Opinion: First responders are sounding the alarm on opioids

When I started my career in law enforcement, I took an oath to serve and protect my community. Now, as executive director of the Pennsylvania Chiefs of Police Association, I see that oath being lived by my fellow law enforcement colleagues throughout the state, from rural areas to the suburbs to urban cities. While each region is different and presents its own set of unique circumstances for law enforcement to work under, it is heartbreaking to see so many lives and communities destroyed by the deadly effects of opioid addiction.  

The opioid overdose reversal agent naloxone has been an invaluable resource when it comes to saving lives – but over the past several years, there have been significant medical breakthroughs and the development of additional overdose reversal agents. 

Naloxone can stop an overdose in its tracks, bringing people back from the brink of death. However, the agent does have its limitations. Synthetic opioids can elude the life-saving effects of naloxone. They are more potent, lead to quicker overdoses, and are longer-lasting than their natural counterparts. Fentanyl, for example, is 50 times stronger than heroin and 100 times stronger than morphine. In fact, just 2 milligrams is considered a lethal dose. For perspective, that dosage is equivalent to 10 to 15 grains of table salt. 

The troubling part is that the illicit drug market is pushing synthetic opioids more and more. We are seeing the majority of overdose deaths linked to synthetic opioids. We are also seeing synthetic opioids mixed with more drugs. An individual might not even know that synthetic opioids are combined into what they are taking. Because the effects of synthetic opioids are so strong, they can outlast those of naloxone, leading to a potential “re-overdose.”

While naloxone is a crucial tool for our first responders and law enforcement, it can’t be our only option.  

But there are other agents available – some that have been found to target the deadly effects of synthetic opioids better. The ability to save lives from synthetic opioid overdoses is crucial in our efforts to combat this pernicious epidemic. Unfortunately, Pennsylvania state health policy prohibits us from accessing these tools. 

Some of the newer overdose reversal agents are longer-lasting and better able to target the deadly effects of synthetic opioids. However, while they have received approval from the U.S. Food and Drug Administration, they are not permitted to be used in the commonwealth due to an outdated standing health order by the Pennsylvania Department of Health. This order only allows for the use of naloxone and doesn’t allow for any new overdose reversal products.  

It’s beyond frustrating when there are tools available that could help us in our quest to save lives. Still, they aren’t available to the law enforcement community due to outdated bureaucratic language. Our inability to quickly adapt and implement every available tool hinders our efforts to fight this crisis. While we stay stagnant and cling to older prevention methods, the illicit drug market is continuing to evolve and finding new ways to evade our efforts to curb the tide of addiction. 

The good news is that the solution is simple, straightforward, and can be implemented quickly (a rarity in government). All it requires is an update to the state’s standing health order to allow first responders, law enforcement, and medical professionals to use any and all FDA-approved opioid overdose reversal agents. The Shapiro administration can unilaterally make this update. Unfortunately, the administration has yet to act. 

It’s time for Pennsylvania to adopt a forward-looking approach to combating the opioid crisis. On behalf of my fellow law enforcement brothers and sisters, I urge the Shapiro administration to act quickly and update Pennsylvania’s standing health order to allow for the utilization of all FDA-approved opioid overdose reversal agents.