Drug overdose death increases straining first responders on the scene

An increase in drug overdose deaths is putting a strain on first responders, prompting the development of new strategies to better help people with addiction and training mechanisms to teach paramedics, police and firefighters how to cope with what they experience on the job once they are off the clock.

Statistics from the Centers for Disease Control and Prevention released this month found a record high of almost 97,000 drug overdose deaths in the 12 months ending in March, a 29.6 percent increase. 

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The continued rise of the opioid crisis and overdose deaths has changed the nature of work for paramedics, as well as those in police and fire.

“What we are seeing is a dramatic increase in suicide and a dramatic increase in overdoses. Those calls are not fun,” said Bruce Evans, president of the National Association of Emergency Medical Technicians.

Evans said when people descend into addiction technicians will often encounter “the same person over and over again.” While on the scene, Evans described a recent overdose death that involved waiting at the family’s house for an hour for the coroner and for other tasks to be completed.

First responders are now exploring new strategies to get people the help they need to avoid more deaths.

In Huntington, W.Va., a quick response team, including a paramedic, mental health professional and a faith leader, visits those who suffer overdoses within 72 hours following a call.

“That tells that person we care for them; we don’t want them to die,” said Jan Rader, the fire chief in Huntington. 

The follow-up can help get the person into long-term treatment or at least give them people to stay in touch with. 

Kevin Roy, chief policy officer for the addiction advocacy group Shatterproof, said that kind of follow-up is critical.

When it comes to a short-term fix, equipping first responders with naloxone, a drug that treats narcotic overdose, is crucial, but Roy called it “necessary but not sufficient.”

In something of a sign of the times, the National Association of Emergency Medical Technicians includes administering naloxone as part of its “First on the Scene” program, which trains the general public on basic emergency response techniques to use until EMTs arrive, alongside more traditional skills like CPR. 

The rising tide of overdoses is also changing the way many police departments think about their work. 

The Police Assisted Addiction and Recovery Initiative (PAARI) is a nonprofit seeking to support police departments to create ways to help people with addiction that do not involve arrest. 

Decades ago, “the solution was to arrest, arrest, arrest; I did that as a young cop,” said Fred Ryan, the former police chief in Arlington, Mass., who is now on the board of PAARI. 

“In many instances that was a failed response,” said Ryan, who now works in community relations for the company Alkermes, which makes a drug used to treat addiction. 

He said the change in policing was really driven home at a recent panel at Harvard Medical School. 

“The policing that I came into in the mid-1980s had evolved so much that we had police executives on a panel with medical doctors talking about the importance of medication-assisted treatment,” he said. 

Before retiring in 2019, Ryan worked to increase outreach to people at risk of drug overdoses. The previous policy, he said, “was simply to wait for the 911 phone to ring.”

“We turned that on its head, really engaged in very proactive outreach,” he said, in an approach that brought “the resources and solution to the problem rather than waiting for the problem to come to the resources.”

In addition to changing the strategies that first responders use to fight addiction, those on the front lines are also trying new strategies to help themselves cope outside of work.

Rader, the Huntington fire chief, said her department has turned to yoga classes, meditation, fitness and mental health coaches, and events for family members to build community and support for those in the line of duty.

“You’re seeing a change in their job,” Rader said. “They need more skill sets. They need more training on how to cope with what they’re seeing.”

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One of the tolls these first responders face is seeing people impacted by overdoses who are often the same age, something Rader said she saw much less of when she became a firefighter. 

For firefighters now, “a lot of times these are their classmates and their friends,” Rader said, adding that repeated calls to help the same person continually overdosing makes responders “feel like you’re beating your head against the wall.”

Ryan Walters, an EMT in Orange County, California, and the president of International Association of EMTs and Paramedics Local 370, reiterated that notion.

“You never forget what it’s like to see someone who is your age, young, full of potential, and have them succumb to something like that,” Walters said.