FDA urged to promote opioid antidote alongside painkillers (copy) (copy)

Legislation introduced by state Rep. William "Smitty" Pignatelli, D-Lenox, would require first Massachusetts first responders to carry opioid antagonists to reverse overdoses.

Holistically addressing the addiction crisis is a big and complex task, but there is something relatively simple that can be done to save lives and protect first responders throughout the commonwealth. The state should mandate that all first responders carry Narcan.

More than ever, our first responders are frequently heading to overdose calls. How we equip that response should be informed by the ongoing toll of the opioid epidemic. Narcan, the brand name of naloxone, is an opioid antagonist that can immediately reverse an opioid-related overdose. It is portable and simple to use, so it can be easily administered at the scene of a suspected overdose and save a victim from respiratory distress and possible death.

Among the Berkshires’ biggest police departments, several already have their officers carry Narcan, while three notably do not: Pittsfield, Lee and Lenox. That would change with the so-called “HOPE Act,” sponsored by state Rep. Smitty Pignatelli, D-Lenox. The bill (H.2125) would mandate that all Massachusetts first responders carry Narcan or another opioid antagonist either on their person or in their vehicles.

Rep. Smitty Pignatelli: It’s time to act on HOPE

Doses can cost between $20 and $40, so it is a financial consideration for police departments that would be responsible for acquiring kits. That price tag, however, can be reduced through bulk purchasing and leveraging external funding programs, such as the ongoing effort by the Berkshire Opioid Abuse Prevention Collaborative to offer opioid antagonists to the county’s police and fire departments at no cost.

Some might think it redundant to train and equip officers with Narcan if local ambulance services have it. As many first responders understand, however, time is precious at these calls. A police officer or firefighter arriving first on the scene of a possible OD and being able to administer Narcan before an ambulance arrives can mean the difference between life and death, especially in the commonwealth’s rural communities where municipal and regional EMS are often stretched thin.

We can’t ignore the opioid epidemic’s grim toll. Drug overdose deaths — the vast majority of which were opioid-related — claimed more than 93,000 American lives in 2020. That’s more than all of last year’s traffic- and gun-related fatalities in the U.S. combined. In Berkshire County alone, opioid overdoses killed 56 people — a 44 percent jump from the previous year and more than a tenfold increase from a decade earlier. If we can take a relatively simple step at the state level to reduce harm and perhaps save a fraction of those lives, it’s worth it.

We do not take lightly the notion of asking police officers and other public safety personnel to do and carry a bit more. Their responsibilities have only grown heavier amid the addiction scourge and our lacking national response to mental health crisis more broadly.

Yet this measure would also protect first responders on calls that entail contact with unknown substances. The increased presence of potent synthetic opioids in the U.S. illicit drug supply is linked to rising overdoses. For the average person, the lethal dose of fentanyl is about 2 milligrams; a lethal dose of carfentanil is even smaller. First responders could unknowingly encounter what amounts to dust at a scene before they even realize what drugs are present. That was the case when two Southwick police officers had to self-administer Narcan after displaying symptoms consistent with fentanyl exposure during a 2018 overdose call.

Luckily, they were equipped with opioid antagonists, but it shouldn’t come down to luck for our police officers or firefighters whose calls frequently bring them into contact with the grim reality of the opioid scourge. We owe them this basic line of defense that would also serve to mitigate the death and despair of an opioid epidemic that has already caused so much of both. We call on the Berkshire delegation and the Massachusetts Legislature to make the HOPE Act a reality to ensure the commonwealth’s first responders are equipped for the crisis at hand.