LINEVILLE PD

GENERAL ORDERS LINCOLN POLICE DEPARTMENT

SUBJECT: GENERAL OPERATIONS

TITLE: NALOXONE

EFFECTIVE DATE: JUNE 1, 2025

REVISION DATE:

ACCREDITATION: ALABAMA ASSOCIATION OF CHIEFS OF POLICE (AACOP)

APPROVAL: CHIEF DARREN E. BRITTON

NAXOLONE

342.1 PURPOSE AND SCOPE

The purpose of this policy is to provide approved members with guidelines to utilize Naloxone in order to reduce fatal opiate/opioid exposure overdose.

342.1.1 DEFINITIONS

EMS - Emergency Medical Services that provide pre-hospital emergency medical care; such practitioners provide out-of-hospital care for those with an illness or injury.

IN - Refers to the intranasal (IN) administration of Naloxone.

IM - Refers to the intra-muscular (IM) administration of Naloxone. The Intra-muscular device is used to deliver a pre-measured dose of the medication directly into a large muscle that enters the bloodstream.

MUCOSAL ATOMIZATION DEVICE (MAD) - Intranasal Mucosal Atomization Device is used to deliver a mist of atomized medication that is absorbed directly into a person's bloodstream and directly into the brain and cerebrospinal fluid via the nose-to-brain pathway. This method of medication administration achieves medication levels comparable to injections.

NALOXONE - An opioid receptor antagonist and antidote for opioid overdose produced in intramuscular, intranasal, and intravenous forms.

NARCAN - A prefilled injectable device, compatible with the intranasal mucosal atomization device (MAD) for nasal rescue. Narcan is the brand name for Naloxone.

OFFICERS - Employees of the Lincoln Police Department are limited to certified law enforcement officers, and certified detention officers.

OPIATES- Naturally derived from the poppy plant, such as heroin and opium.

OPIOIDS - Synthetic opiate drugs such as fentanyl, morphine, buprenorphine, codeine, hydromorphone, hydrocodone, oxymorphone, methadone, and oxycodone. Opioids also include illegal narcotics, such as heroin, which may be mixed with otherwise legal medications, such as fentanyl.

OPIOID OVERDOSE - an acute condition including but not limited to extreme physical illness, decreased level of consciousness, respiratory depression coma, or death resulting from the exposure, consumption or use of an opioid, or another substance with which an opioid was combined, or that a layperson would reasonably believe to be an opioid-related drug overdose that requires medical assistance.

UNIVERSAL PRECAUTIONS - An approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV, and other blood-borne pathogens.

342.2 POLICY

It is the policy of the Lincoln Police Department for trained officers to administer Naloxone (Narcan), in accordance with state law, guidelines, and oversight, to coworkers and Department Police canines suffering from opiate/opioid exposure overdose at the earliest possible time to minimize chances of death. (Code of Alabama 20-2-280 (b) (2), (d), and 20-2-282)

342.3 USE OF NALOXONE

Only officers trained in the use of Naloxone are authorized to administer Naloxone in the field to coworkers and Department Police canines. Officers shall follow protocols outlined in their Naloxone training when using Naloxone kits.

Officers will maintain universal precautions against pathogens, perform patient assessments, and determine unresponsiveness, absence of breathing, and/or pulse.

Officers shall perform an assessment by checking for signs of opioid overdose, such as: The Opioid Triad:

C - Consciousness - decreased level - (Altered Mental Status)

P - Pinpoint - (Miosis)

R - Respiration - decreased rate - (Bradypnea)

Prior to the administration of Naloxone, the member on the scene shall ensure the following:

The subject is in a safe location, and

Remove any sharp or heavy objects from the subject's immediate reach

Officers should update communications that the patient is in a potential overdose and state that Naloxone administration is intended, this includes each time a dosage is administered.

Communications will promptly notify responding EMS.

Administer Naloxone (Narcan) using the approved MAD or injectable device. If necessary start CPR/rescue breaths using CPR face mask/barrier protection device and continue until victim is revived or EMS responds.

If after two (2) to three (3) minutes of administering Naloxone, there is no improvement or the victim remains unconscious, or no breathing or pulse, and if available, one (1) additional dose of Naloxone (Narcan) may be administered.

Continue CPR/rescue breaths using CPR face mask/barrier protection device until victim is revived or EMS responds.

Officers should use caution as the subject may wake up being combative.

Officers shall also inform EMS who arrive on the scene of the use of the Naloxone kit and each dosage administered. This is done to track the treatment and dosages.

Supervisor notification should be made as soon as practicable, in addition to formal documentation in a written case report and completion of the LPD Naloxone Usage Report.

342.3.1 USE ON DEPARTMENT POLICE CANINES

Clinical signs of opioid overdose are highly variable in dogs. Intranasal or intramuscular Naloxone are both effective in dogs (average-sized working K9s (55 to 88lbs), and the standard dosage carried by most first responders, 2mg or 4mg, falls within the safe range for an average working dog and is appropriate for reversal of potential opioid toxicosis. It is likely that with higher amounts of opioids, repeated treatment with Naloxone may be needed.

First, it is essential to remember that law enforcement K9s may be trained to bite with extreme force. A basket muzzle (which allows the dog to pant, an essential cooling mechanism) is placed on the dog first before an intramuscular injection is given.

If the dog is collapsed, the muzzle should be placed immediately after the Naloxone has been injected.

Naloxone (Narcan®) can be administered via the intramuscular or intranasal route.

Intramuscular injection may last longer and is usually given in the outer side of the rear thigh. The sciatic nerve runs down the back of the thigh so grabbing a section of muscle on the outer thigh and injecting it with the needle facing the dog's head (front of the dog) will prevent injections into the sciatic nerve.

Since you administer intranasal Naloxone without the muzzle, it's essential to consider the dog's demeanor before proceeding. Place a basket muzzle immediately after administering Naloxone.

A dog's response to Naloxone is unpredictable, and the K9 may wake up flailing and biting.

The intranasal injection is very similar to people except for the long nose and hairy face. Hold the snout closed with one hand and place the tip of the atomizer/device inside one nostril.

Then, compress the syringe/device to deliver the Naloxone. Immediately place a basket muzzle on the dog.

342.4 ISSUE OF APPROVED KITS

Naloxone kits and associated carrying cases shall be issued, as available, only to trained members. Kits should be worn on duty belts when feasible by uniformed members.

All members who are issued Naloxone kits shall ensure that the kits are not exposed to high temperatures.

Officers shall monitor the expiration date or shelf life of the Naloxone and not utilize any agent past its expiration date.

All Naloxone shall be replaced three months prior to its expiration date by returning the unused agent for a replacement agent. The officer who is seeking replacement shall sign for the replacement agent.

It is the responsibility of the officer to whom the Naloxone kit is issued to maintain the safety and security of the kit at all times. The kit shall not be left in an unsecured location or in the police unit when the officer is off duty.

Officers shall seek a replacement for the Naloxone agent as soon as possible after a kit is used.

342.4.1 NALOXONE (NARCAN) KIT CONTENT

When available, Naloxone (Narcan) will be provided in a clearly marked kit for either:

Intranasal, or

Intramuscular use.

Each intranasal Naloxone (Narcan) kit shall include:

Instructions for administering intranasal Naloxone;

Two (2) MAD devices.

One (1) CPR face mask/barrier device belt pouch.

Each intramuscular Naloxone (Narcan) kit shall include:

Instructions for administering intranasal Naloxone;

Two intramuscular injectable devices,

One (1) CPR face mask/barrier device belt pouch.

342.4.2 STORAGE OF KITS

Naloxone MAD devices shall be stored in accordance with:

(a) Manufacturer's instructions, and

(b) In agency approved, and provided storage containers.

Containers are used to avoid extreme cold, heat, and direct sunlight.

Naloxone kits shall be carried into the Officers' residence at the end of their tour of duty and placed in their patrol vehicle at the beginning of each tour of duty. Narcan intramuscular injection devices shall be stored in accordance with:

(a) Manufacturer's instructions, and

(b) Not be left in a patrol vehicle when off duty.

Injectable devices shall not be refrigerated or frozen.

Injectable devices shall be protected from exposure to excessive heat.

Injectable devices shall be stored at or near room temperature.

342.5 DOCUMENTATION OF USE

Upon completion of a medical assist with Naloxone administration, the officer shall submit a written report detailing the incident, the care the patient received,and that Naloxone was administered (IN or IM) and whether the Naloxone use was successful.

Additionally, the officer shall complete the LPD Naloxone Usage Report and forward the completed copy via the chain of command to the Naloxone Coordinator (similar to the Use of Force form process).

The Naloxone Coordinator will ensure that a copy of the LPD Naloxone Usage Report is forwarded to the appropriate state Medical personnel. These records must be completed for program integrity, statistical value, and tracking of the Nasal Narcan deployment.

342.6 NALOXONE COORDINATOR

The Naloxone Coordinator will administer the law enforcement program. The Naloxone Coordinator's responsibilities will include:

(a) Ensuring that the Naloxone kits are current and not past the expiration date.

(b) Ensure proper and efficient deployment of Naloxone for field use.

(d) Ensure that any use of Naloxone on a subject is documented in a Case Report.

(e) Replace Naloxone kits that are damaged, unusable, expired, or used.

342.7 TRAINING

Naloxone is discretionary equipment. Officers are not required to carry and use Naloxone. They are encouraged to do so as they may be able to save the life of a co-worker, who may be experiencing an overdose from exposure to, an opioid, but should only do so if they feel comfortable deploying in emergency circumstances.

Mandatory Training:

(a) Whether or not an officer chooses to carry Naloxone, all officers will participate in a course of training on Naloxone via the Department's Training.

(b) Newly hired officers will receive training for the use of Naloxone after graduation, i.e., upon receiving their certification.

(c) Once certified to carry and use Naloxone, officers will participate in a refresher course in the use of Naloxone no later than two years from their last training.

These policies and operating procedures are not designed to cover every possible scenario or situation in society, but rather to define standard operating procedures for members of the Lincoln Police Department. These guidelines are subject to past, present and future judicial review. These guidelines can be amended and or repealed by the Chief of Police as necessary. The policies and procedures herein provided supersede all previous policies and orders.

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