Implementing a Naloxone Protocol

There are naloxone programs in law enforcement that can serve as best-practice examples of these programs in the U.S.

If you or your department has determined that it may be useful to implement a naloxone protocol, there are a number of things to consider:

  • Who will coordinate with the stakeholders involved
  • Who will create and manage the new policies, inventories, and training requirements

However, the process is not as challenging as it may seem. Other programs that have been successful have models and resources you can turn to.

Establish a state-based policy:
All Law Enforcement (LE) officers receive naloxone and training on its use

Deployment Personnel:

  • Front Desk Personnel/Booking area
  • Each patrol car and K-9 Unit (sworn officers)
  • Drug Control Unit
  • Law Enforcement Department Commander Office

Establish Training

Additional Resources – NCHRC.org/law-enforcement

  • Initial training content
  • Continuing Education content
    • Enduring and online
Establish centralized naloxone coordinator
Acquire naloxone from affillated county EMS (also consider centralized ordering with optional documentalized and complimentary shipping) via narcandirect.com
Establish physician standing order for LE departments for direct ordering or utilize state naloxone standing order.
See narcandirect.com
Establish protocols maintenance/replacement and documentation protocols
Establish centralized naloxone coordinator
Acquire naloxone from affillated county EMS (also consider centralized ordering with optional documentalized and complimentary shipping) via narcandirect.com

Establish Training

Additional Resources – NCHRC.org/law-enforcement

  • Initial training content
  • Continuing Education content
    • Enduring and online
Establish physician standing order for LE departments for direct ordering or utilize state naloxone standing order.
See narcandirect.com
Establish protocols maintenance/replacement and documentation protocols

The Bureau of Justice Assistance (BJA) National Training and Technical Assistance Center (NTTAC) has established a law enforcement naloxone toolkit as a clearinghouse of resources to support law enforcement agencies in establishing a naloxone program.

You can access the toolkit at the BJA NTTAC website.

Ultimately, a naloxone program can be set up in just a few weeks.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has prepared a downloadable resource for first responders and others to prepare for naloxone distribution.

Click here for the SAMHSA resource.

There are naloxone programs in law enforcement that can serve as best-practice examples of these programs in the U.S.

One such example is the North Carolina Harm Reduction Coalition (NCHRC), which you can learn more about by visiting its website.

According to the NCHRC, since its Overdose Prevention Project became operational on August 1, 2013, it has dispensed over 69,000 free overdose rescue kits that include naloxone and have received 11,000 confirmed reports that the medication was administered successfully by lay individuals.

Another example is the Police Assisted Addiction and Recovery Initiative in Gloucester, MA. Visit the website at www.paariusa.org.

For qualifying group purchasers

All first responders (EMS, Fire Department, and Police) may now purchase NARCAN® Nasal Spray as a qualified group purchase, at a 40% discount off the Wholesale Acquisition Cost (WAC) of $125 per carton.

  • $37.50 per 4 mg dose ($75 per carton of 2 doses)

If you would like to make a group qualified purchase, call 1-844-4-NARCAN (844) 462-7226 or click here.

INDICATION AND IMPORTANT SAFETY INFORMATION

What is NARCAN® (naloxone HCl) Nasal Spray?

NARCAN® (naloxone HCl) Nasal Spray is used for the treatment of an opioid emergency or a possible opioid overdose with signs of breathing problems and severe sleepiness or not being able to respond. NARCAN® Nasal Spray is to be given right away and does not take the place of emergency medical care. Get emergency medical help right away after giving the first dose of NARCAN® Nasal Spray, even if the person wakes up because symptoms may return. Repeat doses may be necessary.

Do not use NARCAN® Nasal Spray if you are allergic to naloxone hydrochloride or any of the ingredients in NARCAN® Nasal Spray.

What is the most important information I should know about NARCAN® Nasal Spray?

NARCAN® Nasal Spray is used to temporarily reverse the effects of opioid medicines. The medicine in NARCAN® Nasal Spray has no effect in people who are not taking opioid medicines.

Use NARCAN® Nasal Spray right away if you or your caregiver think signs or symptoms of an opioid emergency are present, even if you are not sure, because an opioid emergency can cause severe injury or death.

Family members, caregivers, or other people who may have to use NARCAN® Nasal Spray in an opioid emergency should know where NARCAN® Nasal Spray is stored and how to give NARCAN® before an opioid emergency happens.

Get emergency medical help right away after giving the first dose of NARCAN® Nasal Spray.

Rescue breathing or CPR (cardiopulmonary resuscitation) may be given while waiting for emergency medical help.

The signs and symptoms of an opioid emergency can return after NARCAN® Nasal Spray is given. If this happens, give another dose after 2 to 3 minutes using a new NARCAN® Nasal Spray and watch the person closely until emergency help is received.

NARCAN® Nasal Spray may cause serious side effects, including sudden opioid withdrawal symptoms.

Opioid withdrawal symptoms may include body aches, diarrhea, increased heart rate, fever, runny nose, sneezing, goose bumps, sweating, yawning, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, stomach cramping, weakness, increased blood pressure.

In infants under 4 weeks old who have been receiving opioids regularly, sudden opioid withdrawal may be life-threatening if not treated the right way. Signs and symptoms include: seizures, crying more than usual, and increased reflexes.

These are not all of the possible side effects of NARCAN® Nasal Spray. Call your doctor for medical advice about side effects.
To report SUSPECTED ADVERSE REACTIONS, contact ADAPT Pharma, Inc. at 1-844-4NARCAN (1-844-462-7226) or FDA at 1-800-FDA-1088 or
www.fda.gov/medwatch.

Please see full Prescribing Information.

References: 1. NARCAN® Nasal Spray. Prescribing Information. Adapt Pharma, Inc. Radnor, PA; 2017. 2. Centers for Disease Control and Prevention. Vital Signs—Prescription Painkiller Overdoses in the US. Available at: https://www.cdc.gov/vitalsigns/painkilleroverdoses/index.html. Accessed August 2018. 3. United Nations Office on Drugs and Crime. Annual Prevalence of Drug Use. Available at: https://dataunodc.un.org/drugs/prevalence_table. Accessed August 2018. 4. Surgeon General's Advisory on Naloxone and Opioid Overdose. U.S. Department of Health and Human Services. https://www.surgeongeneral.gov/priorities/opioid-overdose-prevention/naloxone-advisory.html. Accessed May 2018. 5. US Department of Justice, Drug Enforcement Administration. A Briefing Guide for First Responders. 6. Drug Enforcement Administration. DEA issues nationwide alert on fentanyl as threat to health and public safety. Available at: https://www.dea.gov/press-releases/2015/03/18/dea-issues-nationwide-alert-fentanyl-threat-health-and-public-safety. Accessed August 2018. 7. PoliceOne. White paper: Building an opioid overdose reversal program. Availabe at: https://www.policeone.com/police-products/medical-supplies/articles/212042006-White-paper-Building-an-Opioid-Overdose-Reversal-Program/. Accessed August 2018.

INDICATION AND IMPORTANT SAFETY INFORMATION

What is NARCAN® (naloxone HCl) Nasal Spray?

NARCAN® (naloxone HCl) Nasal Spray is used for the treatment of an opioid emergency or a possible opioid overdose with signs of breathing problems and severe sleepiness or not being able to respond. NARCAN® Nasal Spray is to be given right away and does not take the place of emergency medical care. Get emergency medical help right away after giving the first dose of NARCAN® Nasal Spray, even if the person wakes up because symptoms may return. Repeat doses may be necessary.

Do not use NARCAN® Nasal Spray if you are allergic to naloxone hydrochloride or any of the ingredients in NARCAN® Nasal Spray.

What is the most important information I should know about NARCAN® Nasal Spray?

NARCAN® Nasal Spray is used to temporarily reverse the effects of opioid medicines. The medicine in NARCAN® Nasal Spray has no effect in people who are not taking opioid medicines.

Use NARCAN® Nasal Spray right away if you or your caregiver think signs or symptoms of an opioid emergency are present, even if you are not sure, because an opioid emergency can cause severe injury or death.

Family members, caregivers, or other people who may have to use NARCAN® Nasal Spray in an opioid emergency should know where NARCAN® Nasal Spray is stored and how to give NARCAN® before an opioid emergency happens.

Get emergency medical help right away after giving the first dose of NARCAN® Nasal Spray.

Rescue breathing or CPR (cardiopulmonary resuscitation) may be given while waiting for emergency medical help.

The signs and symptoms of an opioid emergency can return after NARCAN® Nasal Spray is given. If this happens, give another dose after 2 to 3 minutes using a new NARCAN® Nasal Spray and watch the person closely until emergency help is received.

NARCAN® Nasal Spray may cause serious side effects, including sudden opioid withdrawal symptoms.

Opioid withdrawal symptoms may include body aches, diarrhea, increased heart rate, fever, runny nose, sneezing, goose bumps, sweating, yawning, nausea or vomiting, nervousness, restlessness or irritability, shivering or trembling, stomach cramping, weakness, increased blood pressure.

In infants under 4 weeks old who have been receiving opioids regularly, sudden opioid withdrawal may be life-threatening if not treated the right way. Signs and symptoms include: seizures, crying more than usual, and increased reflexes.

These are not all of the possible side effects of NARCAN® Nasal Spray. Call your doctor for medical advice about side effects.
To report SUSPECTED ADVERSE REACTIONS, contact ADAPT Pharma, Inc. at 1-844-4NARCAN (1-844-462-7226) or FDA at 1-800-FDA-1088 or
www.fda.gov/medwatch.

Please see full Prescribing Information.

References: 1. NARCAN® Nasal Spray. Prescribing Information. Adapt Pharma, Inc. Radnor, PA; 2017. 2. Centers for Disease Control and Prevention. Vital Signs—Prescription Painkiller Overdoses in the US. Available at: https://www.cdc.gov/vitalsigns/painkilleroverdoses/index.html. Accessed August 2018. 3. United Nations Office on Drugs and Crime. Annual Prevalence of Drug Use. Available at: https://dataunodc.un.org/drugs/prevalence_table. Accessed August 2018. 4. Surgeon General's Advisory on Naloxone and Opioid Overdose. U.S. Department of Health and Human Services. https://www.surgeongeneral.gov/priorities/opioid-overdose-prevention/naloxone-advisory.html. Accessed May 2018. 5. US Department of Justice, Drug Enforcement Administration. A Briefing Guide for First Responders. 6. Drug Enforcement Administration. DEA issues nationwide alert on fentanyl as threat to health and public safety. Available at: https://www.dea.gov/press-releases/2015/03/18/dea-issues-nationwide-alert-fentanyl-threat-health-and-public-safety. Accessed August 2018. 7. PoliceOne. White paper: Building an opioid overdose reversal program. Availabe at: https://www.policeone.com/police-products/medical-supplies/articles/212042006-White-paper-Building-an-Opioid-Overdose-Reversal-Program/. Accessed August 2018.