Association for Public Policy Analysis & Management

Almost 64,000 deaths in the United States were attributable to prescription opioid overdose in 2015, including deaths associated with heroin, illicit fentanyl, and non-synthetic prescription opioids. The American opiate epidemic has grown since the early 2000s and continues to worsen: the rate of opioid-related deaths has risen by more than 300% since the year 2000, while the rate of fentanyl-related deaths rose by 540% between 2013 and 2016 alone. While abuse of opioids continues to rise, states and local communities have responded with a variety of policies, including prescription drug monitoring programs (in their diverse forms), painkiller clinic regulation, and limits on initial prescriptions for opioids from physicians. One of the interventions upon which policy makers have placed the most hope is, however, increasing access that first responders and the general public has to naloxone. Naloxone is a rescue medication that if administered soon after overdose can reverse an overdose and even resuscitate victims who have suffered respiratory arrest. However, since a primary vector of administration is first responders such as police, the speed with which such personnel can respond to calls for assistance may have significant effects on mortality. We utilize data on all emergency calls for service to police from 29 municipalities nation-wide to assess the impact of increasing burdens of emergency calls on monthly opioid-related mortality in the community. For a subset of communities with reliable time-to-response data, we also assess the impact of additional minutes of response for drug-related (overdose) calls on the numbers of deaths monthly. Finally, we compare these associations across communities with greater and lesser ease of access to naloxone for emergency personnel and consider the mortality benefits that may accrue from increasing capacity to respond to emergency calls and increasing the availability of naloxone for police.