Fight against opioid epidemic in Allegheny County heightens on front lines
The number of police departments in Allegheny County equipped with the opioid-overdose reversal medication naloxone increased more than seven fold during the past year, yet the toll of the drug epidemic is rising, officials said.
"We're certainly hearing in the field that more and more departments are (using) it," said Dr. Karen Hacker, director of the Allegheny County Health Department. "I think it's catching on. You get to a tipping point where more numbers go up and sort of convince other departments as well to get on board."
Sixty-seven of the little more than 100 departments in the county allow their officers to use naloxone, up from 13 last December, according to numbers from the Pennsylvania Department of Drug and Alcohol Programs, which relies mostly on self-reporting from municipal police departments to compile its numbers.
In the little more than two years that police departments have been permitted under state law to carry naloxone, officers countywide have reversed 25 overdoses, as of late November, the state's department reports.
Yet that represents a fraction of the number of people dying because of drug overdoses, specifically from opioids, which include heroin and prescription pain medications such as morphine, codeine, oxycodone, methadone, fentenyl and Vicodin.
In 2014, more than 2,500 people died from drug overdoses statewide. The total rose about 40 percent in 2015 to nearly 3,500, and officials said this year's total is expected to surpass that.
In 2015, there were 422 overdose deaths in Allegheny County, 126 in Westmoreland and 73 in Washington, according to a Drug Enforcement Agency report.
"We continue to have a really big problem in our county with opioid overdoses," Hacker said. "Naloxone is in no way going to be a cure for addiction, but it can save lives and give people an opportunity to recover."
In Pittsburgh, police had used 21 kits of Narcan — the brand name for naloxone — through mid-October, spokeswoman Emily Schaffer said. However, Schaffer noted that does not mean officers used the drug each time or that each incident was an overdose. For instance, Narcan was used on a patient in cardiac arrest, and twice firefighters arrived after police had opened their naloxone kit and firefighters used the officers' supply.
"Whoever gets to the patient first should have Narcan. (The patient) has a better chance for survival," said Pittsburgh Public Safety Director Wendell Hissrich, noting that police also have bag-valve masks as part of administering naloxone. Bag-valve masks help provide air to patients who are not breathing.
"Time is of the essence when someone is overdosing, which is why we have Narcan-ed all the first responders," Hissrich said.
Pittsburgh police began carrying naloxone in May. City paramedics have carried it since 1976.
Paramedics aren't always first on the scene, making it paramount that other first responders carry the drug, officials said.
In February, Aspinwall police Officer Dan Ament was the first on scene for a report of an unresponsive woman. He administered naloxone, and when the woman awoke, she directed him to a nearby address where the man with whom she had been shooting up also was suffering an overdose.
Ament revived the man as well.
In Beaver, Butler and Armstrong counties, no departments carried the reversal drug in 2015. A year later, three of 32 departments in Beaver and 10 of 21 in Armstrong carry naloxone kits, and all but one of Butler's 17 municipal departments carry.
First responders have reversed one overdose in Beaver, three in Armstrong and 11 in Butler, according to the DDAP.
About half of Westmoreland County's 36 police departments carry naloxone, most of which is provided by the district attorney, the county Drug Overdose Task Force or the Westmoreland Drug and Alcohol Commission. DDAP reports 29 reversals in the county since November 2014, when Act 139 allowing police to carry naloxone took effect.
Cutting the wait time
In rural areas, the need for all first responders to carry naloxone is even more critical, said Washington County District Attorney Eugene Vittone, whose county briefly became the face of the rural heroin epidemic in July when police and paramedics responded to 25 overdoses — three of them fatal — over two days.
"A lot of places that we have (naloxone) right now are areas that, a couple years ago, you would have had to wait for an ambulance from Washington (City) or one of the more urban areas to get there," Vittone said. "By that time, because they're not breathing, they can suffer brain damage or death.
"Having fire departments and police equipped with this eliminates this problem."
In 2015, 11 Washington County departments equipped officers with naloxone, a number that jumped to 26 by late 2016, according to the DDAP. Police in the county have reversed more than 100 overdoses since November 2014, Vittone said.
"I think (departments) are recognizing the primary mission of public safety and law enforcement is to protect lives," Vittone said. "This fits right in with that mission."
For the past two years, grants — mostly from insurance companies across the state — have paid for the naloxone kits police keep on hand.
Carol Gifford, a DDAP spokeswoman, said companies and other organizations have donated more than $600,000 in grants since Act 139 went into effect. State district attorneys' and police chiefs' associations managed the money and worked with local police and district attorneys to obtain the drug.
The idea behind the initial funding, Gifford said, was that it would act as seed money, "with the expectation that once local law enforcement started carrying naloxone and using it for overdose reversals, they would continue to do so, and naloxone kits would be replenished using local or state funding."
Allegheny County District Attorney's Office spokesman Mike Manko said his office received 200 doses through the Pennsylvania District Attorney's Association, most of which has been given to county police, the county sheriff's office and a handful of small municipal departments.
Manko said his office will continue to purchase naloxone on its own when the initial supply is gone but will place greater restrictions on which departments receive them, likely handing them out to departments that cannot afford them on their own.
Vittone stressed that Washington County taxpayers do not pay for naloxone.
"We use drug forfeiture money," he said. "This is a harm-reduction strategy," he said. "You keep people alive ... in the hope they get into treatment and recovery. That's a perfect fit for law enforcement's mission."
Megan Guza is a Tribune-Review staff writer. Reach her at 412-380-8519 or firstname.lastname@example.org.