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The wrong prescription

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Having sheriff’s deputies in Jefferson County do everything they can to help someone during a medical crisis seems like a no-brainer.

When an emergency call is made concerning a drug overdose, for example, the sheriff’s deputies are usually the first ones on the scene. It makes sense to expand their capabilities to take life-saving measures as they wait for medical personnel to arrive.

This has spawned talk of allowing sheriff’s deputies to administer the drug naloxone hydrochloride, which makes it easier for people to breathe during an overdose. Marketed under the brand name of Narcan, the drug reverses respiratory distress when the body is reacting adversely to a controlled substance by blocking receptors in the brain.

Anita K. Seefried-Brown, director of community prevention for the Alcohol and Substance Abuse Council of Jefferson County, has encouraged county officials to move forward with a plan to permit sheriff’s deputies to carry Narcan with them. She accompanied Charles F. Brenon III, director of the Jefferson County Emergency Medical Services, to give a presentation to members of the Jefferson County Board of Legislators Health and Human Services Committee in May.

Legislators Anthony J. Doldo and Robert D. Ferris, both from Watertown, said they favor the plan. Sheriff John P. Burns said he would support the idea of having his deputies carry Narcan as long as they received the proper training.

Implementing such a plan, however, may be more complicated than previously suspected.

During a meeting Tuesday of the Health and Human Services Committee, County Attorney David J. Paulsen laid out what steps the county would need to take. For one, it would need to create an opioid overdose prevention program. This would necessitate a program director, clinical director, training program for administering the drug and record keeping system for when the drug is given, Mr. Paulsen said. He added that sheriff’s deputies could be liable for gross negligence or reckless conduct.

Legislators James A. Nabywaniec, R-Calcium, and John D. Peck, R-Great Bend, as well as County Administrator Robert F. Hagemann III voiced concerns about the idea during the recent meeting. While the plan has the potential for good, county officials must fully examine the risks and costs before moving forward.

The county has seen a rise in cases of drug overdose. EMS teams responded to more than 300 last year. Mr. Brenon compared this plan to increased access to automated external defibrillators in public settings.

There is, though, a major difference between using an AED and administering Narcan. An AED is programmed to detect anomalies in a person’s vital signs that could lead to cardiac arrest. The machine then makes the decision about whether the situation requires delivering electrical currents to revive a regular heartbeat, not the person using the AED.

The choice to administer Narcan, however, would solely be up to the sheriff’s deputy on the scene. Would he or she know how to diagnose someone experiencing an overdose from a person having a seizure? What if the victim has an allergic reaction to Narcan?

It’s true that dispensing Narcan has been simplified. It can now be given nasally as opposed to an injection.

But all other factors involved in possessing and delivering prescription medications make this plan worrisome. Is the county willing to absorb the costs of any liability insurance required for this program? How will it pay for the additional personnel needed to oversee it?

If any such resources are available, they should be used to ensure EMS personnel are available to respond to potential cases of drug overdose along with sheriff’s deputies. Dispensing drugs for overdose treatments should be done by medical professionals, not law enforcement agents.

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