Katherine Taylor/The New York Times
Police Chief Bill Collins says some days his officers in Marion, Ohio, respond to several drug overdoses an hour, as the local opioid crisis has become so severe his department is now unable to handle basic tasks like routine patrols.
"It takes away from a lot of our pro-active policing; it takes away from our response time. Maybe we couldn't get to a burglary [in time] because we were on an overdose," Chief Collins says from Marion, a county of about 66,000 people a 2
"Sometimes, these come in two, three, four an hour and you're just going from one to another to another."
Police officers in U.S. cities hit hardest by overdoses from fentanyl and other opioids have essentially become front-line medics – the first to arrive to overdoses and, armed with naloxone, the ones best-positioned to reverse their effects. Police in Canada have also begun carrying the drug as part of their response to the opioid epidemic that is gripping B.C., Alberta and, increasingly, Ontario.
Cincinnati recorded 174 overdoses in six days last week – a figure health officials called "unprecedented." Last year, accidental overdoses killed 3,050 people in Ohio – an average of eight per day. Communities in neighbouring Indiana, Kentucky and West Virginia have also seen the number of overdoses rise in recent years, driven in large part by the growing prevalence of illicit fentanyl.
Last week, the U.S. Surgeon-General took the unprecedented step of contacting every physician in the country with a plea to help turn the tide on the opioid crisis. More than 14,000 Americans died of overdoses involving prescription opioids in 2014, according to the U.S. Centers for Disease Control and Prevention. Canada has no national-level data for prescription-opioid related deaths, but the figure is estimated to be about 2,000.
People who abuse or are dependent on prescription opioids are much more likely to transition to street drugs such as heroin, experts say.
In Hamilton County, which includes Cincinnati, a new initiative from the county's anti-heroin task force has officers bringing willing drug users to treatment facilities rather than jail, said Tom Synan, Newtown police chief and head of the anti-heroin coalition.
"We've gone from traditional policing to everything from being lifesavers by carrying [naloxone], to getting people prepared for treatment and driving them to treatment, working with addictions specialists to help them," Chief Synan said.
"It has forced us to really focus on the user just as much as we focus on the dealer. Our traditional role has been reducing the supply; this has really forced us to work on reducing the demand."
Chief Synan said the steep rise of overdose deaths had been "overwhelming" for police and forced departments to re-evaluate what their roles are when it comes to drugs.
"I don't think we're there yet. Right now, we're getting overwhelmed and we're just starting to bring up these questions and say, 'This isn't working. What can we do that would work better?' "
Police in Marion and Newtown are among a growing number of departments in both the U.S. and Canada now carrying naloxone, a drug that reverses the symptoms of an opioid overdose. Police in Vancouver and Surrey also carry the drug.
On Monday, the Ontario Association of Chiefs of Police and the Waterloo Region Crime Prevention Council were among four groups to issue an advisory warning of an imminent public health crisis due to illicit fentanyl, an opioid that can be 50 to 80 times more potent than morphine.
B.C., which has seen illicit overdose deaths increase 74 per cent this year over the same period last year, declared a public health emergency in April.
In Vancouver, police have a policy of not responding to overdose calls, leaving those to paramedics. Constable Brian Montague, a spokesman for the city's police department, said while police have been investigating a growing number of drug-related deaths, the policy means resources have not had to be diverted as a result in the recent surge.
Joe Couto of the Ontario Association of Chiefs of Police said officials in that province are bracing for the crisis to move east.
"We have a growing concern that what's already happening in B.C., where they have a health emergency, will eventually wind up happening here in Ontario," said Mr. Couto. "It's sort of inevitable."
The federal government, too, has been forced to respond. Canada is the world's second-largest per-capita consumer of opioids, behind only the United States.
Health Minister Jane Philpott has endorsed harm-reduction facilities such as supervised injection sites, and Ottawa has made naloxone available without a prescription.
Ms. Philpott's office has also released a five-point plan of action on opioid misuse that includes a proposal to require a prescription for low-dose codeine products, mandatory risk-management plans for certain opioids and promotion of prescription-monitoring programs that would track how many prescriptions are written and how many are filled.
An opioid summit is also planned for the fall, although a date has not yet been set.