Greetings, I hope this finds everyone well. At a recent Board of Directors meeting, we discussed the amount of time it is taking officers to receive Narcan replacements. The conversation then transitioned into how much Narcan we should be administering in the field and whether we can dispense too much. The conversation concluded with an opinion from the Executive Board that the Narcan you carry is intended for you and your partner. You should conserve your supply of Narcan in case you or another officer are exposed or show signs and symptoms of an exposure. Since this meeting, I’ve obtained some answers from Health and Safety regarding replacement and some information from the heroes at the local fire department regarding use.

Let’s start with replacement. According to Health and Safety, the turnaround time for processing a replacement OD kit is one day. The clock starts ticking once Health and Safety receives your report-of-use form via thousand-miler or email. The replacement kits will be sent to you via thousand-miler. In theory, if you administer a dose of Narcan in the field on your Monday and you submit the report-of-use form by the end of your shift, you will likely have your replacement kit before you start your weekend. If you hand-deliver your report-of-use form to Health and Safety, they will provide you with your replacement kit while you are at their office. Additionally, each area command is responsible for having a Narcan liaison who should have access to spare kits at the area command. Health and Safety believes the liaison should be able to issue you a spare. Full disclosure: The list of Narcan liaisons is grossly out of date. I counted five liaisons who are now retired. If you are a liaison, you should consider updating this with Health and Safety.

During the previously mentioned Board meeting, an officer stated they were recently at a call for service and a member of the fire department informed the officer we should not be giving more than two doses of Narcan. I followed up at a local fire station. Fortunately for me, I was able to catch the firefighters in between their grocery store run and their pickleball game. The fire department is adhering to the guidelines put forth by the Southern Nevada Health District. How do I know this? Because the EMT didn’t initially have an answer, he looked it up on his phone for me. He went directly to the SNHD website, which stated that if a person displays the signs of an opioid overdose, you should administer one dose of Narcan. If there is no improvement within five minutes, administer a second dose. Most information available supports the “two doses if necessary” protocol. The CDC — you may remember them from their chart-topping hit “COVID-19” — recommends providing a second dose after two to three minutes. The amount of Narcan you use may depend on the strength of the opioid, the presence of fentanyl or one of its analogs, and the amount of time it takes medical to reach you.

Why does the Executive Board believe Narcan is allocated for you and other officers? The same reason we believe your tourniquets and trauma kits are meant for you and other officers. Your safety and well-being are paramount to us. Although we all signed up to help people, you can’t help them if you are sick or injured. Think of it as if you were on an airplane; prior to taking off, the flight attendant broadcasts instructions stating that if the cabin loses pressure, you should put on your oxygen mask before helping other passengers put on theirs. In the event you respond to a scene in which there may be an exposure, you need to make sure you can take care of yourself before taking care of those already exposed. In addition to an actual exposure, the concern of potential exposure may add to the anxiety and chaos of a scene.

Department policy 10.275, Medical Supplies and Equipment, discusses the use of Narcan. Under the Opioid Overdose Kit section, the policy initially states that members of the Department are trained in the use of Narcan to reduce the number of fatalities within the community. The policy later states the OD kits “allow authorized users to respond to a member who appears to be experiencing an opioid overdose after an accidental exposure.” Even though the policy discusses caring for injured persons and rendering first aid (6.300 Protecting Crime Scenes and Rendering Aid), the common theme is to summon medical attention. While it is likely a citizen purposely ingested the substance that caused their OD, there is no guarantee you are not at risk of exposure. Are you willing to take that chance?

I’m sure this opinion will ruffle some feathers. Within days of sharing our view at the Board meeting, we received calls from supervisors seeking to confirm our stance. Our answer was simple: Our members come first. This is a dangerous profession. Just because you may be injured while doing your job, that doesn’t mean you have to be injured. We mitigate risk every day when encountering violent individuals; why wouldn’t we do the same at an overdose event? Why does one danger require greater risk to you than the other? Ultimately, the decision to use Narcan on a citizen is yours to make. You will need to evaluate the circumstances and weigh the risks to you, your partner and the public. I can appreciate that no one wants to stand by and watch as a citizen suffers the effects of an overdose. However, I am certain no one wants to watch the Honor Guard present a crisply folded flag to your grieving family, either. As always, stay safe, and trust your training.