Police Officers’ Views of Naloxone and Drug Treatment: Does Greater Overdose Response Lead to More Negativity?

• Author: Brenda Russell,Jennifer Murphy
• DOI: 10.1177/0022042620921363
• Published date: 01 October 2020
• Date: 01 October 2020
• Subject Matter: Articles

https://doi.org/10.1177/0022042620921363

Journal of Drug Issues

2020, Vol. 50(4) 455 –471

© The Author(s) 2020

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/0022042620921363

journals.sagepub.com/home/jod

Article

Police Officers’ Views of Naloxone

and Drug Treatment: Does Greater

Overdose Response Lead to More

Negativity?

Jennifer Murphy1 and Brenda Russell1

Abstract

Police officers and emergency personnel are on the frontlines of the opioid crisis. This research

examines police officer attitudes about naloxone administration, drug treatment, and their role

in handling drug-related incidents through an online survey. Although officers view themselves

as adequately trained in administering naloxone/Narcan, almost half (43%) believe there should

be a limit on how often someone who overdoses receives Narcan and the majority (83%)

view naloxone/Narcan as providing an excuse to continue drug use. Officers also view drug

treatment as ineffective. Negative attitudes differed as a function of frequency of overdose

responses; officers who responded to more overdose calls and administered naloxone more

frequently demonstrate more pessimistic attitudes toward drug treatment and the use of

naloxone/Narcan. Officers more frequently exposed to drug overdoses need education and

training about drug addiction issues to decrease stigma and elicit greater empathy toward

people struggling with addiction.

Keywords

drug policy, overdose, naloxone, stigma

Introduction

The opioid overdose death rate in the United States continues to be a major national issue. In

2019, research showed that, for the first time in history, the likelihood of dying from an acciden-

tal opioid overdose was higher than for dying in a car accident (National Safety Council, 2019).

Deaths from opioids is also a major contributor to declining life expectancy in the United States

(Centers for Disease Control and Prevention, 2019). Because of the dramatic increase in opioid-

related deaths, President Trump declared opioid abuse and related deaths to be a public health

emergency in 2017. Similarly, many of the most-effected states have also declared their own

statewide emergencies in an effort to reduce opioid overdose deaths. In 2017, the states with the

highest death rates for drug overdoses were found in West Virginia (57.8), Ohio (46.3), and

Pennsylvania (PA; 44.3).

One policy response to this crisis has been an increase in the availability and use of naloxone

(Narcan), an overdose-reversing drug. By 2017, every state passed legislation increasing access

1The Pennsylvania State University, Reading, USA

Corresponding Author:

Jennifer Murphy, Berks College, The Pennsylvania State University, P.O. Box 7009, Reading, PA 19610, USA.

Email: jxm1192@psu.edu

921363JODXXX10.1177/0022042620921363Journal of Drug IssuesMurphy and Russell

research-article2020

456 Journal of Drug Issues 50(4)

to naloxone (NCSL, 2017; Parker et al., 2018). In addition, most states have passed “Good

Samaritan” laws preventing arrest for possession and other low-level drug offenses during an

overdose call (NCSL, 2017). These policies have been linked to reduced death rates from opioid

overdoses (Abouk et al., 2019; Rando et al., 2015; Rees et al., 2017). Still, little research has

examined police attitudes toward the administration of naloxone and their views of drug addic-

tion and treatment. Given that they are often the first responders to drug overdose calls, police

officers can serve as a positive referral source for someone to enter drug treatment (Formica

et al., 2018; Schiff et al., 2017). However, if they feel overwhelmed by overdoses in their com-

munity, or hold stigmatizing views toward people who use drugs, police officers may have nega-

tive interactions with them or may not want to engage with people who need treatment. The

current study explores police officers’ attitudes toward the use of naloxone, their role in the opi-

oid crisis, and how they view drug addiction and drug treatment. It also investigates the extent to

which exposure to overdose incidents might affect these attitudes.

Attitudes Toward Naloxone (Narcan)

It has become much more common for police officers and other first responders to carry nalox-

one in the last few years (Lurigio et al., 2018). In many areas, community residents can also

obtain naloxone at no cost and, often, anonymously (Wheeler et al., 2015). There is widespread

public support for naloxone expansion (Rudski, 2016), and police chiefs have shown support for

carrying naloxone (Smyser & Lubin, 2018). Still, the increasing availability of naloxone is not

without controversy, and people who hold stigmatizing views toward opioid users may be less

likely to support nonprescription naloxone access (Calabrese & Bell, 2019).

Because this is a relatively new development in policing, there is not much research on police

officers’ attitudes about responding to overdose calls and using naloxone. A 2013 study examined

police knowledge and attitudes about the Good Samaritan law in Washington State, finding that

only 16% of police respondents knew about the law, which had been in effect for over a year

(Banta-Green et al., 2013). The same survey found that police officers were more likely to have

negative views of the immunity component of the law. About 22% of officers also viewed nalox-

one as enabling drug use. Similarly, Green et al. (2013) conducted interviews with 143 officers

in two states and found officers often felt a sense of ineffectiveness and helplessness and a loss

of empathy for individuals who overdose. Other researchers have found police officers often feel

as though naloxone/Narcan provides a free pass and enables drug users to continue their use

(Beletsky et al., 2005; Burris et al., 2009; Green et al., 2013) or engage in riskier drug use

(Reichert et al., 2019; Saunders et al., 2019).

Overdose training and training on the use of naloxone for first responders and law enforce-

ment has shown much success in increasing knowledge about opioid overdose and addressing

concerns about naloxone administration, as well as improving self-efficacy in responding to

overdose calls (Crocker et al., 2019; Dahlem et al., 2017; Khorasheh et al., 2019; Kitch & Portela,

2016; Purviance et al., 2017; Ray et al., 2015; Saucier et al., 2016; Simmons et al., 2016; Wagner

et al., 2016). However, research that examines police officers’ training and attitudes about nalox-

one has rarely also included an examination of their attitudes toward people who use drugs, and

none have assessed their knowledge about addiction. This study attempts to bridge these areas of

previous research to better understand how stigma can play a role in police officers’ views of the

opioid crisis.

Stigma and Drug Addiction

A growing body of research reveals significant public stigma toward people who use drugs and

people with substance use disorders. Research on stigma toward people who have a substance