Alexandria “Alex” Macmadu, PhD (she/her) is a Presidential Postdoctoral Research Associate in the Department of Epidemiology at the Brown University School of Public Health, and she is a member of the People, Place and Health Collective (PPHC) at Brown University, which is located in Providence, Rhode Island, USA.

Background: Narrow or non-existent Good Samaritan Law protections and harsh drug selling statutes in the United States have been shown to deter bystanders from seeking medical assistance for overdoses. Additionally, little is known about the actions that police take when responding to overdose events. The objectives of this study were to assess the prevalence and correlates of naloxone administration by police, as well as to examine the characteristics of incidents in which police responded to overdoses.

Methods: We analyzed incident reports of police responding to an overdose between September 1, 2019 and August 31, 2020 (i.e., 6 months prior to and during the COVID-19 pandemic) from a city in Rhode Island. We examined incident characteristics, and correlates of police naloxone administration were assessed using Wilcoxon rank sum tests and Fisher’s exact tests.

Results: Among the 211 incidents in which police responded to an overdose during the study period, we found that police administered naloxone in only 10% of incidents. In most incidents, police were the last group of first responders to arrive on scene (59%), and most often, naloxone was administered by others (65%). Police were significantly more likely to administer naloxone when they were the first professionals to arrive, when naloxone had not been administered by others, and when the overdose occurred in public or in a vehicle. People who overdosed were rarely (1%) described by police as being ‘combative’.

Conclusions: We found that police were rarely needed to administer naloxone and that people who overdosed were rarely perceived as combative. Considering these findings, we recommend that police only attend an overdose incident if specifically requested by the 911 caller. We also recommend that police continue to receive overdose response and prevention training and carry naloxone, as police often encounter overdoses that occur in public or in a vehicle.