PLYMOUTH — Law enforcement and emergency medicine intersected yesterday at a symposium sponsored by the Lakes Region Mutual Fire Aid at Plymouth State University. About 100 police officers, physicians, and EMT/Paramedics met to discuss opiate and heroin addiction and the possible use of the drug Narcan by law enforcement.
Narcan is an opiate antagonist — a drug that can reverse the effects of opiates and potentially save the life of a person who is overdosing. It has been used for years by emergency medical responders.
With what Nick Mercuri, the chief of the New Hampshire Bureau of Emergency Medical Services and others, including U.S. Sen. Kelly Ayotte have described as an "epidemic" of heroin and opiate overdoses in New Hampshire, some police departments in other states have equipped their police with doses of the drug.
The day began with LRGHealthcare emergency room physicians explaining how opiates and other drugs effect brain function, how usage turns into addiction, and what addiction does to the brain.
Doctors also spoke of predispositions to drug abuse through genetics as well as exposure to drugs at a young age and how casual and social uses often leads to addiction.
Dr. Paul Racicot spoke at length about marijuana, saying while its impossible to know how many people who smoked marijuana as youths didn't become addicts, the evidence shows that nearly every drug addict that eventually seeks treatment or comes to the emergency room with overdose or withdrawal symptoms has smoked marijuana — often as young as age 10 or 11.
"We get frustrated that pot is not considered a gateway drug," Racicot said, dismissing the argument that thousands of Americans are incarcerated for possession of minor amounts of marijuana.
He also said the medical industry is challenging the 1980s concept that every person's pain has to be relieved, describing that decade as the time in American history that pain clinics and "pill mills" became fashionable and inadvertently paved the way to today's heroin and opiate "epidemic."
He said the data shows that many of those who become addicted to heroin began their relationship with opiates because of an injury that required pain killers.
Increasingly, he said high school male athletes are testing the waters of opiate use by stealing them from unused prescriptions from their family members. He noted that many young women who become drug addicts are initially exposed to drugs there by their boyfriends.
As the pain killers become too expensive or as doctors refuse to refill prescriptions, the newly addicted turn to cheap and available heroin and eventually crime to support their habits.
"Your brain hijacks you," explained one physician while another added that addiction can destroy a person's moral code and make things like drug dealing and stealing acceptable to the addict.
Ground zero is where opiate addition intersects with law enforcement and the judicial system.
As the rates of deaths from heroin and opiate overdoses in the state rises, yesterday's symposium organizers provided the above clinical and psychological information to test the waters to learn if area police departments would want police officers to carry and administer Narcan to those who have overdosed.
According to , Narcan (naloxone hydrochloride) is the safest drug EMTs carry.
Now available in nasal form, officers in departments that choose to use it don't have to worry about needles or injections. Like CPR, the goal is to keep the person breathing and his or her airway free until emergency medical responders arrive.
Narcan is an opiate inhibitor and can almost instantly reverse the effects of heroin or opiate addiction. Mercuri said it was administered 832 times in New Hampshire in 2013.
For a variety of reasons, police departments are hesitant. Some worry about liability. Yet others worry about training, paperwork, and storage.
Det. Sgt. Tom Swett represented the Laconia Police Department at yesterday's symposium and said that on a scale of 1-to-5 — with five being very likely to support officers carrying Narcan — he was a three.
"I was a three going into the meeting and I was a three coming out of it," he said.
"We need more information," he said, saying he still has a lot of unanswered questions.
Many of Swett's concerns about Narcan are administrative. He doesn't know if the nasal spray can stay active if it sits in a police cruiser that can reach 120 degrees on a hot day or goes below freezing in the winter. He questioned how much paperwork, certification and training would be involved. He has some concerns for costs and for medical reporting requirements currently required by emergency medical responders but not police.
He said that Laconia's approach toward heroin and other opiate addiction is three-fold — prevention, enforcement, and treatment. There is some desire on the part of some members of the City Council to budget an additional amount of money for a community outreach coordinator who would shepherd the "three-pronged" approach advocated by city police.
"It's not a single sector issue," he said.
He said if the decision is made for Laconia Police to carry Narcan it will be done the right way and likely in coordination with the fire department.
"Once we take on a mission, we will do it," he said. "And we'll have to do it at 100 percent."
Speaking generally, Swett also noted that different police departments have different needs. In Laconia, he said, the fire department provides full paramedic services 24 hours a day, seven days a week that in some way offsets the need for city police to carry Narcan.
"The response times (for paramedics) in the city are terrific," he said.
He said a smaller, more rural community with an all-volunteer fire department would have different fire department response times that could make the first responding police officer, either a local or state police officer, the only person on the scene of an overdose for a while.
Tamworth Police Chief Daniel Poirier said he would definitely carry Narcan if it was an option.
"It's another way to save a life," he said, likening it to defibrillators in cruisers and CPR training that police officers have.
CAPTION: Dr. Paul Racicot of LRGHealthcare and the Nathan Brody Chemical Dependence Program speaks about marijuana being a gateway drug at a symposium about drugs, opiates, heroin and the drug Narcan sponsored by Lakes Region Mutual Fire Aid at Plymouth State University yesterday. (Laconia Daily Sun photo/Gail Ober)