Is the life of a person who is overdosing on drugs worth saving?
For most people, the answer would probably be “Yes.”
But in at least two communities in Ohio, the answer among some officials is … “Maybe not.”
A sheriff in Butler County has told his deputies not to carry a product that could save the life of someone experiencing a drug overdose.
In addition, a city councilperson in another part of the state has proposed that emergency responders not be dispatched to help someone if they are experiencing their third overdose.
In both cases, the officials say a lot of time and money is being spent on people who are abusing drugs.
Their attitude, however, strikes many who work in drug addiction treatment programs as uninformed, and even cruel.
‘When does it stop?’
Every day, 78 people in America die from an opioid-related overdose.
Opioids, which include legal prescription drugs such as the painkillers Percocet or OxyContin, and illegal drugs such as heroin, have been responsible for more than 183,000 deaths since 1999.
Overdoses, though, can be reversed with naloxone, which is called an ‘opioid antagonist’ for its ability to block the effects of opioids in the brain.
Naloxone nasal spray (also known as Narcan) is sprayed directly into the nose, allowing a person having an overdose to breathe regularly within two to eight minutes.
There is also Evzio, an voice-guided naloxone injectable that can be administered straight into a person’s thigh.
Both FDA-approved medications temporarily reverse the effects of the overdose, which allows the person more time to get emergency medical help.
Naloxone has primarily been used by emergency medical technicians (EMTs) responding to a call of an overdose.
However, others such as police and fire personnel, and even lay people without specialized medical training, increasingly carry it.
“People who have been around overdoses want to respond,” Janie Simmons, EdD, founder and director of Get Naloxone Now in New York, told Healthline. “They’re watching people die. They get there first and they’re waiting for the ambulance [with the naloxone].”
But not everyone wants first responders to carry the lifesaving medication.
Sheriff Richard K. Jones made national headlines earlier this month after he announced his deputies in Butler County in southwestern Ohio do not, and will not, carry naloxone.
“We don’t do the shots for bee stings. We don’t inject diabetic people with insulin. When does it stop?” Jones told The Washington Post. “I’m not the one that decides if people live or die. They decide that when they stick that needle in their arm.”
When pressed by Cincinnati.com as to his reasoning, Jones cited babies who are born already addicted, sometimes to women in jail.
The sheriff also said people who are revived from an overdose may become violent or aggressive upon seeing the police.
In another part of Ohio, an elected official has proposed that the city stop sending emergency responders to situations where a person is experiencing their third overdose.
In Middletown, Ohio, City Councilman Dan Picard wants to give people with drug additions two chances. On each of their first two overdoses, they would be given a summons and be required to do community service work.
However, if they didn’t show up in court or do the community service, then emergency personnel would not respond on a third overdose.
Picard told CNN he isn’t trying to solve the opioid epidemic. He simply believes his city doesn’t have the money to keep rescuing people who are overdosing.
According to Middletown Fire Department records, their emergency units responded to 535 opioid overdoses in 2016. Of those, 77 people died.
Picard estimated the city spent $1.2 million responding to overdoses.
“Either we go down the road with my plan or we don’t and we run out of money,” he told CNN. “In either scenario, they’re not going to get treatment.”
Others, however, see alternative solutions.
‘Why would we not?’
Police Chief Ty Sharpe of Dilworth, Minn., brought naloxone to his department this June with the assistance of a grant.
Although Dilworth only has 4,500 citizens, it also contains a Walmart, which brings an influx of visitors to the town.
Sharpe said he recalls his department responding to about 10 overdoses in 18 months, three of which resulted in death.
“For us [getting naloxone] made sense,” Sharpe explained.
Dilworth usually has only four officers on call at a time. Officers take a naloxone kit with them in their cars when they begin a shift and return it at the end.
The naloxone kits cost the department about $38 apiece and have a shelf life of about two years, Sharpe explained.
Typically, nasal Narcan retails for about $149, said Simmons. There is a cheaper version that can be purchased by community programs. Evzio is more expensive.
“The cost was nominal,” he said. “In fact, if I throw it away in two years and buy all new kits because we did not need it, I will gladly do so. For me it was more of a question ‘Why would we not?’”
How much of a burden?
Dr. Sharon Stancliff, medical director of the Harm Reduction Coalition in New York, called it “misguided” to dismiss people struggling with opioid addiction as “just junkies.”
According to the Department of Health and Human Services, more than 240 million prescriptions were written for opioid medication in 2014. The department also reports that four out of five new heroin users began by abusing prescription opioids.
“It’s a public health and a medical issue,” Stancliff said.
She said she understands how some may not want to feel that people with drug addiction are “enabled” by being revived from an overdose.
She explained, “There is frustration [among law enforcement] that they may respond to an overdose on a person more than once.”
However, paramedics respond to plenty of emergencies for the same person more than once.
Furthermore, many people put themselves at risk by smoking or eating fattening food and police aren’t choosing not to respond to their emergencies, Stancliff said.
“Police officers are supposed to save lives,” Simmons added. “They don’t get to decide [who is and who isn’t saved].”
‘People are scrambling’
Ideally, the response of law enforcement to the opioid epidemic will eventually include pointing people in the direction of addiction treatment, Stancliff said.
For example, police in Gloucester, Mass., announced in 2015 that the department would help people with opioid addictions get referrals for treatment.
Although the results of this program won’t be apparent right away, Gloucester police reported they’d helped more than 400 people into treatment as of last year, according to NBC News.
Simmons added that typically the public has viewed drug addiction as a criminal justice issue and not a public health issue, but that paradigm is shifting.
Although the companies that make Narcan and Evzio do provide the product for free to first responders, according to Simmons, police departments simply “need to budget for it” just like they would for defibrillators.
“This is just a must,” she said. “People are scrambling … We need as many people equipped in the community as possible.”