“We're not in the business of watching people die whether it's from drugs or someone being shot at,” commented Dill. “We're here to save lives and make things safer, and that's what we're going to continue to do.”

Editor’s Note: The first in a series on opioid misuse or abuse in the Lake of the Ozarks tri-county region, this article focuses on law enforcement carrying the opioid antidote, naloxone. The next part of this series will look at the extent of opioid abuse in the region.

“I don’t care what they say or do, one person dying is not okay. If we can save one person, why wouldn’t you do it?”

So says Captain Chris Twitchel of the Camden County Sheriff’s Office, as he leads an effort to have all CCSO deputies trained and carrying Narcan, the name brand of a nasal spray form of naloxone.

And that attitude towards the easily-administered FDA-approved opiate antidote appears to be the consensus among law enforcement around the Lake area as more local agencies begin carrying Narcan in patrol vehicles. However, the overdose treatment isn’t just to protect those deliberately misusing opioids, it is also needed for accidental cases.

There’s more to the story than you might think.

Who has it

The CCSO is pursuing a grant with the Department of Health, Bureau of EMS for the State of Missouri for all road deputies to be trained to administer and carry Narcan.

The grant would cover EMS licensing training for proper use and cover the cost for 28-30 deputies to carry it, according to Twitchel, approximately $3,000-$4,000 to equip all deputies. The department might also consider starting a coalition with other agencies to help them cover the cost.

In the meantime, however, the Miller County Sheriff’s Office announced deputies had undergone training and would start carrying Narcan in mid-July.

“With the growing heroin epidemic, this training will help save many lives,” the July press release from Miller County stated. “Deputies will also be able to provide information on resources, and help those addicted get the help they need.”

The department’s training in Columbia was provided by the National Council on Alcoholism & Drug Abuse - St. Louis.

In mid-September, the Missouri State Highway Patrol announced it was training troopers and would begin phasing it in starting with the regions of the state with the biggest opioid problems.

Within the week, troopers administered life-saving doses to two people who had overdosed in St. Louis. MSHP personnel within the Troop F region, which includes Camden, Miller and Morgan counties, have not yet administered Narcan. Troopers within the region are being trained in phases so not all of them have begun carrying Narcan at this time.

Lake Ozark Police Chief Gary Launderville says his department has one officer trained, but does not have any Narcan for use. The Sunrise Beach Police Department is in the opposite boat. It has Narcan, but does not yet have officers trained to use it.

According to Osage Beach Police Chief Todd Davis, the OBPD does not carry Narcan, however its ambulance service - similarly to other ambulance services - does carry it and has for years. 

All local law enforcement agencies within Morgan County - including the sheriff’s office, Laurie, Versailles and Stover police departments - now carry and have had training for NARCAN, funded through CLERF. Set up by state statute through the judicial system, the County Law Enforcement Restitution Fund receives monies through court-ordered restitution from the convicted.

Morgan County Prosecutor Dustin Dunklee approached the CLERF board of directors for the funding after being approached by the Morgan County Sheriff’s Office.

While both the prosecutor and the sheriff can request funding from the CLERF board, since its creation, the two offices have communicated about the best uses with the prosecutor making requests to the board, according to Dunklee.

Morgan County has typically used these funds for annual special projects from tasers for the Versailles Police Department and computers for the Stover Police Department to cell phones for officers in various departments.

This year, Dunklee was approached by MCSO Captain J.D. Williams about purchasing NARCAN for the department along with related training for all deputies. After approaching police chiefs around the county, the decision was made to try to fund this program for all of the departments.

The request was approved. It cost approximately $3,500 for the first round of purchases, according to Dunklee. They were able to get a rebate from Walmart due to buying the drug in bulk.

Narcan has a shelf life of two years, and of course, the doses have to be replaced as used.

The Morgan County Sheriff’s Office made one of the first reported uses of Narcan by a Lake area law enforcement agency when a deputy saved a man’s life on Sept. 17, administering a dose to a 20-year-old male subject who was found unresponsive after a 911 call reporting a possible overdose at a residence off Route TT. The deputy was first on scene with the ambulance arriving later.

Dunklee indicated his intent to help cover the ongoing expense of officers carrying Narcan by seeking restitution from defendants in cases where Narcan was used.

The cost for one dose is $75.

Morgan County justice officials are also keeping eyes open for possible federal or state grants. There has also been discussion of possible state funding to supply Narcan free to anybody who requests. If that occurs, local departments may seek to outfit their officers that way.

Since its press release that a deputy had administered a life-saving dose of Narcan, Morgan County Sheriff Norman Dill said he has received some negative feedback from the public, concerned that it was a waste of taxpayer money.

He emphasized that no tax funds were used for the program, and that he didn’t know many people who would balk at $75 to save the life of someone’s son or daughter.

“We’re not in the business of watching people die whether it’s from drugs or someone being shot at,” commented Dill. “We’re here to save lives and make things safer, and that’s what we’re going to continue to do.”

It’s for officers too

Police carrying NARCAN is not just a matter of saving those who choose to abuse opioids; it’s also a matter of officer safety.

“There is discussion that has started in regards to equipping officers with Narcan but more so for accidental overdoses due to coming into accidental contact with some of these drugs during the course of the officer’s duties,” said Osage Beach Chief Davis.

According to Sheriff Dill, the main impetus behind funding Narcan for its deputies was to protect them.

“One of my biggest concerns is a deputy accidentally getting it in their system and overdosing themselves,” he said. “This is more for officers, but if we have the opportunity to help someone - and a lot of times we do get to the scene first - we’re going to do that.”

The increasing mix of fentanyl into the opioid abuse market is main factor putting police officers’ lives at risk in these situations.

This synthetic opiate is 40 to 50 times more potent than heroin and 100 times more potent than morphine, according to an online officer safety alert from the Drug Enforcement Agency (DEA). It is extremely dangerous, especially when mixed with heroin or cocaine.

Commonly sold as heroin, the smallest amounts of fentanyl ingested or absorbed can be lethal, according to the DEA. There have been reports around the country of officers being poisoned after accidentally inhaling or touching a small amount of the drug.

To ensure officer and canine safety, the 2016 DEA alert urged law enforcement agencies to “take appropriate precautions and forego field testing when dealing with the drug.”

The Morgan County Sheriff’s Office does not field test heroin due to the potential for fentanyl poisoning. Unlike with methamphetamine in which a Nartech test is used to verify the substance, suspected heroin and fentanyl is packaged up and sent to the Missouri State Highway Patrol crime lab for testing at a secure location.

“I don’t want to handle it and subject my people to it,” said Dill.

Because of the situation this creates, arrests may not be immediately made in some of these cases, giving the community the false sense that police are not enforcing the law, or are even enabling addicts by continuing to rescue them to continue using without repercussions. Other criticisms from the public - enumerated in comments on the Morgan County Prosecutor’s and Sheriff’s Facebook pages and the MSHP page - include questions over funding and why police don’t carry other emergency antidotes such as EpiPens or why the government is essentially offering a free treatment when others have to pay their own way for treatments like insulin.

The male subject revived Sept. 17 in Morgan County was not arrested in the immediate aftermath of the incident, but that does not mean charges are not still possible, according to Dill.

Opioid overdoses are often linked to batches of heroin cut with fentanyl. In the Morgan County case, witnesses told deputies that the male drank from a jar containing what they claimed was an unknown liquid. The officers seized suspected fentanyl and drug paraphernalia from the residence, but have to wait for the state lab testing of the liquid to confirm that it is an illegal drug before charges can be filed.

A key to keep in mind is that every situation is handled on a case-by-case basis, and much relies on what evidence can be recovered from the scene. The state of Missouri is also considering legislation - already approved by a few other states - that would provide immunity to someone seeking medical help in these situations.

According to Prosecutor Dunklee, the last four heroin overdoses in Morgan County, prior to the Sept. 17 incident, led to the death of the overdosed individual because the people around the person were afraid to call for help out of the fear of being prosecuted. 

It should also be noted that police officers, especially in certain departments such as the MSHP, would be less likely to come across situations in which EpiPens and similar non-drug-related emergency treatments are needed, in comparison to overdoses. Police do not necessarily respond to emergency medical calls. Just as some form of naloxone has long been carried by EMS units so too do these agencies carry other emergency treatments.