Law enforcement leaders call for a declaration of a public health emergency

Law enforcement officials like us are on the front lines of the opioid epidemic. That is why we had hoped that the President would invoke the federal public health emergency law as his Commission on the opioid crisis recommended. Declaring a formal public health emergency is much more than a symbolic recognition of reality. It will enable the government to take immediate and effective action to save lives.

The public health emergency act has been used to respond to Zika, the 2009 flu epidemic and hurricanes such as Sandy and Katrina. The threat to public health from the opioid epidemic is at least on the same scale as these past emergencies. Opioids have rapidly become the leading cause of death for people under 50 in this country, and on average more than 140 Americans die each day from opioid use. The sudden rise of fentanyl as a killer drug is just like a tsunami hitting our communities and the damage will be felt for years.

Police, fire and other first responders in our neighborhoods now carry and administer naloxone, a medicine that reverses an overdose and saves lives.  Naloxone should be in the hands of every first responder in the country. However, there are impediments that only federal emergency action can remove quickly: increasing cost, individual prescribing requirements and liability concerns. The federal government can buy large quantities of naloxone at a deep discount and distribute them throughout the country in the same way it has for other health emergencies. Requirements for an individual prescription for naloxone can be waived.  Another federal law, the PREP act can be invoked to provide Good Samaritan immunity for people who administer naloxone in good faith.

More than 280 police departments around the country are actively helping people with opioid use disorders get into treatment and recovery. We have learned there are effective treatments for opioid addiction but they are not widely available. Only federal emergency action can achieve the rapid expansion in treatment that is urgently needed because, sadly, existing federal regulations are major barriers to increasing access to care. Virtually all of these restrictions can be waived under an emergency declaration to ensure adequate medical care for Medicaid and Medicare recipients.  For example, all federally supported health centers, VA, Indian clinics and methadone treatment programs can be required to develop programs that use all effective medication and behavioral treatments.  Regulations that restrict use and payment for methadone and buprenorphine can be waived. By enforcing the mental health and addiction parity laws, the federal government can remove insurance company imposed limits on access to effective continuing treatment.

After our officers and first responders reverse an overdose and transport the victim to the hospital, it is common that they see that person again very soon. Most hospital emergency rooms today discharge overdose survivors without any plan to help them get treatment or avoid a future overdose. Almost no ERs provide medication that will prevent a person from going into withdrawal almost as soon as they are back on the street. Overdose death within hours of being discharged from a hospital emergency room is all too common. Since virtually all hospitals serve Medicare and Medicaid patients, the federal government  can use the emergency declaration to order them to develop programs to treat patients with opioid disease and get paid for the care they provide.

We try hard to avoid arresting people simply because they have the disease of addiction. A very high percentage of incarcerated individuals have opioid disorders. Almost none receive any treatment while they are in jail or prison. Nor are they connected to community treatment and recovery services prior to release. As a result, individuals leaving incarceration are at very high risk of sudden death within days of being released to the community if they start to use opioids again. An emergency declaration can create the framework and resources for interagency collaboration to expand treatment in jails and prisons and build the community infrastructure to support returnees in the community. After a hurricane the federal government often helps rebuild levees and other protection against future calamity. We need that kind of help to stem this flood of heroin and fentanyl.

There is a public health emergency on the streets of our communities that demands immediate action. Law enforcement throughout the country stands ready to help.


The authors are the members of the National Police Council of the Police Assisted Addiction and Recovery Initiative (PAARI), a network of more than 280 law enforcement agencies across that county that believe in treatment over arrest and incarceration