Legislation sponsored by Assemblyman Vince Mazzeo (D-Atlantic) to supersede overbearing local EMS protocols mired in bureaucratic red tape that are putting the well-being of New Jersey residents in danger was approved Monday by the Assembly Health & Senior Services Committee.
The bill’s (A-4467) two-pronged approach would allow first responders to more quickly deploy additional doses of naloxone – the life-saving anti-overdose medication – without an additional and unnecessary approval of their EMS Director and allow first responder departments to use any FDA-approved naloxone product, regardless of dosage.
Current protocols coming from the New Jersey Office of Emergency Medical Services (OEMS) mandate that first responders – including EMT’s and Firefighters – can only give one dose of naloxone, and if the patient is not revived, attempt to call their EMS Director for approval of additional doses. The same protocols also limit first responders’ access to varying naloxone products, including the name brand NARCAN® nasal spray because of the higher dosage in the new products.
Mazzeo noted only EMT and fire departments are under this direction, while police departments and even civilians are free from these restrictions.
“First responders shouldn’t have to pick up a phone to ask permission to save someone’s life,” said Mazzeo, the legislation’s prime sponsor. “Naloxone is proven to save lives time and again. Studies have shown that patients can’t overdose on it. The question, then, is why is the state standing in the way of first responders’ ability to save lives?”
Buena Vista Township Committeeman John Armato of Atlantic County, a 40-year volunteer firefighter, former EMT and current certified recovery coach, worked with Mazzeo’s office in crafting the bill.
“I’ve been on the front lines of the opioid and heroin epidemic and I’ve personally sat for minutes that felt like lifetimes awaiting instructions from an EMS Director instead of doing what my training tells me to do – save lives,” said Armato. “The difference between reviving someone after two minutes and after 10 minutes could mean someone’s life or lifelong mental incapacitation. I’m grateful for Assemblyman Mazzeo’s forward-thinking leadership on this important issue.”
Besides the dreaded phone call for authorization, OEMS is also limiting the market by only allowing first responder departments to purchase 2mg versions of naloxone. Products like the NARCAN® Nasal Spray, a 4mg product and one of the cheapest products on the market, is not allowed to be purchased by departments overseen by OEMS.
“This isn’t about one company or one product,” added Mazzeo. “With the introduction of synthetic opioids like Fentanyl – a drug 50 to 100 times more powerful than morphine – blended with traditional heroin on the street, first responders need the stronger dose to revive someone. Any company switching to a 4mg dose will be left out by the state. It’s simply counterproductive to our mission of saving lives.”
In the “traditional” dose of 2mg naloxone, the patient only actually absorbs 0.4mg. In new products such as NARCAN® Nasal Spray, the dose is 4mg with 2mg actually being absorbed. In many case, the higher dose negates the need for additional doses. Likewise, in October 2016, two advisory panels convened by the FDA voted to recommend an increase of the minimum naloxone dose to 2mg absorption.
Dr. Ken Lavelle, MD, FACEP, NR-P, BC-EMS, a Board Certified Emergency Medicine and Board Certified EMS Physician, oversees over 40 EMS and fire departments in New Jersey as their Medical Director. Despite the fact that he is personally issuing these OEMS protocols to his departments and is in charge of approving the additional doses for EMTs, he testified this morning in support of Mazzeo’s legislation, in direct contradiction to the protocols he has issued.
“My agencies cover one million people and respond to 170,000 calls per year. Police and even civilians can deploy naloxone in a way that my EMTs and firefighters can’t. The state is leaving first responders with one hand tied behind their back and in the end it will cost someone their life. This epidemic is fast moving. Opioids, heroin and synthetic opioids are more powerful than ever. EMTs across the state need access to the best products available at the cheapest cost. That’s why I’m supporting this important legislation.”
The measure now awaits final consideration by the full Assembly.