Officers have been armed with doses of a drug called naloxone that brings drug users back from the brink of an overdose death — essentially enlisting officers to stand in as medics until an ambulance arrives.
“A lot of times, and especially out in the county, we may be that first one on the scene,” Haywood Sheriff Greg Christopher said.
Naloxone is something of a miracle drug in the prescription pain pill epidemic. It temporarily restores the central nervous system long enough to get an overdose victim to a hospital, but time is of the essence.
“If somebody’s not breathing, every second we have brain cells that are dying,” Christopher said. “If we suspect that it is an opiate overdose of some kind, then we can administer this drug to them and it automatically starts to work on them and bring them back around.”
The initiative is a testament to the outreach philosophy shared by Haywood County law enforcement officers when it comes to opiate addiction struggles.
“If they have an issue or problem with addiction we don’t feel it warrants a death sentence. Those who say ‘Well, they’re addicts, just let them die,’ we aren’t going to have that attitude,” Waynesville Police Chief Bill Hollingsed said. “Any time we have an opportunity to save a life, we will take advantage of that tool.”
Skyrocketing abuse of highly addictive prescription pain pills has besieged Appalachian communities over the past decade. Haywood County was averaging a dozen overdose deaths from prescription pain pills, hitting a high of 19 deaths in 2013, before starting to come back down, with only half a dozen the next year, credited in part to aggressive community awareness campaigns and proactive treatment programs.
The life-saving function of naloxone has only recently made it into officers’ hands, however.
Medics have carried it for years, according to Jim Pressley, the head of Haywood County Emergency Medical Services. But it had to be injected.
Hollingsed said that wasn’t a real good fit for officers.
“The first kind we got was the old vial and needle and officers weren’t real comfortable with that form,” Hollingsed said.
Now, it comes in nasal spray form or pre-loaded, single dose auto injectors that work like an epi-pen.
“It is easier to store and train on and certainly easier to administer. They don’t even have to worry about keeping up with needles,” said Pressley.
Every Haywood County law enforcement officer — including all four town police departments and sheriff’s deputies — now carry the auto-injection form.
Haywood County was among the first statewide to embrace the idea of making naloxone standard issue for their officers. Only a handful of other departments in the state gave out naloxone to officers when Haywood adopted the practice last summer.
Today, only 85 local law enforcement agencies statewide — around 18 percent — carry it. While the number grows every month, Haywood still stands out in its commitment.
“We are the only county in the state where every single law enforcement officer in the county has been issued naloxone,” Hollingsed said.
Hollingsed said the death toll alone speaks for itself.
“Since the advent of automobiles, car crashes have always been the leading cause of accidental death in the United States. Accidental deaths from opiate overdoses surpassed crashes two years ago,” Hollingsed said. “We felt like it was up to us to work with our partners to do something about it.”
A grant from the maker of auto-injection naloxone — known under the brand name Kaleo — covered the upfront cost of 100 doses for Haywood officers last year, as well as replacement doses to last two more years.
Naloxone has a one- to two-year shelf life and must be replaced periodically. It’s unclear where a steady source of funding to continue the program will come from in another two years.
And as demand for the overdose antidote rises — due in part to the growing number of law enforcement agencies starting to carry naloxone nationally, and in part to sweeping programs to hand it out directly to drug users — the cost has been rising exponentially.
The Haywood HealthCare Foundation is prepared to help with the cost of replacement doses in the future if needed.
“We strongly support this effort,” said Ginger Lang, chair of the Haywood Healthcare Foundation. “Law enforcement officers need to have Narcan available in their vehicles as they are often first on the scene of an opiate drug overdose and can act quickly to reverse the overdose and save a life.”
But Hollingsed said the state may ultimately provide funding as well. This year, lawmakers earmarked money in the state budget for the purchase of naloxone for officers and designated the N.C. Harm Reeducation Coalition to coordinate which departments it should go to based on the greatest need.
“The state is starting to provide funding for some of these mitigation issues to decrease opiate overdose in communities,” Hollingsed said.
The N.C. Harm Reduction Coalition keeps a database of law enforcement agencies that carry the overdose antidote, when they started, and how many times they have actually used it. Over the past year, officers have administered it nearly 90 times around the state.
“It has proven many, many times to save lives,” Christopher said.
Consequences can still be dire for a drug overdose victim. Even those saved from death can end up physically and mentally disabled due to irreversible effects on the nervous system.
“Any time your body is insulted like that, there is a chance for lingering harm. That’s why we want to get the drug pushed out there so it can be administered more quickly,” Pressley said.
The naloxone kits have also been issued to fire departments throughout the county.
“In our rural areas, those community fire department guys are closer to the call because they live in the district the call’s coming from,” Christopher said.
Pressley said officers seemed receptive based on the training sessions he led for the police departments and sheriff’s office.
“It was something new, but once they went through the training, everybody is pretty well comfortable with it,” Pressley said.
A Waynesville police officer used a naloxone dose on an overdose patient last summer, less than two days after getting the kit and going through training on it, Hollingsed said.
When asked about his striking description of a drug user as a “patient,” Hollingsed said his department’s approach is not to villainize the individual user.
“If we find someone who has overdosed on an opiate, whether it is a prescription pain pill or heroin, the individual at that point is a user of this drug and our focus is to save their life number one — and number two, provide substance abuse treatment,” Hollingsed said.
His compassion turns to outrage when it comes to the dealers of these drugs, however.
“It is a priority for law enforcement to put the people victimizing residents of our community behind bars,” Hollingsed said.