In the wake of the opioid crisis, police services across the country have adapted to better support the needs of their struggling communities.

Since 2016, more than 10,300 people in Canada have died from opioid-related causes, according to the Public Health Agency of Canada. One of the most simple and effective practices has been equipping front line officers with naloxone, a drug that reverses opioid overdoses. The practice of equipping naloxone has been embraced by nearly all of Ontario’s major police services, and has consequently saved lives. Yet in Windsor, Ont., police chief Al Frederick has refused to equip his officers with the life-saving drug, despite requests from his own police association.

“We feel the best response to a health care crisis is a health care responder,” Frederick said in an interview with VICE, noting that police do not typically transport people to hospital where they can receive further treatment.

The 25 largest municipalities in Ontario are covered by 17 different police services, and all but one—Windsor—have equipped their officers with naloxone. In 2018 alone, London police successfully reversed 57 overdoses by using naloxone on 59 people, saving all but two. The Waterloo Regional Police Service has administered naloxone 51 times since they began carrying it in 2018, and the Ontario Provincial Police has administered it 55 times since 2017. As of last December, Hamilton police saved 16 lives using naloxone.

Though there isn’t much else the Windsor Police Association (WPA) can do, they are still in favor of carrying naloxone on the front lines, having made a recommendation to Frederick to allow officers to carry it. “Any opportunity to save someone’s life, the association supports it,” says WPA president Jason DeJong. “If we found someone with a cardiac arrest and they need CPR or a defibrillator, we have access to those tools and we’re gonna use them.” When asked why Frederick ignored their recommendation, DeJong said: “You’d have to talk to the chief on that. I don’t quite understand it.”

Frederick said he sees police carrying naloxone differently from the association and other police services. As a medical response, he believes paramedic and firefighting services are better suited to deal with overdoses.

Of course, Windsor police provide first aid and CPR, but Frederick says, “we are not trained, and we are not mandated by the legislation to administer naloxone.” He adds, “most importantly, I want to be part of a system that is based on evidence. And the evidence is that the medical responder is the best responder.”

In response to evidence that police have saved lives using naloxone in municipalities across the province, Frederick said, “I couldn't speak to what's happening to those communities at all. I have no idea.” When asked, given the statistics, if he could acknowledge that police carrying naloxone has life-saving potential, he said “I couldn’t say that for sure.”

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Windsor is currently experiencing a problem with methamphetamine, but opioid deaths in the area have closely followed the provincial rate since 2014. Between that time and June 2018, there have been 131 opioid deaths and 581 emergency department visits in Windsor-Essex county, according to data from the Windsor-Essex County Health Unit. The downtown core has been hit hardest, which Ward 2 councillor Rino Bortolin called “a ground zero” for drug-related activity in the city. Bortolin lives and works in his downtown ward, which receives the majority of Windsor’s calls for drugs and opioid overdoses. Bortolin, who was recently appointed to the Windsor Police Services Board and has a naloxone kit at home, wants to push the issue of naloxone to the board. “I would just like to better understand why the chief continues to take the stance that the police shouldn’t be carrying it.”

Naloxone is an easy-to-use drug that can immediately reverse the effects of an opioid overdose. It’s widely available to civilians, and its proliferation has been instrumental in responding to the increased presence of highly powerful opioids like fentanyl in Canada over the past five years. Fentanyl and other opioids have also been laced in non-opioid drugs, making the threat of overdose a possibility for substances that have not been tested.

The reason to equip police with naloxone is twofold: it’s a precautionary measure for officers who could be potentially exposed to substances like fentanyl, and it’s an effective first response tool for suspected overdoses on the street. But until April 2018, the Special Investigations Unit (SIU), which investigates cases of police malfeasance, were looking at cases where people died after police administered naloxone. Liability issues made some police chiefs hesitant to carry naloxone, until the SIU ruled against making such investigations last year. Without any financial or liability constraints, there is now little reason to oppose carrying naloxone.

“There are a lot of times where [police] are there first and EMS might be a minute or two behind us,” says London deputy police chief Daryl Longworth. “That can make all the difference in the world.” It only takes a few minutes of circulatory and respiratory stoppage to cause permanent brain damage from an opioid overdose, which naloxone can instantly reverse.

Beyond carrying naloxone as a precautionary measure, the 57 overdoses his officers reversed in seven months are proof to Longworth that the policy has been successful. “Would EMS have arrived and done the same thing? Yes. Is it possible some of those effects couldn’t be reversed because of the time delay? Maybe. So I would say it’s a success.” However, he couldn’t comment on whether or not carrying naloxone was an appropriate measure for areas outside his jurisdiction.

Longworth acknowledges the need to delineate medical responses from police responses, but says “we can’t forget that one of our primary mandates is the protection of life. If somebody was bleeding on the street and we had a tourniquet, which our officers carry, we would use it.” To Longworth, naloxone is “just one more step. We’re not talking about doing heavily invasive medical steps, but it seems to be something easy.”

Barring the equipping of naloxone, Frederick says Windsor police have taken additional steps in response to the opioid crisis. They just hired 24 officers to specifically address drug issues downtown, and the city set up a mobile outreach unit that receives police support. Ultimately though, Frederick points to provincial legislation, which doesn’t mandate equipping police with naloxone. “The legislation doesn’t identify police as medical first responders,” he says. “And as I said, the medical response is the best response.”

Frederick had planned to retire over a year ago, but a suitable replacement was not found. He is now set to retire in June, and the Windsor Police Board is still early in the process of finding a new chief.

Windsor Mayor Drew Dilkens, who serves as chair of the police services board, did not offer comment for this story, despite numerous requests.

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Though its potential for saving lives has been demonstrated, there is little research and oversight into how naloxone is being used by police in Ontario and across Canada. Ontario’s Ministry of Community and Correctional Services doesn’t track the police’s use of naloxone, and gives police chiefs the final word on whether or not to equip it. The Ontario Association of Chiefs of Police surveyed their colleagues in 2017 to determine which services were equipping naloxone, but only 35 out of 51 replied. The survey was also conducted before the SIU ruled against investigating failed overdose reversals, which at the time was a major concern for many services who were still deciding whether or not to carry it.

Some police services openly provided VICE their naloxone use statistics, but the levels of detail were varied, and others would not disclose their statistics without a Freedom of Information request. Ottawa police doesn’t even keep comprehensive records of police administering naloxone, according to their media relations department. This is a major barrier for creating evidence-based research that can help police chiefs make informed decisions about whether or not to equip officers with naloxone.

But naloxone is only effective as an immediate emergency response. Longworth stressed the need for available treatment and prevention resources for people experiencing addiction, but says, “I don’t think we’re at that point as a province.

“We may be preventing their death today through harm reduction, but they may die next week, next month, next year. So what are we doing to help them in the long run?”

As the Ford government defunds several supervised injection sites as part of new overdose strategy that places a limit on the number of sites in the province, the onus for proactive solutions is falling more and more onto municipalities. In Windsor, Bortolin says “we continue to blame the province for inaction and the lack of funding for mental health, for addictions services, which are all true. But there are actions that can be taken that are happening in municipalities across the province that are more proactive from a municipal lens.”

Overall, Bortolin says he’d like to see less of a “hard on crime” approach from police and more done on the harm reduction and treatment front, and to him, equipping officers with naloxone is a part of that solution. “At the end of the year, if it’s one or two lives saved, what’s the price tag on that? Why wouldn’t we, even if it was one [life]?”

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