By K.C. Myers

Cape Cod Times

HYANNIS, Mass. — More than two months after Gov. Deval Patrick declared opiate addiction a public health emergency and authorized police to carry the lifesaving drug naloxone in their cruisers, most Cape police departments still aren't able to use the drug.

"The devil is in the details," Dennis Police Chief Michael Whalen said. "We want to offer it. But right now we're wading through a regulatory morass."

The state Department of Public Health regulations regarding naloxone, which is often referred to by the brand name Narcan, are complicated, Harwich police Sgt. Robert Brackett said.

Members of the public can be trained in less than an hour to use the nasal spray, which displaces opiates from the brain temporarily, to revive overdose victims. Narcan has no side effects and causes no harm if administered to someone who is not overdosing.

But police officers — who often respond first to overdose calls — are hampered by state rules.

Specifically, they must get a medical director to oversee the training and write a standing prescription for the administration of the medication. And finding a medical director has proven to be challenge on Cape Cod.

Opiate and heroin addiction has reached epidemic levels in many parts of the country following years of heavy use and abuse of prescription painkillers, which have served as a gateway to heroin.

The governor's emergency health declaration was a response to this crisis. Along with allocating $20 million toward drug treatment and prevention, the declaration was supposed to expedite the regulatory process by which police could begin carrying the drug that has saved thousands of lives. Quincy police have reversed more than 200 overdoses since 2010, when they began carrying Narcan as part of a state pilot program.

Patrick's emergency order is supposed to allow all departments to use Narcan like Quincy. But DPH regulations requiring medical oversight remain a barrier.

The DPH recommends that police get a memorandum of understanding with a hospital to oversee the Narcan program.

Cape Cod Healthcare, which operates both Cape hospitals, has refused to do this.

"The issues surrounding the training of police officers to administer naloxone are complex and involve EMS, fire, police, the state Department of Public Health and the medical community," hospital officials wrote in a prepared statement. "Hospitals have no unilateral responsibility to provide such training, and the police or any other agency interested in being trained are free to contract with any willing and appropriately trained physician to accomplish that task."

The DPH also allows local ambulance services to oversee the program, during the health emergency, according to the regulations.

However, the Cape & Islands Emergency Medical Services System Inc. has also refused. It's illegal to distribute prescription drugs from the ambulance supply, said Alden Cook, deputy director of the Cape & Islands EMS, which conducts training and helps fire departments with the administration of emergency services.

So local police have been working with the state to come up with another option. It now appears that Dr. Steven Descoteaux, medical director of the Barnstable County Correctional Facility, may serve as the countywide overseer of the police's naloxone program.

"I'm happy to allow him to serve as medical director if that's all it takes to get it going," said Barnstable County Sheriff James Cummings.

Anne Roach, DPH spokeswoman, cautioned in an email that the state has "only had preliminary conversations" with Descoteaux and there is no final agreement.

For most police departments, these complications have delayed their Narcan programs.

"It's baloney, but it's typical," said Bourne Police Chief Dennis Woodside.

"It's happening but it's very slow," said Brewster Police Chief Richard Koch. "If we don't get some progress soon, we'll go doctor shopping."

Some police departments aren't waiting for the regulations to be finalized.

The AIDS Support Group of Cape Cod, which is licensed to train civilians to use naloxone, is serving as medical director for the Provincetown Police Department, said Lt. Jim Golden.

And Falmouth and Mashpee have been trained and are carrying naloxone kits.

"The chief wants to be able to save a life and not worry about the red tape," Falmouth police Lt. Sean Doyle said.

Mashpee police already have used it once about two weeks ago, Police Chief Rodney Collins said.

If there are legal questions, Cape and Islands District Attorney Michael O'Keefe will back up the police, Doyle said. O'Keefe said those departments will be legally protected.

In the meantime, O'Keefe has been working with the sheriff's office and the DPH to get a medical director for the entire county.

"I emphasized (in a conference call with the DPH on Tuesday) we wanted to get this done as quickly as possible," O'Keefe said.

Donna Beers, a Bourne nurse, shares the same wish.

On Feb. 26, she got a call from her son's friend. He told her that her son had stopped breathing inside a car. He said he would pull into a Bourne gas station where he saw some police cruisers.

Beers grabbed her Narcan kit and raced to meet them.

"When I got there, the police were doing CPR," Beers said.

She fumbled to assemble the Narcan kit, but kept dropping it in a panic.

"I asked the police for help, and he said he just couldn't do it," Beers said.

He was not trained and was prevented from administering Narcan because of state regulations, she said.

Her son, an opiate addict who she did not want to name, was revived by the Narcan she eventually gave him, as well as the dose given to him when the ambulance arrived.

"I'm glad I had it," Beers said.