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Narcan initiative runs into challenges

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The initiative to arm Jefferson County Sheriff’s deputies with a new form of an overdose reversal medication faced some intense scrutiny at a meeting of the Board of Legislators Health and Human Services Committee on Tuesday.

County Attorney David J. Paulsen told members of the committee that, by state regulation, the county must create an Opioid Overdose Prevention program before it is able to allow deputies to carry the drug naloxone hydrochloride, commonly known as Narcan.

Since Narcan is technically a prescription medication, the program would have to be sponsored by a health care facility, a physician, physician’s assistant or nurse practitioner, a drug treatment program or the local health department, Mr. Paulsen said.

The program would have to provide a program director, a clinical director, a training program for the administration of the drug, and a record keeping system for when the drug is administered.

Mr. Paulsen also raised concerns regarding the potential risk of liability to which deputies could be exposed after administering the drug.

Under state law, if the proper program framework is put in place and the proper training is received, the administration of Narcan is treated as first aid but deputies could still be responsible for gross negligence or reckless conduct, Mr. Paulsen told legislators.

Narcan, which blocks the opioid receptors in the brain, is traditionally injected into the body. A new intranasal form of the drug, which is sprayed into the nostrils via an atomizer, makes it easier and safer to administer Narcan.

It can reverse the potentially fatal respiratory depression caused by an overdose of opioid-based prescription painkillers and heroin.

Narcan already is carried by the 13 advanced life support emergency response agencies in the county.

However, sheriff’s deputies are often first to arrive on scene in predominantly rural Jefferson County, making them the first line of defense for overdose victims, according to advocates for the initiative.

Allowing deputies to carry the intranasal form of Narcan in their duty bags would allow them to quickly respond to an overdose situation before emergency medical personnel arrive, advocates contend.

The effects of the drug last 30 minutes and overdose patients who receive it must be taken immediately to a medical facility before the effect of the drug wears off.

Anita K. Seefried-Brown, director of community prevention at the Alcohol and Substance Abuse Council of Jefferson County and a member of the county’s Rapid Response Coalition, opened the meeting by asking legislators during the public comment period to consider passing a resolution authorizing deputies to carry Narcan.

After Mr. Paulsen gave his preliminary findings about the steps needed to implement the program, he posed questions about what county agency would sponsor the program and how the county would pay costs associated with implementing it, before concluding the matter was a policy concern best left to the Board of Legislators to decide.

A vigorous discussion ensued, with advocates for the program voicing their displeasure with the apparent lack of enthusiasm for enacting the program as soon as possible and more circumspect members of the committee wondering out loud about some of the finer points of implementation.

Legislator Anthony J. Doldo, R-Watertown, is a member of the Rapid Response Coalition and has been supporting the Narcan initiative since attending a presentation about the drug earlier this year. He was the first to speak after Mr. Paulsen concluded his comments.

“What would be the liability for the deputy responding to a scene and not administering Narcan and not saving a life? That life is worth something. How can we put a value on a life?” he said.

Committee Chairman James A. Nabywaniec was more cautious, saying that he wanted to see the board examine the program further.

“I wouldn’t want to risk the liability of a deputy,” Mr. Nabywaniec said.

Legislator John D. Peck, R-Great Bend, voiced his concerns about the possibly violent reactions of overdose victims suddenly revived by Narcan, while Legislator Robert D. Ferris, R-Watertown, said that he was in favor of the program and wanted to see a resolution about it brought forward.

Director of Jefferson County Emergency Medical Services Charles F. Brenon III compared the Narcan program to the program that allows the county to have automated external defibrillators available in county buildings and asked legislators to give the county Public Health Department the go ahead to move forward with structuring a program.

County Administrator Robert F. Hagemann III cut Mr. Brenon off, saying that more homework needed to be done on the initiative and that Public Health officials should prepare a program proposal, complete with cost estimates, that the county board could examine.

Narcan, which has a shelf life of two years, would initially be provided to the county by the New York City-based Harm Reduction Coalition, Mr. Brenon said.

After that, the drug would cost $22 to $27 a dose, according to Mr. Brenon.

Sheriff John P. Burns, who attended the meeting, told legislators that if his deputies received the proper training, he would have no problem having them carry Narcan in their duty bags.

The debate ended with a request for a plan the board could look at during its meeting next month.

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