The following is the summary of “Outcomes of law enforcement officer administered naloxone” published in the December 2022 issue of Emergency medicine by Gooley, et al.
Naloxone, when provided by a law enforcement officer (LEO), is a highly successful intervention for treating opioid overdoses outside of a hospital setting. Their goal is to assess the frequency of negative behavioral effects and the factors related to their effectiveness after LEO naloxone delivery. This is a 5-year, retrospective cohort study of patients in a single county’s EMS system who were given naloxone after being arrested. When an opioid overdose was suspected, police used intranasal 4 mg/0.1 mL. Data were collected from paperwork LEO filled out after administering naloxone.
Descriptive statistics were run. Naloxone’s positive effects on patients’ neurological status were the major outcome of univariate regression analysis, whereas patients’ irritation and aggressiveness were secondary outcomes. There were 597 documented instances of LEOs administering naloxone. The LEO reported that Naloxone was successful in 370 of these instances (62%), with 6 exhibiting combativeness and 57 having the composite outcome of irritation or combativeness. Specifically for heroin and fentanyl, the rate of perceived efficacy was higher when an opioid was suspected than when a non-opioid drug was suspected (239/346 [67%] vs. 83/165 [50%], OR 2.21, 95% CI 1.51-3.23).
Their secondary outcome, irritability or combativeness, was solely related with suspicion of fentanyl exposure (7/22 [32%] vs. 45/489 [9%], OR 4.60, 95% CI 1.78-11.8). An overdose victim’s chances of survival are increased when law enforcement officers provide naloxone; this benefit is more noticeable when opioids are the primary cause of the overdose. Rarely does administering naloxone to a LEO result in increased aggressive behavior. To better understand the correlation between post-naloxone behavioral abnormalities and suspected fentanyl intoxication, more study is required.