Narcan and EMS

Today’s burning question: Can a fire department that is not a licensed EMS provider equip its apparatus and train its personnel to carry and administer Narcan?

Answer: In most states the delivery of emergency medical services (EMS) is regulated and licensed at the state level. As such, the precise answer to this question will vary from state-to-state. Typically the state department of health oversees the administration of emergency care by EMS personnel, and more specifically controls the administration of medications to patients in the pre-hospital environment.

Due to the opioid-crisis, most states today are taking a rather unprecedented approach to Narcan. According to Jason Rhodes, Chief of the Rhode Island Department of Health, Center for Emergency Medical Services: “Narcan is now considered to be in the nature of a first aid treatment, and does not have administered by licensed EMS personnel.”

As such, there is no state licensure requirement to carry or administer Narcan, despite its status as an FDA-approved medication. Non-EMS licensed fire departments, police officers, and others (including civilians) are able to carry and administer Narcan. This rather unique exception to EMS regulation by the state does not exempt licensed EMS providers from following their EMS protocols. Rather, it simply permits non-licensed personnel to legally carry and administer this medication.

States like Rhode Island have enacted a special opioid Good-Samaritan law to provide express authorization and immunity protection to anyone administering Narcan in good faith to a suspected overdose patient. Here is the Good Samaritan Overdose Prevention Act of 2016, RIGL §21-28.9

21-28.9-3 Authority to administer opioid antagonists – Release from liability.

(a) A person may administer an opioid antagonist to another person if:

(1) They, in good faith, believe the other person is experiencing a drug overdose; and

(2) They act with reasonable care in administering the drug to the other person.

(b) A person who administers an opioid antagonist to another person pursuant to this section shall not be subject to civil liability or criminal prosecution as a result of the administration of the drug.

A word of caution: because EMS is regulated on a state level, the law will differ from state-to-state. However, most (if not all) states are quickly moving in this direction. Providers should always check with local legal counsel to make sure.

About Curt Varone

Curt Varone has over 45 years of fire service experience and 35 as a practicing attorney licensed in both Rhode Island and Maine. His background includes 29 years as a career firefighter in Providence (retiring as a Deputy Assistant Chief), as well as volunteer and paid on call experience. He is the author of two books: Legal Considerations for Fire and Emergency Services, (2006, 2nd ed. 2011, 3rd ed. 2014, 4th ed. 2022) and Fire Officer's Legal Handbook (2007), and is a contributing editor for Firehouse Magazine writing the Fire Law column.
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