For 18 years, retired Fire Chief Larry Sexton, EMT-B, rallied his company to tackle structure fires or deploy hazmat teams.

Today, he works for Montgomery County Alcohol & Drug and Mental Health Service as a Project Save director in Dayton, Ohio, managing grant funding to provide first responders access to the lifesaving drug Narcan. This could prove a powerful weapon for EMTs in their battle against the opioid epidemic.

The $2 million Project Save grant will be distributed over four years through the Substance Abuse and Mental Health Services Administration (SAMSHA) under the First Responders — Comprehensive Addiction and Recovery Act Cooperative Agreement.

“The grant allows all first responders to provide Narcan to first responders in several counties in southwest Ohio,” said Sexton, who also is a fire officer II, level II firefighter and hazmat specialist. “They can use Narcan on a community member at risk of overdose exposure, or on their partner.”

He added not all first responders — police officers in particular — carry Narcan or receive training to use it. If more police officers carried Narcan, it could save lives if an overdose takes place and a person becomes unconscious.

“When police officers arrive on scene, if they have (Narcan) when they roll up on an auto accident, they can administer it to an overdose patient, and won’t have to wait on EMS to get there,” he said. “Or if they show up at an overdose scene, they can furnish it to the family to administer because relapses often occur when there is an addiction problem.”

Getting the opioid epidemic funds to first responders

Operating under the U.S Department of Health and Human Services, SAMHSA offers behavioral health resources, which include a suicide prevention hotline and an opioid treatment locator, to name a few.

In response to the opioid epidemic, SAMHSA offers grant funding opportunities to provide addiction treatment programs and services for people addicted to opioids or individuals at risk of overdose, said Judith Ellis, lead public health adviser for SAMHSA in Rockville, Md.

At first, SAMHSA began taking first responder grant applications in 2017. They then began distributing $11 million over four years — with an additional $22 million in 2018, over four years.

“There is a four-year distribution of the first responder grants, but the $11 million was tied to 2017 only, and 2018 is for $22 million,” Ellis said.

After organizations receive grant funding, they can operate at their own level of governance, within the guidelines of the grant.

“Eligible applicants fall under state, local government entities, like health departments, fire departments, law enforcement and tribal organizations,” Ellis said. “States and communities in states are supported by the first responders’ grant.”

First responder grant eligibility is funded by Section 546 of the Public Health Service Act, Ellis said.

“The grant is for people most at risk of overdose from opioids including prescription opioids and heroin,” she said.

FR-CARA guidelines state: “Grantees will train and provide resources to first responders and members of other key community sectors at the state, tribal and local governmental levels on carrying and administering a drug or device approved or cleared under the Federal Food, Drug and Cosmetic Act for emergency treatment of known or suspected opioid overdose.”

Whose job is it and what’s the exposure risk?

Exposure risks on the job prove very real for first responders, Sexton said.

Case in point: While transporting a suspected overdose patient from Fairborn, Ohio, to the hospital, according to news reports, the ambulance driver felt sick and struggled to read the speedometer, to the point his partner jumped out of the ambulance and administered Narcan.

All first responders can become at risk of accidental exposure. Sexton thus meets with police chiefs regularly to discuss potential risks when Narcan isn’t available.

“In 2017, Ohio had the second highest rate of drug overdose deaths involving opioids in the U.S. There were 4,293 reported deaths,” according to the National Institute on Drug Abuse.

Given the number of overdose deaths in the state of Ohio and the likelihood of police officers stumbling onto a drug bust scene, it’s logical to carry Narcan. But the two minds don’t always agree, Sexton said.

“Our biggest customer right now for this grant is law enforcement,” Sexton said. “Even so, police departments are still reluctant to carry Narcan. They usually say no, it’s the fire department’s job.”

But, there are exceptions to the rule, Sexton said. Some officers receive treatment immediately, such as those involved in drug busts who may become exposed.

“One of the ironic things I run into, every officer carries Narcan for their canine officers,” Sexton said. “They want Narcan available for their dogs, but at the same time, it’s easy enough for the officers themselves to get exposed.”

Sexton advocates for all first responders to carry Narcan, including inside jails, considering the amount of drugs confiscated during pat-downs. An April 2018 incident at Darke County Jail in Greenville, Ohio, is one example.

Visit the National Institute on Drug Abuse website to explore how your state compares on overdose deaths.

Learn more about the opioid epidemic in our course Live Individual ALS L-2 — Includes Capnography, Oxygenation & Opioids.