Other Alaska law enforcement agencies carry Narcan. Why don’t Anchorage police?

Calls are mounting for Anchorage police to start carrying the opioid overdose reversal drug naloxone — from advocates, health professionals and at least one mother who lost her son to an overdose last year.

The Anchorage Police Department doesn’t require officers to carry or administer naloxone, also referred to by the brand name Narcan. The department’s policy hasn’t changed even as overdose deaths in the Anchorage area have nearly tripled since 2018. By contrast, other major law enforcement agencies in the state, including Alaska State Troopers and police departments in nearby Mat-Su, have had officers carrying naloxone for years.

Anchorage’s policy calls for officers to perform CPR when someone has overdosed and isn’t breathing. Responding Anchorage Fire Department paramedics who typically arrive within minutes of police assess the situation and administer naloxone if needed.

Some are concerned that policies like that could cost precious time and put patients at higher risk.

Through the afternoon Tuesday, about 20 protesters gathered near police headquarters downtown to push for a change to the department’s policy on naloxone. They held signs asking “Why won’t APD carry Narcan” that also featured images of Bruce Snodgrass, a 22-year-old who died last October of fentanyl poisoning.

Most at the demonstration expressed frustration and confusion about a policy that didn’t make sense to them. When Rebecca Brotzge first heard about the policy, she said, she couldn’t believe it.

[Alaska issues health alert to parents and families amid record overdose deaths driven by fentanyl]

Brotzge’s life had been saved a few years ago when her husband administered Narcan after she accidentally overdosed on a prescription painkiller prescribed by a doctor after a car accident.

She’s thankful that her husband happened to have naloxone on hand because of his job, and she says she doesn’t understand why police officers wouldn’t carry it as well.

“I mean, what’s the issue? Do they not want to pay for it? I don’t get it,” she said.

Overdose deaths in Alaska have risen as fentanyl has increasingly taken a toll in recent years, part of a national opioid epidemic that’s claimed thousands of lives. In 2021, Alaska reported the largest increase in overdose deaths of any state, according to preliminary data from the Centers for Disease Control and Prevention.

If used at the correct time, naloxone can quickly reverse the effects of a drug overdose that would otherwise be fatal.

Requiring police officers to carry Narcan could save lives, said Sandy Snodgrass, Bruce’s mother.

“The goal is, for me, and I think everyone, is to save lives, to keep people alive, including APD officers,” Snodgrass said.

[‘People will listen to a grieving mother’: An Anchorage mom who lost her son to fentanyl wants to tell her story]

Different approaches

When asked about the reasoning behind the department’s policy, a police spokeswoman said by email that using Narcan is secondary to administering CPR in the case of an overdose.

“The most important component of saving a life is establishing airflow which is accomplished through CPR,” which is what officers are trained to do while they wait for paramedics with the Anchorage Fire Department to arrive, police spokeswoman Renee Oistad wrote.

“We live in an area where both APD and AFD response times are quick,” she said. “Should APD arrive on scene first, administering CPR is the proper response until AFD arrives to assess the situation. Should it be appropriate to administer Narcan or any other drug, AFD will make that determination and do so.”

The Anchorage Police Department rejected a request for an interview with its medical adviser and did not provide any further explanation for why officers don’t carry Narcan.

Oistad did say that in weighing a policy for officers to carry and administer Narcan, APD would consider “operational, medical and legal recommendations.”

“As situations and recommendations evolve, so do our policies,” Oistad said.

In the past few years, drug overdose deaths in the Anchorage area have sharply risen: 51 in 2018, 57 in 2019, 90 in 2020 and a staggering 142 in 2021. And Anchorage’s overdose death rates — reflecting how many deaths occurred per 100,000 people — far outpaced Alaska’s overall rates in 2020 and 2021.

Statewide, 245 overdose deaths were reported last year, and six out of 10 were linked to fentanyl, according to Dr. Anne Zink, Alaska’s chief medical officer. The drug is so deadly because of how potent it is, and how small the margin of error is for a fatal dose.

As overdoses have continued to rise, distributing naloxone has become a key part of Alaska’s overdose prevention efforts. Many other police departments around the state, including in Wasilla and Palmer, require officers to carry the drug.

“It is absolutely our policy for our officers to carry Narcan, and use it when it’s appropriate,” said Amanda Graham, a spokeswoman with the Wasilla Police Department. She said that has been the policy since before she joined the department in 2013.

[Alaska saw a major spike in opioid overdose deaths. Naloxone is a key part of the strategy to prevent more.]

Narcan is safe and easy to administer and poses little safety risk to a patient, and “if there’s any question that somebody’s overdosing, usually (officers) hit him with Narcan” because there are few adverse effects, Graham said.

That policy is particularly important in the Valley, which occasionally goes into “status zero,” meaning there are no ambulances available, Graham added.

“The cops usually get to those calls first, especially in the city limits of Wasilla,” she said. “So it’s definitely, definitely a thing we have out here.”

Between April 2021 and April 2022, Wasilla police administered Narcan 10 times, she said. All of those instances were successful, meaning the patient lived, according to Graham.

Austin McDaniel, a spokesman with Alaska State Troopers, said in an email that troopers are also equipped with naloxone, and have been since 2017.

The Fairbanks Police Department doesn’t have an official policy on Narcan, department spokesperson Teal Soden said in an email. But kits from Project HOPE, a program of the state’s Office of Substance Misuse and Addiction Prevention that assembles and distributes naloxone kits, have been distributed to officers “in case they need it in the event of an emergency involving an overdose,” Soden said. Fairbanks city-run ambulances also carry Narcan, for use and distribution, he said.

Juneau police also carry naloxone while on duty, and if they come across a person with a suspected heroin or opioid overdose “with respiratory depression or unresponsiveness,” officers are instructed to administer the Narcan and request emergency medical services to the location, according to Krag Campbell, special operations lieutenant with the Juneau Police Department.

Nationally, there’s no strong consensus on whether police departments should have officers carry Narcan. Objections have included arguments about cost; whether administering overdose treatments enables drug use or addresses the root of the problem; and whether paramedics are better suited to administer naloxone.

But police Narcan programs have been credited with saving lives in cities around the country, from cities such as Seattle, Chicago and New York to communities such as Tempe, Arizona; Norman, Oklahoma; and Quincy, Massachusetts.

Advocates say reviving someone from an overdose not only gives them a chance to live but also — in cases where someone who overdosed might suffer from addiction — offers an opportunity for them to seek treatment if it’s available.

‘Giving them what they need’

Mike Levy, Anchorage EMS areawide medical director with the Anchorage Fire Department, said he thinks the city’s current policy has been effective. That’s in part because of the fire department’s quick response time, and how closely the police and fire departments work to respond to potential medical emergencies, Levy said in an interview.

Levy advises AFD on their policies and spoke with a previous police chief on the pros and cons of officers administering Narcan when the police department’s current policies were being developed. He said Saturday that he hadn’t discussed the issue with current Anchorage Police Chief Michael Kerle.

While he doesn’t work for the police department in an official capacity, Levy is considered to be APD’s medical adviser, Kerle said during an Anchorage Assembly Public Safety Committee meeting Wednesday afternoon.

The Anchorage Police Department declined to make their medical adviser available for an interview, but Levy — when contacted by a Daily News reporter — agreed to discuss the city’s emergency response to overdoses, as well as the use of naloxone.

“There’s been no incidents of which I’m aware — and I’ve been doing this with the department since 1990-ish — in which we had a situation where we had somebody who was alive and showing signs of life, and then by the time that AFD got on the scene for somebody who’s a pure opiate overdose, that was unsalvageable,” Levy said.

But many people are asking: What’s the harm in having APD officers carry Narcan?

“Unquestionably, naloxone works to reverse somebody who has a significant overdose who’s still alive,” Levy said. He also noted that there’s little harm that can be caused by naloxone, which he described as “a relatively benign drug.”

From Levy’s perspective, he thinks it’s critical for police responding to an overdose to assume the patient may have gone into cardiac arrest — which Narcan cannot help with — and to prioritize administering CPR.

Keeping them breathing makes sure that oxygen can get to their heart and brain.

“If you have somebody that’s had an overdose of an opiate, and you don’t have naloxone but you just breathe for them, then you’re giving them what they need,” he said. Then paramedics can further assess a patient’s condition and use naloxone if needed.

Zink, the state’s chief medical officer, thinks Narcan and CPR are both vital to provide in an immediate response to an overdose.

If it takes paramedics a couple minutes longer than it takes police to arrive, the risk for the patient is higher, she said in an interview: “A lot depends on the timing, the EMS facility, how fast police and EMS work together, how quickly they can have it on scene.”

[Alaska’s fatal overdoses surged last year, a spike driven by fentanyl]

From a policy standpoint, Zink said, a response time of more than a few minutes by paramedics would indicate a need for police to carry the drug.

“It’s surprising to me that Anchorage police don’t carry naloxone,” she said.

Levy believed that police administering CPR was a medically sound response while waiting for paramedics to arrive.

Zink said that from a clinical standpoint, administering CPR to someone who has overdosed “is better than just watching them” — but it’s not a substitute for Narcan, and cannot reverse an overdose.

“That is not as good as someone breathing on their own, and their heart beating on their own,” which naloxone helps facilitate when it’s administered properly, she said.

‘Fed up’

In a recent interview, Sandy Snodgrass said she was “fed up” with APD for its reluctance to change its policy even in the face of so many overdose deaths in recent months and years.

Anchorage recorded the highest opioid-related overdose death rate of any region in the state from April 2021 to March 2022, followed by the Gulf Coast, Southeast and Mat-Su, according to state data.

“Fentanyl is a poison,” Snodgrass said. “And what possible explanation could APD have to not carry Narcan in light of the current situation in Anchorage, Alaska?”

Police didn’t directly answer a question about whether the department is considering changing its policy, so whether Anchorage police officers could someday carry naloxone — either for distributing to the public or administering themselves — remains unclear.

But it’s not for a lack of opportunity. Project HOPE sent the Anchorage Police Department hundreds of their naloxone kits recently.

Police returned the kits so they could be used elsewhere, because they don’t have a policy in place for officers to carry Narcan, said APD spokeswoman Oistad.

Snodgrass has been handing out the kits to officers she sees when she’s out and about.

“I have 100 of them, and I’m handing them out every single day to APD officers,” she said. “I handed out two today to APD officers. And they were very glad to have it. I have never met an APD officer that did not want a Narcan kit.”

Levy, with the fire department, said he wanted to emphasize the point that it’s extremely important for regular people to carry Narcan, and for them to use it when they believe they are witnessing an overdose.

Levy said he also had no qualms with APD officers carrying naloxone, either to administer or distribute — as long as officers were properly trained, and as long as administering CPR remained their priority, too.

“If it was the wish of the police department leadership to do that,” he said, “I would support that.”

[Editor’s note: This story has been updated to clarify Mike Levy’s relationship to the Anchorage Police Department and add comments that APD Chief Michael Kerle made at a public safety committee meeting Wednesday afternoon.]