York City Pilot Policy and Procedure

Norwood Overdose Police Department Policy

Rhode Island State Police Policy and Procedure

Vermont State Police Naloxone Policy and Procedure