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Jefferson County Heroin Epidemic
Certified Public Manager® Program 2015 CPM Solutions Alabama
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1 Jefferson County Heroin Epidemic
Table of Contents
Team Members .................................................................................................................. 2
Acknowledgements ........................................................................................................... 3
Abstract ............................................................................................................................. 4
Evolution of Heroin ........................................................................................................... 5
The Problem ...................................................................................................................... 7
Solutions ........................................................................................................................... 11
Recommendations ............................................................................................................ 16
References ......................................................................................................................... 20
Appendix ........................................................................................................................... 21
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2 Jefferson County Heroin Epidemic
CPM Solutions Alabama Jefferson County Heroin Epidemic
Team Members
Alabama Alcoholic Beverage Control Board
Tonia Stephens: [email protected]
Alabama Department of Corrections
Linda Houston: [email protected]
Alabama Department of Environmental Management
Kelley Hartley: [email protected]
Lisa Hicks: [email protected]
Alabama Department of Revenue
Judia Green: [email protected]
Alabama Department of Youth Services
Terrence Johnson: [email protected]
Ernest Robinson: [email protected]
Alabama Historical Commission
Stacye Hathorn: [email protected]
City of Columbiana
J. Mark Frey: [email protected]
City of Vestavia Hills
Jim St. John: [email protected]
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3 Jefferson County Heroin Epidemic
Acknowledgements
The Addiction Prevention Coalition
Reverend J. Sandor Cheka
Bradford Health Services
Penny Barnes, Community Representative
John Nicolini, Counselor
Anthony Reynolds, Regional Director
City of Hoover Police Department
Sergeant Ted Davis
Officer Lance Thompson
Jefferson County Coroner/Medical Examiner's Office
Bill Yates, Chief Deputy Coroner
Jefferson County Department of Health
Dr. Mark Wilson, Health Officer
Jefferson County Sheriff’s Office
Jude Washington
Alabama House of Representatives
Representative Oliver Robinson, Jefferson County
City of Vestavia Hills Fire Department
Jeff Burleson
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4 Jefferson County Heroin Epidemic
Summary
Since the year 2000, Interstate 20/59, which passes through Birmingham,
has become a primary thoroughfare for drug trafficking. As a result, there has been
an increase of illicit drug permeation, including heroin, in Jefferson County,
Alabama’s largest county. The largest city in the state, Birmingham has become a
hub for dealers who smuggle drugs to larger cities such as Atlanta, Chicago,
Detroit, Houston, Los Angeles and San Diego.
The elevated drug presence in the Birmingham area, combined with the
increased availability of heroin in general and the decreased availability of opioids
in the form of prescription drugs, has accelerated the use of heroin in Jefferson
County at an alarming rate. The number of heroin related deaths in Jefferson
County doubled in 2012. Two years later that number had more than doubled yet
again. By December 2014, the number of deaths related to heroin had increased by
53% to a startling 137, as evidenced in Figure 1. Sadly, 2015 is proving to continue
this alarming trend.
Figure 1. Number of deaths in Jefferson County due to heroin overdose from 2008 to 2014
137
0
20
40
60
80
100
120
140
160
number of deaths
2008
2009
2010
2011
2012
2013
2014
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5 Jefferson County Heroin Epidemic
Our team was assigned the task of researching the precipitous rise in heroin
related deaths in Jefferson County. Specifically, we were charged with identifying
the demographic profile of heroin users in Jefferson County and the cause of their
accidental overdoses. We were asked to evaluate strategies to bring awareness of
the high risk of accidental overdose and death to users and identify potential
prevention strategies. The team studied statistical information, interviewed subject
matter experts and researched solutions suggested by a local task force organized to
address the problem in Jefferson County and evaluated solutions implemented
elsewhere.
Many stakeholders contributed to the concepts outlined in the proposed
solutions, and we appreciate their participation and commitment to reducing the
use of heroin, and associated deaths across Alabama.
Evolution of Heroin
The Bayer Company began commercial production of heroin in 1898 (J.
Burleson, personal communication, March 20, 2015). In pharmacological studies,
heroin proved to be more effective than either morphine or codeine. The first
clinical trials were so encouraging that heroin was believed to be a wonder drug. In
fact, it was initially advertised as a non-addictive alternative to morphine.
However, despite product claims, repeated administration of heroin resulted in the
development of drug tolerance. Patients quickly became heroin addicts (S. Hostafi,
2001).
Morphine addicts learned about the euphoric properties of heroin in the early
1900s. They quickly discovered that this euphoric effect was enhanced by
administering heroin intravenously. The abuse of heroin spread quickly. In 1924,
the Heroin Act declared all use, manufacturing and distribution of heroin illegal,
including medicinal heroin. As a result of the Heroin Act, both the production and
the consumption of heroin significantly decreased after 1931. However, drug
traffickers recognized the scarcity, and thus the demand, of heroin and began to
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6 Jefferson County Heroin Epidemic
produce and traffic it illegally. The amount of heroin seized by law enforcement
agencies rose gradually at first but the growth of the illicit heroin industry has
exploded worldwide in recent decades, with a tenfold increase since 1970 (S.
Hostafi, 2001).
In recent years, heroin has become less expensive and more readily available
due to increased production in places such as Afghanistan, Mexico and Columbia.
Since the year 2000, Interstate 20/59, which passes through Birmingham, has
become a primary thoroughfare for drug trafficking. As a result, there has been an
increase of drug trafficking and presence in Jefferson County. Birmingham has
become a hub for dealers who smuggle to larger cities such as Atlanta, Chicago,
Detroit, Houston, Los Angeles and San Diego. Birmingham's location on a major
drug trafficking artery ensures that there is an abundant supply of heroin available
in Jefferson County (Jefferson County Drug Task Force, personal communication,
February 20, 2015).
The Problem
Many heroin users become addicted to opioids through the use of prescription
pain killers, often prescribed following an injury or surgical procedure. Others use
pills prescribed to a friend or a family member. Common prescription opioids are
codeine, morphine and hydrocodone, which sells by the brand names of Vicodin and
Lortab; and oxycodone, which sells by the brand name OxyContin. In 2010,
OxyContin, a prescription opioid, changed its formula so that it could not be crushed
and snorted or converted for intravenous use (P. Anson, 2012). Due to this and the
high price of prescription opioids, many have switched to heroin as a more
affordable alternative. According to Anthony Reynolds, Regional Director of
Bradford Health Services, it requires approximately $100 worth of prescription
opioids to achieve the same effect as $15 worth of heroin (personal communication,
April 17, 2015).
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7 Jefferson County Heroin Epidemic
Street-level drug dealers thrive on the paradigms of the long-held economic
principle of supply and demand. Dealing in heroin and other illegal drugs, while
dangerous, is highly profitable. Dealers, as Bradford Health Services Counselor
John Nicolini observed, are “purveyors of death” (personal communication. April 27,
2015) and those in Jefferson County are no exception; a confidential informant
reported heroin dealers netting $12,000 profit per week (personal communications,
March 20, 2015).
Because heroin is illegal and unregulated, the potency is highly variable. The
illegal drug market is extremely competitive and dealers respond to consumer
demand by selling increasingly pure and thus progressively lethal doses of heroin.
Adding to the danger, heroin may be cut with other highly potent opioids such as
fentanyl a highly potent post-surgical pain reliever. Due to this variable potency,
using heroin is like "playing Russian roulette" (M. Wilson, 2014).
Bill Yates, Chief Deputy Coroner for Jefferson County, noted that there were
80 deaths attributed to prescription opioids, 137 deaths attributed to heroin and
seven more deaths in which heroin was a contributing factor in 2014. The majority
of deaths occurred in adult, white males. Out of 137 deaths, 120 people were white
and 17 were black, 90 were male and 47 were female. The distribution of death by
age range is depicted in Figure 2 (B. Yates, personal communication, February 3,
2015).
Age at time of death by heroin overdose Number of deaths in Jefferson County in 2014
0-19 3
20-29 28
30-39 47
40-49 29
50-59 28
60-69 2
Figure 2. Age at the time of death by heroin overdose in Jefferson County in 2014.
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9 Jefferson County Heroin Epidemic
After use, usually by intravenous injection, the victim’s respirations slow and
can altogether stop. This causes all of the body’s tissues to suffer from a lack of
oxygen, especially the sensitive cardiac cells of the heart. After a few minutes
without oxygen, the heart ceases to beat, causing clinical death.
Solutions
Sanders (2001) wrote that the effects of opioid overdose are reversible by the
administration of drugs known as opioid antagonists. These drugs block opioids
from the receptors and allow the brain stem to control respirations. Naloxone is an
opioid antagonist that Field (2006) and the Alabama Department of Public Health
(ADPH) Office of Emergency Medical Services (2013) both identify as useful in
reversing the effects of a heroin overdose. The first steps in supporting an overdose
victim’s respirations rely on manually opening the airway and performing rescue
breathing prior to the administration of an opioid antagonist such as Naloxone (J.
Field, 2006).
Rescue breathing is a foundation of any cardiopulmonary resuscitation (CPR)
training, and is required of emergency medical service personnel in Alabama when
treating an opioid overdose (ADPH, 2013).
The effects of a lethal dose of heroin can be seen as quickly as one minute
after injection. Response time is critical. Putting opioid antagonists in the hands of
first responders is the most immediate way to prevent deaths from heroin overdose.
In the 2015 Alabama legislative session, Representatives Allen Treadaway
and David Faulkner of Jefferson County introduced House Bill 208, which upon the
Governor’s signature on June 4, 2015, became Act 2015-364, authorizes physicians
and dentists to prescribe an opioid antagonist to people at risk of experiencing an
opioid-related overdose or to someone who is in a position to assist another person
who is at risk of experiencing an opioid-related overdose. The law also provides
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10 Jefferson County Heroin Epidemic
immunity for physicians or dentists who prescribe an opioid antagonist and for the
people who administer the opioid antagonist. For the people who seek medical
assistance for another person who has overdosed, Act 2015-364 provides immunity
from prosecution for possession or consumption of alcohol if they are under the age
of 21 and immunity from prosecution for certain controlled substance offenses.
Finally, the law requires training about the use of opioid antagonists for certain law
enforcement officers (HB208, 2015).
Although the U.S. Attorney's Office, State and local authorities have handed
down more stringent sentences for those who traffic heroin, over the past few years,
the number of deaths from heroin overdoses continue to rise. Certainly, drug
trafficking interdiction and strict sentencing are important aspects of the solution,
but law enforcement agencies are understaffed, jails are overcrowded and the high
demand for heroin ensures that there are new dealers eager to replace those whom
they arrest (Jefferson County Drug Task Force, personal communication, February
20, 2015).
Representative Oliver Robinson from Jefferson County believes the long-term
solution must address the demand for heroin. We must educate children, teens and
parents about the dangers of heroin, the effects of heroin on the body and the
damage that heroin addiction does to families. It is crucial to focus on the entire
family, especially the children who constitute our next generation (personal
communication, February 20, 2015). According to Reverend J. Sandor Cheka of the
Addiction Prevention Coalition, the most effective drug prevention programs for
children and teenagers are peer based, led by students who are willing to invest
time and understand the problems associated with addiction. Each school chapter
of a peer-led addiction prevention program must also be supported by a faculty
sponsor who cares about and connects with the children (personal communication,
May 14, 2015). The resulting abstinence among students who participating in a
peer-led addiction program is reported in Figure 4.
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11 Jefferson County Heroin Epidemic
Self-Reported Year End Results for Peer Based Drug Counseling 2011 - 12 2012 - 13 2013 - 14
Abstinence from Alcohol 78.3% 80.4% 88.9%
Abstinence from Marijuana 85.1% 82.2% 90.7%
Abstinence from Illegal Drug Use 91.5% 100% 100%
Abstinence from Medication Abuse N/A N/A 97.7%
Figure 4. Self‐Reported Year End Results for Peer Based Drug Counseling.
To reiterate, many heroin users begin their dependency on opioids by taking
prescription opioid pain medications. According to Cheka, 64% of high school users
acquire prescription drugs from family members, often without their knowledge
(personal communication, May 14, 2015). Prescription drug monitoring and
prescription drug drop-off programs may help prevent access to opioids and
subsequent addiction.
In an effort to detect diversion, abuse and misuse of prescription drugs
classified as controlled substances, the Prescription Drug Monitoring Program
(PDMP) was created. Mandatory reporting began in 2006, and anyone dispensing
controlled substances is required to report the activity to the database controlled by
Alabama Department of Public Health. The goals of the program are to educate
prescribers, dispensers, law enforcement and the public about diversion, abuse and
misuse and to provide a central information source that can be used to provide
information about an individual’s prescription history, reduce abuse and to assist
with possible drug diversion cases.
The Drug Enforcement Agency discontinued their successful prescription
drug take-back events in September 2014. These events allowed individuals to
safely dispose of prescription drugs from their homes. The final collection day
resulted in 5,624 pounds of prescription drugs collected from Alabama households
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12 Jefferson County Heroin Epidemic
deposited at 100 drug take-back sites across the state and 309 tons nationwide from
5,495 drug take-back sites across the U.S. As of October 2014, certain private
entities, such as pharmacies and doctors’ offices, are allowed to collect prescription
drugs. Currently, there are a few drop-off sites made available through grant
money in Jefferson County.
A crucial aspect in the long-term solution is treating recovering heroin
addicts so that they do not return to their habit. Heroin addiction is both
physiological and psychological; such a complex problem cannot be properly
addressed with either short-term inpatient treatment or outpatient treatment.
According to Anthony Reynolds, Regional Director of Bradford Health Services, 86%
of recovered heroin addicts relapse. Those who have been most successful have
participated in a year-long sober living program which combines pharmaceutical
intervention to restore their brain chemistry with psychological and social therapy
(personal Communication, April 27, 2015).
The final piece of the long-term solution is raising awareness. In August of
2014, Jefferson County Health Department led stakeholders in the Jefferson
County area to develop a strategic plan that would reduce the ill effects of heroin
and prescription drug abuse. Ultimately, they developed the “Pills to Needles:
Action Plan." In the plan, there are five strategic priorities which are: Public
Awareness, Partnership with Law Enforcement, Medical Community Engagement,
Effective Research and Policy and Access to Resources. Heightened awareness and
education are key to a long-term solution. It is vitally important that providers are
educated regarding the over prescription of controlled substances, and that
providers, in turn, educate patient populations and their families about the risk of
prescription drug use. It is equally important that education and public awareness
take place among parents and in communities including schools, churches and other
organizations.
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13 Jefferson County Heroin Epidemic
Recommendations
Opioid antagonists
The Opioid Antagonists Act 2015-364, which provides for the prescription
and administration of an opioid antagonist would be bolstered by an expansion of
the Good Samaritan Act, AL Code; Section 6-5-332, to provide immunity to those
who administer an opioid antagonist (see Appendix).
Opioid antagonists are expensive. Currently, a two milligram dose of the
opioid antagonist Naloxone costs $41. A patient experiencing a heroin overdose
usually requires two doses. Financial aid for municipalities wishing to purchase
Naloxone for their first responders should be researched and considered. One
example of such a proactive measure can be seen when Blue Cross of Northeastern
Pennsylvania contributed funds in partnership with the Pennsylvania Department
of Drug and Alcohol Programs which made Naloxone available to police and campus
security officer across northeastern and north central Pennsylvania (Matrisciano
2015). Similar corporate sponsorships should be sought and considered in Alabama.
We further recommend an awareness campaign about the immunity provided
by Opioid Antagonists Act 2015-364, the technical use of an opioid antagonist and
its life saving benefits.
Bulk Currency Legislation
We recommend a state law that parallels the section of Patriot Act of 2001,
which prohibits the smuggling of bulk currency through Alabama. Such a law
would allow Alabama law enforcement officers, particularly those engaged in drug
interdiction, to stop the smuggling of bulk cash used in drug transactions. This
would decrease profit in the sale of heroin by confiscating cash derived from the sale
of drugs being smuggled through Jefferson County on Interstate 20/59 and charging
the driver with a crime.
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14 Jefferson County Heroin Epidemic
Subsections of the Patriot Act of 2001, which prohibit the smuggling of bulk
currency and falls under the U.S. Immigration and Customs Enforcements (ICE)
Homeland Security Investigations (HSI) allows the Jefferson County Drug Task
Force, Interdiction Division, to stop traffic violators to search and seize their
vehicles for drugs and large sums of cash. Due to the lack of a bulk currency law in
Alabama, an officer who locates a large amount of currency during a traffic stop can
seize the money, but cannot arrest the driver unless a crime has been committed or
outstanding warrants exist.
Without a bulk currency law in Alabama, law enforcement officers are forced
to continue allowing suspected drug traffickers found with large volumes of money
to continue their route and carry out potential drug trafficking operations.
Therefore, legislation to enact a bulk currency law and a commitment to increase
resources for those involved in narcotics enforcement in Jefferson County, and their
abilities to intercept drugs and illegal drug sales profits is also recommended.
Prescription Drug Drop-off Programs
Prescription drug drop-off expansion and awareness campaigns are needed to
help eliminate easy access to prescription pills in the home. Internet searches
reveal only three available drop-off sites in Alabama, all of which are in Mobile and
Baldwin counties. Although articles on AL.com report that drop off sites are
available in Vestavia Hills and Mountain Brook, the location of these drop of sites
were not readily available to the public. These drop-off points cannot be properly
utilized if the public cannot find them.
Treatment and Prevention
Through our research, it became apparent that addiction, particularly to
opioids, requires a long-term systematic treatment approach. Treating opioid
addiction is as complex as treating traumatic brain injury. As stated above, the
relapse rate is 86%. However, Vivitrol (naltrexone) which blocks the effects of
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15 Jefferson County Heroin Epidemic
narcotic drugs has shown promising results when included as a part of a year-long
sober living program with psychological treatment. We recommend enhanced
treatment and prevention programs, in which heroin addicts receive long-term
treatment in sober living programs including both pharmacological and
psychological intervention. As discussed above, heroin addicts have an alarmingly
high rate of relapse and such long-term treatment plans have proven to be more
successful than outpatient or short-term inpatient treatment programs in providing
the care necessary to treat heroin addiction. (J. Nicolini, personal communication.
April 27, 2015).
Public Awareness
Finally, we recommend campaigns to promote heightened awareness about
the growing heroin problem. Parents must understand the problem, and children
and teens must understand the dangers. Although children and teens best respond
to peer-based programs, open and honest dialogue in the home, and in schools, is
necessary to lay the foundation for prevention. Furthermore, we must reach out
with educational programs targeting addicts so that they will know about both the
life-saving law which made opioid antagonists more readily available and about
treatment options available to help them overcome addiction. Finally, similar to the
Zero Meth campaign designed to raise awareness to users of meth, we must inform
heroin users of the substantial risks of injecting heroin. Users need to know that
pure heroin kills, heroin mixed with fentanyl kills, and that it is a high that can
literally take their breath away.
The Pills to Needles: Action Plan, discussed above, is an excellent model for
addressing the heroin problem in its multiple facets. It is an example of how the
members of a community facing the heroin crisis have cooperated to develop a
strategic plan of action which addresses five specific areas though which they may
address the problem.
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16 Jefferson County Heroin Epidemic
Conclusion
The problem of heroin deaths in Jefferson County is a dynamic issue which
must be approached on multiple levels. The problem of saving an addict's life from
overdose may be addressed in immediate terms by making opioid antagonists more
readily available. However, the pervasive availability of heroin, educating users,
potential users and families about the dangers and ultimately heroin addiction
itself require not only opioid antagonists to save the lives today but also more
comprehensive, long-term and strategic solutions. Such solutions must include
increased staffing of law enforcement and specialized drug task forces assigned to
eradicate these drugs, laws to stop the smuggling of drug money through Alabama,
prescription drug monitoring programs, prescription drug drop-off points, enhanced
treatment and prevention programs to reduce the number of heroin addicts in the
future, and a heightened awareness of users that heroin is highly unregulated,
inconsistently prepared, and sold to them with no regard for their life.
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17 Jefferson County Heroin Epidemic
References
Alabama Department of Public Health Office of Emergency Medical Services. (2013). Alabama EMS patient care protocols (7th Ed.). Montgomery, AL: Author. Alabama. Pending Laws. HB208 (2015). An Act Authorizing Administration of Opioid Antagonists. 2015. Alabama Acts 2015-164. June 2015. Anson, P. (2012, July). New OxyContin Formula has Many Users Switching to Heroin. American News Report. Retrieved from http://americannewsreport.com/new-oxycontin-formula-has-many-abusers- switching-to-heroin-8814984 Field, J. M. (Ed.) (2006). Advanced cardiac life support: Provider manual. Dallas, TX: American Heart Association. Hosztafi, S. (2001 Aug). The History of Heroin. Acta Pharm Hung; 71(2):233-42. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11862675 Matrisciano, A. (2015, May). Blue Cross of Northeastern Pennsylvania Funds Naloxone for Local Law Enforcement. Blue Cross is now Northeastern Pennsylvania. Retrieved from https://www.bcnepa.com/OurCompany/News/Press/Release.aspx?id=4073 National Institute on Drug Abuse. (2013, October). Drug Facts: Heroin. Retrieved June 17, 2015, from http://www.drugabuse.gov/publications/drugfacts/heroin
Sanders, M. J. (2001). Mosby’s paramedic textbook (Rev. 2nd ed.). St. Louis, MO: Mosby.
Wilson, M. (2014 June). Heroin Epidemic in Birmingham. (Opinion by Mark E. Wilson. MD. AL.com Retrieved from http://impact.al.com/opinion/print. html/entry=2014/06/heroin_epidemic__in_birmingham.html
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18 Jefferson County Heroin Epidemic
Appendix
The Good Samaritan Act, Suggested amendment in red.
Section 6-5-332
Persons rendering emergency care etc., at scene of accident, etc.
(a) When any doctor of medicine or dentistry, nurse, member of any organized rescue squad, member of any police or fire department, member of any organized volunteer fire department, Alabama-licensed emergency medical technician, intern, or resident practicing in an Alabama hospital with training programs approved by the American Medical Association, Alabama state trooper, medical aidman functioning as a part of the military assistance to safety and traffic program, chiropractor, or public education employee gratuitously and in good faith, renders first aid or emergency care at the scene of an accident, casualty, or disaster to a person injured therein, he or she shall not be liable for any civil damages as a result of his or her acts or omissions in rendering first aid or emergency care, nor shall he or she be liable for any civil damages as a result of any act or failure to act to provide or arrange for further medical treatment or care for the injured person.
(b) Any member of the crew of a helicopter which is used in the performance of military assistance to safety and traffic programs and is engaged in the performance of emergency medical service acts shall be exempt from personal liability for any property damages caused by helicopter downwash or by persons disembarking from the helicopter.
(c) When any physician gratuitously advises medical personnel at the scene of an emergency episode by direct voice contact, to render medical assistance based upon information received by voice or biotelemetry equipment, the actions ordered taken by the physician to sustain life or reduce disability shall not be considered liable when the actions are within the established medical procedures.
(d) Any person who is qualified by a federal or state agency to perform mine rescue planning and recovery operations, including mine rescue instructors and mine rescue team members, and any person designated by an operator furnishing a mine rescue team to supervise, assist in planning or provide service thereto, who, in good faith, performs or fails to perform any act or service in connection with mine rescue planning and recovery operations shall not be liable for any civil damages as a result of any acts or omissions. Nothing contained in this subsection shall be construed to exempt from liability any person responsible for an overall mine rescue operation, including an operator of an affected facility and any person assuming responsibility therefor under federal or state statutes or regulations.
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19 Jefferson County Heroin Epidemic
Appendix (continued)
(e) A person or entity, who in good faith and without compensation renders emergency care or treatment to a person suffering or appearing to suffer from cardiac arrest, which may include the use of an automated external defibrillator, shall be immune from civil liability for any personal injury as a result of care or treatment or as a result of any act or failure to act in providing or arranging further medical treatment where the person acts as an ordinary prudent person would have acted under the same or similar circumstances, except damages that may result from the gross negligence of the person rendering emergency care. This immunity shall extend to the licensed physician or medical authority who is involved in automated external defibrillator site placement, the person who provides training in CPR and the use of the automated external defibrillator, and the person or entity responsible for the site where the automated external defibrillator is located. This subsection specifically excludes from the provision of immunity any designers, manufacturers, or sellers of automated external defibrillators for any claims that may be brought against such entities based upon current Alabama law. Such immunity shall also apply to the administration of an opioid antagonist as provided by Act 2015-364.
(f) Any licensed engineer, licensed architect, licensed surveyor, licensed contractor, licensed subcontractor, or other individual working under the direct supervision of the licensed individual who participates in emergency response activities under the direction of, or in connection with, a community emergency response team, county emergency management agency, the state emergency management agency, or the Federal Emergency Management Agency shall not be liable for any civil damages as a result of any acts, services, or omissions provided without compensation, in such capacity if the individual acts as a reasonably prudent person would have acted under the same or similar circumstances. The immunity provided in this subsection shall apply to any acts, services, or omissions provided within 90 days after declaration of the emergency.
(g) Any person, who, in good faith, renders emergency care at the scene of an accident or emergency to the victim or victims thereof without making any charge of goods or services therefor shall not be liable for any civil damages as a result of any act or omission by the person in rendering emergency care or as a result of any act or failure to act to provide or arrange for further medical treatment or care for the injured person if the individual acts as a reasonably prudent person would have acted under the same or similar circumstances.
(Acts 1966, Ex. Sess., No. 253, p. 377; Acts 1975, No. 1233, p. 2594; Acts 1981, No. 81-804, p. 1427; Acts 1987, No. 87-390, p. 558, §1; Acts 1993, No. 93-373, §1; Act 99-370, p. 595, §3; Act 2006-104, p. 134, §1; Act 2011-579, p. 1253, §1.)