State prevention leaders joined forces with local police departments to create an effective naloxone training, distribution, and monitoring program.

On June 3, 2015, then Governor Nikki Haley signed the South Carolina Overdose Prevention Act into law, increasing medical professionals' access to the anti-overdose drug naloxone and authorizing first responders, including firefighters and police officers, to carry and administer it.1,2 The need to expand the safe use of this life-saving medication was urgent. In 2015, 468 people in South Carolina had died from opioid-related overdoses, up from 453 deaths the previous year.3

Police involvement in administering naloxone was critical, as police officers were frequently first on the scene of many overdoses. "Many of our counties are very rural. It takes anywhere from six to eight minutes for an ambulance to respond to a 911 call, whereas law enforcement typically responds in four minutes or less," says Michelle Nienhius, Prevention Manager for the South Carolina Department of Alcohol and Other Drug Abuse Services (DAODAS). "When someone overdoses on heroin or other opioid drugs, minutes can mean the difference between life and death."

But the new state law presented challenges to local law enforcement. "Many of them thought that it was not their place, that administering naloxone was for [emergency medical services] to provide," says Nienhius.

To prepare law enforcement for their new role, DAODAS worked with the state Department of Health and Environmental Control's Bureau of Emergency Medical Services to create a pilot overdose prevention/naloxone training and monitoring program. "We were fortunate to have a forward-thinking partner who had experience training EMTs to use naloxone," Nienhius says. With additional input from the state’s Fifth Circuit Solicitor’s Office, and naloxone products donated by two pharmaceutical companies, the team created the Law Enforcement Officer Naloxone (LEON) program—a comprehensive training and online reporting system.

In January 2016, the state began pilot-testing LEON with six county law enforcement agencies. The program was highly successful, with all participating officers passing the mandatory post-training exam. With funding from SAMHSA's Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths (PDO), DAODAS expanded the program to 15 high-need counties, and eventually to 65 law enforcement agencies across South Carolina’s 46 counties.

Today, law enforcement officers routinely administer naloxone—saving lives and giving people with substance use disorders another chance at recovery.

Nienhius attributes the success of the pilot to the close attention DAODAS and partners paid to ensuring “fit.” The state worked closely with county sheriffs and chiefs of police, taking time to learn about law enforcement culture and build relationships. These efforts helped to improve buy-in and ensure that the program was culturally competent. "We learned that cultural competency isn’t just about working with a particular population," she says. "It also means understanding the culture of the partner agencies we're working with."

According to initial evaluation findings, the LEON program “has led to a number of successes that can be considered 'saves.'"5 As of November 2017, more than 3,700 law enforcement officers have been trained across 102 agencies, resulting in 127 lives saved so far across the state.6 As the program continues to roll out across the state, more and more law enforcement officers report feeling comfortable and confident using this medication.

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