OBJECTIVES: Communities in West Virginia (WV) have been disproportionately impacted by the opioid epidemic with 35.5 drug-overdose deaths per 100,000 persons in 2015. Law enforcement officers (LEOs) have the legal authority to stock, carry, and use naloxone, but the real-world use and availability through LEOs in WV is unknown. The objective of our study was to assess the readiness of LEOs in WV to provide emergency naloxone in the communities they serve. METHODS: A prospective cross-sectional study was conducted using a self-administered questionnaire between September and December 2016. The questionnaire consists of demographic information, current experiences with naloxone, prior experience with opioid overdose situations, perceived barriers to carrying and administering naloxone, the level of knowledge of opioid overdose management, and attitudes towards managing an opioid overdose. RESULTS: The survey was completed by 149 active, non-retired WV officers who had an average age of 45.6(±11.4) years and 13.8(±10.0) years of experience at their department. The results indicated that the use of naloxone was rare, only 12.7% of respondents said that naloxone was available for use, 72.7% of LEOs reported being at the scene of an opioid overdose in the past 12 months, and the majority (58.6%) reported being at the scene before EMS. Half of the respondents were not interested in receiving training to administer naloxone, and of those individuals, 53.5% were serving counties with elevated prescription drug death rates (≥20 per 100,000). Knowledge scores were higher for officers who had completed training on naloxone than those who did not or were not interested (t=2.27,p=0.02). Barriers to naloxone use identified by the LEOs included lack of training, time, safety, cost, storage, and liability. CONCLUSIONS: We conclude that willing officers should continue to be trained, but for officers in counties where death rates are the highest, new strategies to increase buy-in are still needed.