The Bureau of Justice Assistance’s Law Enforcement Naloxone Toolkit is a clearinghouse of resources to support law enforcement agencies in establishing a naloxone program. The Trump administration vows to work closely with law enforcement to help combat the opioid epidemic, including expanding access to drugs, such as naloxone, that can help reverse opioid overdose. The Law Enforcement Naloxone Toolkit provides law enforcement with the knowledge and tools needed to reduce opioid overdoses and help save lives. 

In the toolkit you will find answers to frequent questions about naloxone and sample documents and templates, such as data collection forms, standard operating procedures, training materials, press releases, community outreach materials, and memoranda of agreement (MOA) between first responders and medical directors. These templates can be downloaded and customized for your own agency.

On November 1, 2017, the White House announced the release of the Fentanyl Safety Recommendations for First Responders. The Recommendations provide first responders with unified, scientific, evidence-based recommendations to protect themselves when the presence of fentanyl is suspected. The recommendations are the result of a Federal Interagency Working Group coordinated by the White House National Security Council. The U.S. Department of Justice served on the Federal Interagency Working Group and is pleased to support the release of these recommendations as a critical first step in keeping first responders safe in the field. Stakeholder associations and organizations representing the medical, public health, law enforcement, fire, emergency medical services (EMS), and occupational safety and health disciplines provided invaluable input to inform the Interagency Working Group’s efforts, and their feedback helped ensure the recommendations are operationally relevant, appropriately tailored to first responders, and conveyed in a user-friendly one-page format.

Download the Fentanyl Safety Recommendations for First Responders, or visit https://www.whitehouse.gov/ondcp/key-issues/fentanyl for more information. 

Below are several sample resource documents related to liability.

Resources:

Changing Law from Barrier to Facilitator of Opiod Overdose Prevention

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Summarizes how encouraging the prescription and use of nalox­one and the transformation of bystanders into Good Samaritans may reduce opioid overdose deaths.

Legal Interventions to Reduce Overdose Mortality

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Discusses the ways in which access to naloxone and other emergency treatment is often limited by laws and regulations that pre-date the overdose epidemic and provides an overview of Good Samaritan laws by state.

Providing first aid to an opioid overdose victim carries the same general occupational risk inherent to other first aid activities that are part of policing. Universal precautions should be taken when coming into direct contact with the overdose victim, including moving them into the recovery position, providing rescue breathing, and any other manipulation. Given that a substantial proportion of opioid overdose victims are people who inject drugs, law enforcement officers should be aware of the high likelihood that hypodermic needles may be present on the victim’s person and elsewhere on the scene.

Injection of intramuscular (IM) naloxone carries a remote risk of an accidental needle stick injury (NSI).  If the officer experiences an NSI after administering the drug, there is a risk of contracting a blood borne infection, such as Hepatitis C or HIV. Aftermarket atomizers enable intranasal administration of naloxone without using a needle. Most law enforcement agencies have determined that the added expense of purchasing atomizers is worth the occupational safety gains from not having to use needles to administer the drug. The retractable needle system of the EVZIO® naloxone auto-injector is designed to prevent needle stick injury.

Overdose victims rescued by naloxone may experience opioid withdrawal symptoms. In very rare instances when such symptoms are severe, the victim may become combative. This is reported in about one percent of all rescues. There are no reported cases of injuries to law enforcement officers or the victim in the context of law enforcement overdose response programs.

Generally, no. In most states, a legal concept called the Public Duty Doctrine blocks such lawsuits. This means that officers have no legal duty to assist others, even when they are in a position to do so. These protections do not apply to any administrative discipline for violating standard operating procedures.

Many communities across the country have come together to develop strategic plans to address opioid abuse, including the City of Baltimore, the State of New Jersey, the State of Pennsylvania, and the State of Wisconsin. Samples of these plans can be found on the Prescription Drug Monitoring Program Training and Technical Assistance Center web site

Resources:

Baltimore Mayor’s Heroin Treatment & Prevention Task Force Report

Date: 
Jul, 2015
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Addressing heroin addiction is a critical priority of Mayor Stephanie Rawlings-Blake, City of Baltimore, who convened the Heroin Treatment and Prevention Task Force to come up with urgent and actionable strategies. This report outlines the recommendations and the work that must continue in order to address this life-and-death issue.

Confronting New Jersey’s New Drug Problem: A Strategic Action Plan to Address A Burgeoning Heroin/Opiate Epidemic Among Adolescents and Young Adults

Date: 
Jan, 2014
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The skyrocketing use of heroin and other opiates has become the number one health care crisis confronting New Jersey. Recognizing the need for a comprehensive and multidisciplinary plan of action to address the prescription drug and heroin epidemic, on March 20, 2012, the Governor’s Council on Alcoholism and Drug Abuse established a Task Force on Heroin and Other Opiate Use by New Jersey’s Youth and Young Adults. The Task Force was charged to present a report with actionable recommendations that would help to stem the tide of this horrific scourge.

Letter to Pennsylvania District Attorneys, Police Chiefs, and County Sheriffs

Date: 
Jan, 2015
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A letter to Pennsylvania’s district attorneys, police chiefs, and county sheriffs from state and community officials, encouraging these groups to collaborate and establish naloxone programs to save saves in the State of Pennsylvania. The letter shares information on state laws, including the Good Samaritan law, and provides resources for more information and funding opportunities.

Project Dawn (Deaths Avoided With Naloxone) Training Video – Part 1

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Project DAWN (Deaths Avoided With Naloxone) is a community-based overdose education and naloxone distribution program. This video is a Project DAWN training video on overdose prevention, including recognizing the signs and symptoms of overdose, distinguishing between different types of overdose, performing rescue breathing, calling emergency medical services, and administering intranasal Naloxone.

Project Dawn (Deaths Avoided With Naloxone) Training Video – Part 2

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Project DAWN (Deaths Avoided With Naloxone) is a community-based overdose education and naloxone distribution program. This video is a Project DAWN training video on overdose prevention, including recognizing the signs and symptoms of overdose, distinguishing between different types of overdose, performing rescue breathing, calling emergency medical services, and administering intranasal Naloxone.

Wisconsin’s Heroin Epidemic: Strategies and Solutions

Date: 
Jul, 2014
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In recognition of the growing heroin problem, the Wisconsin State Council on Alcohol and Other Drug Abuse (SCAODA) established the Heroin Ad-hoc Committee in November 2013. The Ad-hoc Committee was charged with researching and discussing the incidence of heroin use and overdoses in Wisconsin. The Ad-hoc Committee researched and discussed programs that could be used to prevent the use of heroin, the legal and social consequences of heroin use and substance use disorders (SUDs), harm reduction strategies and treatment options to create safer and healthier communities.

See the Community Outreach Letter below for one example of you can highlight partnerships in your community.

Resources:

Quincy (MA) Community Outreach Letter

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Sample community letter discussing a partnership between the Quincy Police Department and other community partners.

Yes, in January 2017, BJA released two funding opportunities as part of the Comprehensive Addiction and Recovery Act (CARA), which is the first major federal substance abuse disorder treatment and recovery legislation in 40 years. The Comprehensive Opioid Abuse Program (COAP) Training and Technical Assistance (TTA) Program and the Comprehensive Opioid Abuse Site-Based Program support CARA’s goals to address the opioid epidemic by encouraging comprehensive, cross-system, data-driven, and evidence-based planning and collaboration among stakeholders from the criminal justice field and substance abuse treatment and recovery system. Under the Comprehensive Opioid Abuse Site-Based Program there is support for overdose outreach projects, which can connect overdose survivors with treatment and recovery services, including naloxone, and educate communities on overdose prevention. The deadline for both of these solicitations is April 25, 2017. 

Additional funding is available through the Harold Rogers Prescription Drug Monitoring Program (PDMP).

Resources:

Comprehensive Opioid Abuse Program (COAP) Training and Technical Assistance (TTA) Program FY 2017 Competitive Grant Announcement

Date: 
Feb, 2017
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BJA is seeking applications to plan and implement comprehensive strategies in response to the growing opioid epidemic. This program furthers the Department’s mission by providing resources to state, local, and tribal governments to intervene with persons with substance-use disorders. 

Comprehensive Opioid Abuse Site-based Program FY 2017 Competitive Grant Announcement

Date: 
Feb, 2017
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BJA is seeking applications to plan and implement comprehensive strategies in response to the growing opioid epidemic. This program furthers the Department’s mission by providing resources to state, local, and tribal governments to intervene with persons with substance-use disorders.

Each state and territory offers information and support regarding substance use disorders through a state substance abuse agency. The role of a state substance abuse agency is to plan, carry out, and evaluate substance use disorder prevention, treatment, and recovery services provided to individuals and families. Specifically, they oversee treatment centers and counselors in their respective states and, in many cases, supply funding to providers, track state trends, and ensure residents receive the services to which they are entitled.

Resources:

NASADAD Membership List

Date: 
Aug, 2014
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Law enforcement agencies interested in contacting their state’s substance abuse agency can find contact information in this list. Your state’s substance abuse agency may be able to help you identify the programs and resources that are available in your local area and how these programs can be accessed.

Examples of promising programs include:

Programs to encourage opioid overdose witnesses to seek help:

Many opioid overdoses are witnessed, but bystanders do not call 9-1-1 because they do not recognize the signs and symptoms of an overdose, or because they are concerned about legal repercussions.

To remove barriers for witnesses of opioid overdoses to call 9-1-1, a growing number of states have passed overdose Good Samaritan laws. These laws shield those who seek help and witnesses from certain criminal charges for drug or alcohol possession. Even in the absence of Good Samaritan laws, arrests at the scene of an overdose are rare in most jurisdictions. Law enforcement agencies are in a unique position to make the public aware of these life-saving policies. However, failure to follow stated policies about arrest or prosecution can detrimentally impact the willingness of drug users, their families, and others to seek help in an emergency.

Example: In Washington State, research suggested that the vast majority of drug users were not aware of the new Good Samaritan law a year after its passage. The State Attorney General was featured in a press conference when the law took effect and he and the medical director of the Poison Control Center appeared in a radio public service announcement to share information about the law. The launch of the video was accompanied by a wide-ranging media campaign to educate the public about the provisions and benefits of the Good Samaritan law. The Seattle Police Department also created a video to be shown at roll call to all patrol officers that featured the narcotics captain, a county prosecutor and the medical director of public health. The video addressed what the law does and does not cover, the basics of what naloxone is, and the fact that public health programs would be distributing naloxone. To address their concerns, community members receiving naloxone were informed that police have received education about the Good Samaritan law and naloxone distribution efforts.

Resources:

Seattle Police Department Training Video

Veterans, residents of rural and tribal areas, recently-released inmates, people completing drug treatment/detox programs, and some young adults are at an especially high risk of opioid overdose. Law enforcement and correctional officers are uniquely positioned to engage in initiatives targeting these high-risk groups, thereby helping prevent fatalities by engaging in outreach initiatives. Individuals re-entering society after a period of incarceration are especially vulnerable. In the first two weeks, formerly incarcerated individuals are approximately 30 times more likely to die of a drug overdose than members of the general public. A number of programs engage law enforcement and correctional staff in educating this population about overdose risk, how to avoid and respond to overdose, and any provisions covering criminal liability of those who seek help.

Example: In Rhode Island’s “Staying Alive on the Outside” program, state prisoners are shown a video about overdose risks as part of the pre-release process. Another example is a program at the Allegheny County, PA, jail, where public health and corrections officials present overdose prevention trainings to inmates prior to discharge. At the jail in Kent, Washington pharmacists train inmates and naloxone is placed in their possession for pick up upon release.

Example: In Indiana, local law enforcement worked in partnership with the Drug Enforcement Administration to revise the drug education curriculum delivered in schools to include key information about overdoses. This includes content covering signs and symptoms of overdose, the substances that are likely to cause overdose, and the considerations involved in calling 9-1-1.

Some law enforcement agencies found it helpful to develop pocket cards or brochures that can be easily distributed. Sample pocket cards and brochures are included in the resources below.

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