As the rate of drug overdose deaths in Maine increases — now up to one per day — more and more police departments are equipping their officers with Narcan, a brand of the opioid antidote naloxone.

The Attorney General’s office reports 372 drug overdose deaths in 2016, 317 of which were caused by at least one opioid. To help combat the epidemic, the AG offers Narcan in nasal-spray form free of charge to law enforcement agencies, and currently the office distributes the drug to 45 agencies across the state.

Until recently, Belfast Police Chief Michael McFadden was not planning to have his officers carry Narcan.

“It seemed redundant to me because the ambulance service is right here and we are a relatively small area,” he said in his office on May 4. It made more sense to him that the Waldo County Sheriff’s Office uses it because it responds to rural areas where an ambulance takes longer to arrive, he said.

Belfast Ambulance crews, which also serve the towns of Belmont, Morrill, Northport, Swanville and Waldo, have administered naloxone 17 times since January 2016. Belfast Paramedic Debbie Heath said this does not include the number of doses that have been given by family members or others in the community who carry Narcan.

“You want to give it to them through the quickest route,” she said. “No breathing or shallow respiration is what we’re trying to turn around.”

Opioids cause respiratory depression by binding to receptors in the brain that signal the lungs to slow down. In an overdose, breathing may stop. Naloxone works by replacing opioid molecules bound to those receptors, reversing the opioid’s effects.

Heath said about police carrying Narcan, “It can make a difference, no question about it.” She said she could think of a couple of instances when police arrived before the ambulance and could have administered the drug.

“Minutes do count in some cases,” she said. “It's one of those things you don’t want to not do; you could have saved someone.”

In the calls to which the ambulance has responded so far in which an overdose has led to death, the victims were found too late for Narcan to revive them. There were 5 drug overdose deaths in Waldo County in 2016, according to research conducted by Dr. Marcella Sorg of the University of Maine for the Attorney General's Office.

McFadden said Narcan is a “miracle drug” and said he has seen it work, but mentioned several concerns that made him hesitant about having his officers carry it. First, he said he had to “wrap his head around the fact that we’re going to be administering a medication,” which he said may increase the department’s insurance rates. Then there is all the added work entailed.

McFadden said the additional tasks and responsibilities the department is “constantly bombarded with” are increasing faster than the manpower needed to address them.

Though it sounds simple, he said, starting a Narcan program is a commitment. It would involve training the officers, developing a Narcan policy, signing up for the program with the AG’s Office, tracking the drug, reporting its use, maintaining it at the proper temperature, and replacing it when it expires. He has heard of the AG’s office sending departments doses that are already several months old, he said.

“It can’t get too hot, it can’t get too cold, and it’s got a one-year shelf life.” he said. “God forbid if we fail to replace the outdated Narcan for a month. I don’t know if it stops working. Do you use it if it’s a month over its shelf life? You can’t leave it in the car in the summer, and you can’t leave it in the car in the winter. Unless people want us to run the cruisers to keep it warm in the winter and cool in the summer, officers would have to carry it on their person — and you see some of these guys; they’ve already got stuff all over them.”

Despite these obstacles McFadden was recently convinced to start seriously researching what it would take after a conversation with two doctors from Seaport Community Health Center’s opioid use disorder treatment program.

One of the two, Dr. David Loxterkamp, said he advocates for people to be aware of the opioid epidemic and to help in any small way they can. Anyone can carry Narcan, he said, and he would not hesitate to write a prescription for people with loved ones struggling with an addiction.

The average age of those who died from an overdose in 2016 was 42. Loxterkamp said this shows that even older, seasoned addicts, who take fewer risks than young users, are dying now.

He explained that the epidemic is changing because of the prevalence of the cheap synthetic opioid, fentanyl, and its analogs, which are far more potent than heroin. Heroin changes hands many times and can be cut with fentanyl or may even be all fentanyl and a user can't tell simply by its appearance. Even a grain of a certain fentanyl analog left on a countertop could harm another person if it contacts the skin, he said. If police officers carry Narcan, it could save an innocent victim, or a detective, he argued.

Since that conversation, McFadden said, “I am satisfied that this isn’t just a redundant service that we would be providing, that it covers any potential gaps in the service that some people may need.”

Ellsworth Police Department began carrying Narcan in November 2016.

Detective Dotty Small said, “Personally, I see no reason not to carry it.”

She said officers already have administered the drug four times during the past six months. In one instance a car was being driven at a high rate of speed and the driver pulled over for police in an Emergency Room parking lot. The officer recognized the signs of an overdose and administered the drug outside the hospital, before medical staff were able to respond. Even though the individual was close to medical help, Small counted the case as “a save which could have gone another way.”

Small said obstacles to beginning the program were not significant. She recalled the former chief based the department’s policy on one developed by another agency. A local emergency room doctor trained Ellsworth officers at no charge.

“It’s pretty self-explanatory,” she said, “You open the package and spray it up their nostril. It’s not really involved.”

Detecting signs of an overdose is more difficult, she said; a person may be unresponsive because of a diabetic coma, for example. But administering the drug to someone who is not suffering an overdose does no harm.

She would administer expired Narcan if it was all she had, she said, and there is nothing in department policy that prevents it.

McFadden said he intends to present his plans to the City Council before implementing a Narcan program.

“I think within a couple of months I will have done all the research I need to do and created all the policies I needed to create,” he said. “I say ‘if we can handle it,’ but my thought is that I think we’re going to be able to handle it.”