Police Attitudes on Naloxone Use for Overdose Improved With Pharmacists’ Help

LAS VEGAS — After pharmacists in one Tennessee county trained police officers on harm reduction and opioid overdose, police attitudes, such as concern and readiness to handle these situations, improved, a survey showed.

Among 89 police officers who completed the survey, mean composite scores in attitude changes towards opioid overdose and use of naloxone (Narcan) improved from 100.73 before training to 106.67 (P<0.0001) after training, as measured by 28 different 5-point Likert scale questions.

“What we can conclude from this is essentially that … pharmacist-led education can improve attitudes towards handling an opiate overdose, decrease implicit biases or stigma, and basically provide a holistic approach to handling the opiate epidemic,” said Gabriele Quaranta, a PharmD candidate at the University of Tennessee’s College of Pharmacy in Nashville, who presented the findings during a poster presentation at the Midyear American Society of Health-System Pharmacists meeting.

From pre-test to post-test, officers’ scores significantly increased among three themes examined:

• Competence, or ability to manage an overdose: 37.7 to 41.9
• Concerns, or concerns about dealing with an overdose: 33.0 to 34.3
• Readiness, or willingness to intervene with naloxone: 30.0 to 30.4

For one question, Quaranta and team saw significant differences in score changes between age and experience groups. In answers to the question, “If I saw an overdose, I would feel nervous, but I would still take the necessary actions,” they found a bigger increase in the score among officers ages 48 and older compared with those ages 47 and younger (0.25 vs 0.02, respectively, P=0.0415), as well as a bigger increase among officers with over 15 years of experience versus less than 15 years of experience (0.24 vs 0.0, respectively, P=0.0243).

Quaranta said that even though there weren’t significant differences in overall scores between younger and older officers, or less or more experienced officers, in subgroup analyses, the differences for this one question suggested that “after the training, older individuals or people with more experience were more willing to intervene as opposed to younger individuals.”

Tennessee remains one of the states hit hardest by the opioid crisis, with the most recent CDC statistics available showing almost 3,000 overdose deaths in 2020. Its police officers are often the first line of defense in preventing these deaths.

“I never heard of this strategy to educate law enforcement personnel, who are the first responders,” Uriel Jimenez Sanchez, PharmD, a pharmacist at Legacy Health in Portland, Oregon, told MedPage Today. “So I think it’s really important that we empower the law enforcement personnel and make them feel comfortable and confident in using these resources.”

Quaranta said that although he’s not sure how clinically significant this intervention is, “I think there are many approaches that can be taken to address the opioid epidemic, and it’s just one of them.”

“We hope that maybe future pharmacist-led trainings in law enforcement can help create a bigger impact,” he added.

Of the 89 Blount County, Tennessee officers who completed the survey, 93.3% were white, 19.1% were women, 55.1% were over the age of 47, and 55.1% had more than 15 years of service.

The training consisted of an hour-long PowerPoint presentation, which was offered as part of an annual in-service training. It covered basic principles of harm reduction, the evidence behind certain harm reduction strategies (i.e., medication-assisted treatment, naloxone, syringe service programs), stigma reduction, and factors that can contribute to substance abuse, like adverse childhood events, poverty, or discrimination. It also reviewed how to recognize overdose and deliver naloxone.

The survey was given before and after training and was sent to officers via email.