Faculty Collaboration Database

Outcomes of law enforcement officer administered naloxone. Am J Emerg Med 2022 Dec;62:25-29

Date

10/11/2022

Pubmed ID

36215781

DOI

10.1016/j.ajem.2022.09.041

Scopus ID

2-s2.0-85139273729 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

OBJECTIVE: Law enforcement officer (LEO) administered naloxone is an effective intervention for treating prehospital opioid overdoses. Our objective is to determine the rate and factors associated with adverse behavioral effects and efficacy following LEO naloxone administration.

METHODS: This is a retrospective cohort study of patients treated with naloxone law enforcement over 5 years in one county EMS system. Law enforcement officers utilized intranasal 4 mg/0.1 mL for suspected opioid overdose. Data were acquired from forms completed by LEO following administration of naloxone. We performed descriptive statistics. Univariate regression analysis with a primary outcome of improved neurological status and a secondary outcome of patient irritability/combativeness post-naloxone.

RESULTS: A total of 597 cases of LEO administered naloxone were reported. Naloxone was felt to be effective by the LEO in 370 (62%) of these cases with 6 (1%) exhibiting combativeness and 57 (10%) having the composite outcome of irritability or combativeness. The perceived rate of efficacy was higher when an opioid, rather than a non-opioid agent was suspected (239/346 [67%] vs. 83/165 [50%], OR 2.21, 95% CI 1.51-3.23), and for heroin and fentanyl specifically. Suspected fentanyl exposure was the only variable associated with our secondary outcome of irritability or combativeness (7/22 [32%] vs. 45/489 [9%], OR 4.60, 95% CI 1.78-11.8).

CONCLUSIONS: LEO administered naloxone remains an effective intervention for overdose victims, with higher perceived efficacy when opioids are specifically implicated. Combativeness is rare following LEO naloxone administration. Further research is needed to understand a relationship between suspected fentanyl intoxication and post-naloxone behavioral disturbances.

Author List

Gooley B, Weston B, Colella MR, Farkas A

Authors

Mario R. Colella DO, MPH Professor in the Emergency Medicine department at Medical College of Wisconsin
Andrew N. Farkas MD Assistant Professor in the Emergency Medicine department at Medical College of Wisconsin
Benjamin Weston MD, MPH Associate Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Analgesics, Opioid
Drug Overdose
Fentanyl
Humans
Naloxone
Narcotic Antagonists
Police
Retrospective Studies