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Fight to curb Jefferson County overdoses shifts to EMS personnel

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Despite an extended push to arm Jefferson County sheriff’s deputies with a new form of the overdose reversal drug naloxone hydrochloride, commonly known as “Narcan,” data show there are misconceptions about how effective that would be since deputies are usually not the first to respond to overdose incidents.

The data, presented Tuesday by county Public Health Director Ginger B. Hall and Public Health Planner Stephen A. Jennings, include information on the location, nature, causes and circumstances surrounding the rapid rise in overdose deaths since 2010 as well as options for instituting a program designed to save more lives.

Deputies responded to only a small percentage of overdose/poison incident calls in the county during 2011 and 2012, according to Mrs. Hall’s and Mr. Jennings’s report to the Board of Legislators Health and Human Services Committee.

There were 18 fatal overdoses in 2011 and 16 in 2012, according to the Jefferson County medical examiner’s office.

Deputies were the first responders on scene in only two of those fatal overdoses in 2011 and none in 2012.

In 2011, deputies responded to 51 out of 286 overdose/poison calls in the county, or 17.8 percent of calls.

In 2012, deputies responded to 49 out of 254 overdose/poison calls in the county, or 19.3 percent of calls.

In lieu of arming deputies, a new strategy has emerged, one that would enable all basic life support emergency medical service providers to carry the intranasal form of Narcan, which is sprayed into the nostrils via an atomizer.

Narcan blocks the receptors in the brain that respond to opioid-based narcotics such as heroin and prescription painkillers, reversing the respiratory depression that can result in death.

The 13 advanced life support agencies in the county already carry a form of the drug that is injected into the body. The intranasal form is supposed to be safer to carry and easier to administer.

Approval is pending by the state Department of Health for basic life support EMS providers to administer intranasal Narcan, according to the report.

Mrs. Hall said that approval may come during a coming meeting of the state Emergency Medical Advisory Committee, though no agenda for that meeting has yet been provided to Jefferson County Health Services.

In addition to the proposed changes to EMS provider guidelines, legislation is pending in the state Senate that would establish a pilot program enabling staff at some public high schools to administer Narcan, as well as law enforcement officers who have received training on properly administering the drug.

The data also show that overdose deaths are evenly divided between the urban and rural areas of Jefferson County.

Of the 18 overdose deaths in 2011, nine were reported in the city of Watertown and nine were reported outside of the city.

Of the 16 overdose deaths in 2012, eight were reported in the city and eight were reported outside of the city.

Though there is a 50/50 split in the number of fatal overdoses in the city versus the county, from a population perspective, the numbers suggest there is more drug abuse activity in the city, according to Mr. Jennings.

Twenty-two percent of Jefferson County’s population lives in the city.

The majority of drug overdose deaths in Jefferson County are attributed to opioids, and the majority of overdose victims are found to be deceased on scene, according to the report.

In an attempt to get emergency personnel to the scene in time, legislation aimed at encouraging drug users to call 911 without fear of prosecution was enacted recently.

The state’s 911 Good Samaritan Law, which went into effect on Sept. 18, 2011, provides some protection to drug users who call for help when someone they are with is overdosing.

Whereas sharing or giving drugs under normal circumstances can constitute the sale of those substances, such activities do not necessarily constitute a sale if someone calls for help under the new law, according to Jefferson County District Attorney Cindy F. Intschert.

However, the law does not protect people who have sold 8 ounces or more of controlled substances, not including marijuana. It also does not protect people with other outstanding warrants or those who may be in possession of an illegal weapon, Mrs. Intschert said.

“It doesn’t mean there won’t be an investigation, but the intent is to save lives,” Mrs. Intschert said.

Mrs. Hall and Mr. Jennings began the study on overdoses at the request of legislators, who asked for more information about the proposal to give sheriff’s deputies the ability to administer Narcan.

That initiative, which steadily gained momentum in the late spring and early summer as medical professionals and substance abuse counselors persistently lobbied county policymakers, eventually stalled out after County Attorney David J. Paulsen raised concerns over the structure of the program.

Mr. Paulsen told legislators in July that according to state regulations, any such program would have to be sponsored by a local health facility or a medical professional and could place deputies at risk for liability.

The proposal to arm deputies with Narcan initially came with the idea that the New York City-based Harm Reduction Coalition would provide the drug to the county for two years, according to comments made during a May meeting of the Jefferson County Board of Legislators Health and Human Services Committee.

That is not strictly accurate, according to Dr. Sharon Stancliff, medical director of the coalition.

The state Department of Health provides free naloxone to registered programs, while the coalition provides training on implementing naloxone programs at registered agencies, Dr. Stancliff said.

At Tuesday night’s meeting, the consensus among legislators was to wait and see what the state would do before considering any other options.

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