Police Chief: Require Hospital Trip for Survivors of Opioid Overdoses

Andrew Kitchenman | November 19, 2015 | Health Care
Use of overdose antidote has reduced deaths, but follow-up treatment deemed crucial to prevent return to drug use

Toms River Chief of Police Mitchell A. Little
Emergency personnel have just saved someone from an opioid overdose. Their next stop is a hospital emergency room, whether the victim wants to go or not.

That’s what the police chief in Toms River says is needed to combat the opioid addiction epidemic.

Chief Mitchell A. Little says his department has had success in curbing overdose deaths over the past two years through the use of the opioid-antidote naloxone, known by the trade name Narcan.

The number of overdoses in Toms River has fallen — with 25 in 2013, 22 last year and 19 so far this year — while the number of naloxone-aided overdose reversals has risen from 26 in 2014 to 48 last year and 54 so far this year.

But Little said some overdose victims refuse to be taken to a hospital for treatment, leaving them open to a quick return to drug use.

That’s why he is calling for changing state law or regulations to require those whose overdoses are reversed to be taken by police to a hospital for treatment, in the same way that emergency responders can involuntarily take people in psychiatric crises in for treatment if they think the pose a threat to themselves or others.

Little said he doesn’t see a difference between a patient with a mental illness “and somebody who’s ingesting a chemical into their body that could potentially kill them – and we’re responding to the scene, we’re hitting them with Narcan, and if we didn’t, they’d be dead.”

The use of naloxone is one of several strategies being employed in attempts to curb the use of heroin and other opioids. Those efforts are yielding success, with preliminary state figures showing that the number of overdose deaths was flat in 2014 after rising 58 percent in the previous three years, from 843 in 2010 to 1,336 in 2013.

Police say they’ve been having success by recommending that defendants in municipal court seek drug treatment, based on the mandatory drug-court approach employed by the state. In addition, the state has launched a pilot program to offer a drug counselor in emergency rooms to help patients follow up emergency care with enrollment in drug-treatment programs.

Little said that despite the reduction in overdose deaths, it’s been difficult in Toms River to reduce the demand for drugs. The police department and a local hospital have been using naloxone so much that on a recent weekend, they ran out, he said.

“That’s how bad it is,” said Little, who’s increased the number of undercover narcotics officers from the two or three he had two years ago to six officers in the coming year. “It just keeps getting worse – when you see these numbers, the only thing we can do is try to keep a lid on it.”

Little took part in a panel discussion yesterday at the New Jersey State League of Municipalities annual conference in Atlantic City. He said he’s hoping other municipal officials will support his call for requiring hospital visits for overdose victims.

“Once we get our hands on them, we have to keep our hands on them,” Little said of overdose victims. “Because once they go out the door, the parents won’t sleep anymore, and they could potentially die at any minute. It’s crazy.”

Gloucester Township is trying to reach people before they have a life-threatening episode, hiring a person to serve as a “drug advocate” in municipal court. They meet with defendants who are in court for offenses ranging from driving while intoxicated and other substance-related charges to shoplifting and domestic violence, and urge them to seek treatment.

While seeking treatment isn’t mandatory, 47 percent of defendants have chosen that route, township Mayor David Mayer said.

“I believe that if we can get to them, steer them in the right direction, it’s going to change their lives,” Mayer said.

In addition, after every overdose, the township provides those with addictions and their families with information about drug treatment.

[related]At the state level, the government is funding a $1 million, two-year pilot Opiate Overdose Recovery Program. Through the program, hospitals in Atlantic, Camden, Essex, Monmouth, and Ocean counties have counselors meet overdose victims in the emergency room to discuss treatment. It’s modeled on a successful Rhode Island program.

Dr. Arturo Brito, deputy commissioner for the state Department of Health, said Gov. Chris Christie’s commitment to reducing addiction, as well as cooperation across state departments and “universal understanding that addiction is a disease,” is helping the state’s efforts.

New Jersey State Police have been at the center of efforts to coordinate timely information sharing about drug use and arrests with state and local agencies.

The daily sharing of information has been key to preventing overdose outbreaks from bad batches of drugs like one in 2006 that led to roughly 100 deaths from fentanyl.

State Police Detective Sgt. First Class Jason Piotrowski warned that the state is seeing an uptick in fentanyl use this year. It’s a fast-acting prescription opioid that’s frequently deadly when abused.

“We’re talking about heroin today, but we’re going to be talking about fentanyl tomorrow,” Piotrowski said.