In the opioid crisis, here's what it takes to save a life | Jan Rader

Summary

A firefighter and nurse from Huntington, West Virginia, shares her experience battling both fires and the opioid epidemic. She highlights the shift in her role from emergency responder to community healer, emphasizing the need to treat substance use disorder with compassion and understanding. By creating programs like the Quick Response Team and offering mental health support for first responders, her community is making strides in reducing overdoses and changing the dynamic of care. The speaker underscores the importance of empathy, collaboration, and community in addressing the opioid crisis.

Takeaways

• 🚒 The speaker has been a firefighter for 24 years in Huntington, West Virginia, leading a team in a male-dominated profession.
• 🩺 Ten years ago, she decided to expand her medical knowledge by earning a nursing degree, recognizing opioid addiction as a growing epidemic.
• 💊 In her county of 95,000 people, there were 1,831 overdoses and 183 deaths in 2017, highlighting the severity of the opioid crisis.
• 🧠 The speaker emphasizes that opioid addiction is a brain disorder, leading to irrational behavior, resistance to treatment, and repeated overdoses.
• 🚑 First responders, including the speaker, are trained to save lives but not to handle long-term issues related to substance use disorder.
• 💬 Huntington has initiated a Quick Response Team (QRT) that visits overdose survivors within 72 hours to offer support and treatment options.
• 🏥 A new specialty clinic called PROACT was opened to provide immediate care and long-term solutions for those suffering from substance use disorder.
• 🧘‍♀️ First responders in Huntington now have access to a self-care program, offering resources like mental health support, yoga, massages, and other stress-relief activities.
• ❤️ The speaker has witnessed a positive change in her team's approach, with firefighters showing more empathy and non-judgmental support during overdose situations.
• 🌍 Huntington, West Virginia, is demonstrating to the rest of the country that change is possible in dealing with the opioid epidemic, with overdose rates down 40% and deaths down 50%.

Q & A

What prompted the speaker to pursue a nursing degree?

The speaker realized that the next big disaster facing her city and others was opioid addiction, which required a deeper understanding of medical care beyond the immediate emergencies firefighters typically handle.

How did the speaker describe the experience of someone who has just overdosed?

She described the person as fragile, embarrassed, and ashamed. When they overdose, they're often woken up by strangers in uniform who have given them naloxone, causing them to feel extremely sick due to withdrawal, leading to defensive and angry reactions.

What challenges do first responders face when dealing with substance use disorder patients?

First responders often feel frustrated and helpless. They are not trained to handle the long-term recovery process, and they frequently encounter the same individuals multiple times without seeing positive outcomes.

How does the speaker suggest first responders need to redefine their role in the opioid epidemic?

The speaker believes first responders need to do more than just save lives in the moment. They must work on rebuilding lives by connecting patients to long-term support and care, shifting from a 'cavalry' approach to a more holistic one.

What is the Quick Response Team (QRT), and what impact has it had?

The Quick Response Team consists of a paramedic, police officer, and members of the recovery and faith communities who visit overdose patients within 72 hours. About 30% of those patients have accepted help, giving first responders a sense of making a real difference.

What is the PROACT clinic, and how does it help with substance use disorder?

The PROACT clinic is a free-standing facility for people with substance use disorder. It provides immediate assessments by addiction specialists and offers treatment options based on individual needs. It also helps clear emergency rooms by offering a referral destination for first responders.

Why was the first responder self-care program introduced, and what does it include?

The self-care program was introduced to address compassion fatigue and PTSD among first responders, who regularly deal with traumatic events. It includes activities like yoga, on-duty massages, cooking classes, and pottery classes to improve their mental health and well-being.

How did the self-care program improve the firefighters' morale?

The program created a more relaxed and positive atmosphere among the firefighters. The speaker noticed that after receiving massages, firefighters were more relaxed and positive, which has also positively impacted their interactions with the community.

What does the speaker believe is the key to addressing the opioid epidemic in Huntington, West Virginia?

The speaker believes that reducing stigma and building community-based programs that focus on compassion and long-term recovery are key to addressing the opioid epidemic. Huntington has already seen a 40% reduction in overdoses and a 50% drop in overdose deaths.

How does the speaker address the criticism that the compassionate response to opioid addiction is due to race?

The speaker acknowledges the criticism that the current compassionate approach might be influenced by the fact that many overdoses now affect white communities, but emphasizes that people of all races are suffering from substance use disorder, and the priority is to prevent unnecessary deaths regardless of race.

Outlines

00:00

🚒 Firefighting and Facing the Opioid Crisis

The speaker, a female firefighter and nurse from Huntington, West Virginia, shares her journey over the past 24 years in firefighting and how her team has been responding to multiple emergencies, including car wrecks and house fires. However, the major ongoing disaster that their community now faces is opioid addiction, labeled as a health epidemic. She recounts the devastating statistics of overdoses and deaths in her county, emphasizing the need to shift their role from just saving lives to helping rebuild them. As first responders, they are challenged with dealing with recurring overdoses, and the lack of medical and social training to address substance use disorder.

05:00

💼 Expanding the Role of First Responders

The speaker reflects on her experience as a firefighter, trained to handle emergencies and save lives. However, the complexity of the opioid epidemic requires more than just immediate rescue— it demands an integrated approach involving first responders, healthcare, social services, and the community. The frustration of repeatedly dealing with the same individuals with no long-term improvement is common among first responders. She realized that solving the problem requires a collective effort, leading her to observe overdoses more closely, engage with patients, and focus on long-term solutions.

10:02

🤝 Community Solutions and Positive Change

In response to the opioid crisis, Huntington has launched several initiatives to address the problem holistically. The Quick Response Team (QRT), consisting of paramedics, police, recovery specialists, and faith leaders, visits overdose patients within 72 hours, offering them treatment options. About 30% of these patients accept help, giving first responders a sense of hope and progress. Additionally, the PROACT clinic provides specialized care for substance use disorder, giving first responders a place to refer patients and reducing pressure on emergency rooms. The speaker also highlights a new first responder self-care program that addresses the mental health toll, offering resources like yoga, massages, and off-duty activities.

🧘 Mental Health and Resilience for First Responders

The speaker shares the personal impact of the opioid epidemic on first responders in Huntington, explaining how they often witness multiple deaths each month, which leads to compassion fatigue and PTSD. In response, the city introduced self-care programs for first responders, including yoga, massages, and other activities like cooking and pottery classes to help them manage stress. The speaker recalls witnessing firefighters in a relaxed state after receiving massages, something she hadn't seen in years, and notes that this improved mental health trickles down to positively impact their interactions with the community.

💡 Changing the Approach and Addressing Stigma

The speaker recalls a recent experience where her firefighters responded compassionately to a young neighbor’s overdose, illustrating the positive change in their approach. Despite the stigma surrounding substance use disorder, including the racial undertones comparing the opioid epidemic to the crack epidemic, the speaker emphasizes that their primary job is to prevent unnecessary deaths, regardless of race or background. She acknowledges the mistakes of the past but stresses that Huntington's focus is now on saving lives in the midst of a deadly crisis. The speaker calls for continued efforts to break down the stigma and barriers in addressing the opioid crisis, which has shown progress, with overdose rates in her community declining by 40% and deaths by 50%.

Keywords

💡Opioid Epidemic

The opioid epidemic refers to the widespread misuse of opioids, both prescription and non-prescription, leading to addiction, overdoses, and death. In the video, the speaker describes how her city of Huntington, West Virginia, has been severely affected by this crisis, with over 1,800 overdoses and 183 deaths in 2017 alone. This epidemic reshaped the speaker’s role as a firefighter and drove her to take action, highlighting the need for a compassionate, community-based response.

💡Substance Use Disorder

Substance Use Disorder (SUD) is a medical condition where the use of drugs leads to significant health, social, or behavioral problems. The speaker highlights that this term has replaced the stigmatized term 'addiction,' emphasizing that it is a brain disorder, not a moral failing. She notes that first responders often lack the training to handle this disorder, which complicates their interactions with overdose patients.

💡First Responders

First responders are individuals such as firefighters, paramedics, and police officers who are the first to arrive at the scene of emergencies. In the context of the opioid epidemic, the speaker explains that first responders are not only tasked with saving lives in the moment but also must adapt to the ongoing challenge of addressing substance use disorder. She advocates for redefining their roles to include rebuilding lives post-overdose.

💡Naloxone

Naloxone is a medication that rapidly reverses opioid overdoses by blocking the effects of opioids on the brain. In the video, the speaker describes how first responders use naloxone to revive people who have overdosed. However, this often induces withdrawal symptoms, leaving the revived patient feeling 'dope sick' and defensive, which complicates the first responder-patient interaction.

💡Quick Response Team (QRT)

The Quick Response Team (QRT) is a specialized team in Huntington that visits overdose survivors within 72 hours of their resuscitation to offer treatment and support. The team includes a paramedic, a police officer, and individuals from the recovery and faith communities. The speaker emphasizes how this program has improved engagement with overdose survivors, with up to 30% accepting help.

💡Stigma

Stigma refers to the negative stereotypes and discrimination associated with substance use disorder. The speaker mentions that stigma remains a significant barrier to effectively dealing with the opioid epidemic. She explains that understanding addiction as a brain disorder rather than a moral failing is crucial for developing compassionate, effective responses. This also includes addressing the historical stigmatization of racial minorities during previous drug crises.

💡Compassion Fatigue

Compassion fatigue is the emotional exhaustion that people experience from caring for others in distress over an extended period. First responders, especially in communities like Huntington, experience this due to the constant exposure to overdose victims and repeated revivals without long-term solutions. The speaker advocates for self-care programs to help first responders manage this fatigue.

💡PROACT

PROACT is a specialty clinic in Huntington that offers comprehensive care to individuals suffering from substance use disorder. The clinic provides immediate assessments and customized treatment plans, giving first responders a place to refer patients who are no longer in immediate danger but still need long-term care. This initiative helps alleviate the burden on emergency rooms while providing focused addiction care.

💡Yoga and Mental Health Support for First Responders

As part of the self-care program for first responders, yoga and other wellness activities are offered to help them manage stress, burnout, and PTSD. The speaker highlights how these programs, including on-duty massages and cooking classes, have helped reduce stress levels among firefighters, contributing to a more positive work environment and improving interactions with the community.

💡Community Response

Community response refers to the collective efforts of various stakeholders—first responders, healthcare providers, social services, and faith groups—to address the opioid epidemic. In the video, the speaker stresses the importance of a united, community-based approach to not only save lives during overdoses but also to provide the ongoing support necessary for recovery. The success of initiatives like the QRT and PROACT demonstrates how coordinated efforts can make a significant impact.

Highlights

The speaker has been a firefighter for 24 years in Huntington, West Virginia, leading a team in a male-dominated profession.

Ten years ago, the speaker earned a nursing degree to better address the growing threat of opioid addiction in the community.

In 2017, in a county of 95,000 people, there were 1,831 overdoses and 183 deaths, highlighting the scale of the opioid epidemic.

The speaker emphasizes the need to redefine the role of first responders, moving beyond just saving lives to rebuilding lives.

The speaker highlights the frustration of first responders when dealing with repeated overdoses, emphasizing that addiction is a brain disorder that alters thinking.

First responders and medical professionals receive little training on how to handle substance use disorder, despite being on the frontlines of the crisis.

The speaker shares personal insights gained from observing overdoses and listening to patients to better understand their experiences.

A Quick Response Team (QRT) was formed in Huntington, consisting of a paramedic, police officer, someone in recovery, and someone from the faith community, to visit overdose survivors within 72 hours.

Around 30 percent of people contacted by the Quick Response Team have accepted help, creating a sense of positive change for first responders.

A free-standing specialty clinic, PROACT, was established to provide immediate treatment options for those suffering from substance use disorder, alleviating emergency room overcrowding.

The community implemented a self-care program for first responders, addressing compassion fatigue and PTSD with services like yoga, massages, and mental health support.

Firefighters are now more relaxed and supportive when responding to overdoses, demonstrating positive change in their approach to patients and the community.

The speaker acknowledges the racial criticisms related to compassionate treatment, reflecting on the mistakes made during the crack epidemic and the importance of doing better.

Overdose incidents in Huntington have decreased by 40 percent, and overdose deaths have decreased by 50 percent, showing the effectiveness of the new approaches.

The speaker stresses the importance of fighting stigma and showing kindness, reminding the audience that everyone has a role in addressing the opioid epidemic.

Transcripts

For the past 24 years, I have been a firefighter

in Huntington, West Virginia.

As firefighters, my team and I are tasked with saving lives

and property

from such disasters as car wrecks, house fires

and also life-threatening medical emergencies.

I am a woman leading a department in a male-dominated profession.

And 10 years ago,

I decided to increase my medical knowledge and I received a nursing degree.

That was because it became clear

that the next big threat facing not only my city,

but other cities around the country,

was not the one-and-done disaster,

where you can ride in like the cavalry, as a firefighter,

put out the fire and leave, feeling like you have made a difference

and everything is OK.

The next big disaster in my city was and is the long, debilitating

and lethal disaster known as opioid addiction.

We now call this a health epidemic,

and we have replaced the name "addiction" with "substance use disorder."

To give you some perspective

of how significant this epidemic has become,

in 2017, in my county of 95,000 people,

we saw 1,831 overdoses

[and] 183 deaths from overdose.

This is the job of my firefighters, as well as other agencies,

to respond to that.

(Coughs)

Excuse me.

So, watching this epidemic unfold for several years,

I developed some insight.

For this disaster, we need to redefine our job as a first responder.

We need to be more than just the cavalry.

We need to do more than just save a life.

We need to find ways to rebuild that life.

And it's going to take a lot of people to do that.

And that is exactly what we are trying to do

in Huntington, West Virginia.

Now, let me give you some insight as to what we do.

First, this is what happens when somebody overdoses.

Imagine you are somebody who is suffering from the brain disorder of addiction.

You are fragile.

You're embarrassed, you're ashamed.

And you overdose.

Maybe a friend or a family member calls 911.

And then all of a sudden,

you are awakened by five or six total strangers in uniform.

And they're rubbing your sternum,

and they're saying, "Wake up, wake up!

You overdosed, you could've died."

Now, would you not be defensive and angry?

Because I know I would be.

And on top of that,

those strangers gave you a dose of naloxone,

which has sent you into withdrawals,

or what is better known as "dope sickness."

Dope sickness makes you feel absolutely horrible.

Some say it's like the flu, times ten.

Nausea, vomiting, diarrhea, body aches.

So not only did we, as strangers, wake you up,

but we also made you feel really sick.

So in turn, you, the patient, are not going to be very kind to us.

And you're going to refuse further medical treatment.

OK, well, then that's going to frustrate the heck out of us,

and we're going to be mad,

because you're ungrateful that we just saved your life.

This is not a good dynamic here.

What we are dealing with is a brain disorder

that changes your thinking.

It convinces you that you don't have a problem.

So, this might have been not only the first time you've overdosed,

it might have been the third, fourth or fifth time

that we, personally, have revived you.

This is not a good situation.

Second,

first responders do not receive much education

on what substance use disorder is.

Neither does the medical community.

We're not trained how to deal with those suffering from substance use disorder.

I am trained to put out many different types of fires.

I am trained to save a life in the moment.

But I am not trained to deal with the intricate interaction

between first responders, the health care community,

social services

and the wider community that is necessary to save a life long-term.

Thirdly,

and this hits home.

As a first responder, I consider myself the cavalry.

We're knights in shining armor.

We want to swoop in, do our job and leave feeling satisfied

that we've made a difference in somebody's life.

But that just doesn't happen

when we're dealing with somebody with substance use disorder.

We leave feeling frustrated and useless.

We deal with the same people over and over again,

with no positive outcome.

And you know what?

At some point, I realized that it is up to us as first responders

and as a community

to solve this problem,

to find better ways to deal with those that are suffering.

So what I did is I started observing more on overdoses.

I started talking and listening to my patients.

I wanted to know what led them to where they are.

What exactly are they experiencing?

What makes their situation worse?

What makes their situation better?

I began experimenting with my words

and paying attention to my own actions

and how it affected those of my patients.

The education that I have received

and continue to receive on a street level in Huntington

has been both eye-opening and life-changing for me.

So, in Huntington, West Virginia, we have come together as a community,

and we are changing the way that we treat

those that suffer from this horrible disease.

We have started many programs, and it's making a difference.

I'll tell you about just a few of those.

Last year, we started a Quick Response Team,

QRT for short.

The team consists of a paramedic,

a police officer,

somebody in the recovery community and somebody in the faith community.

As a team, they go out and visit people who have overdosed

within 72 hours of that resuscitation.

They talk.

They listen.

They build a rapport with that patient,

and they offer them treatment options.

Right now, about 30 percent or up to 30 percent

of those that the Quick Response Team have reached out to

have accepted some form of help.

And the wonderful thing about this

is the first responders who are involved in this team,

they actually feel like they can make a difference.

Positive change where there wasn't any.

This year --

(Applause)

This year, we opened a free-standing specialty clinic, called PROACT,

for those suffering from substance use disorder.

It's a one-stop shop, if you will.

A patient comes in,

they're immediately assessed by somebody who's an addiction specialist.

They work with them to provide treatment options

based on their own needs, individual needs.

This does several things for us.

It gives first responders a place to either take or refer our patients

who are no longer in a life-threatening situation,

that have refused to go to the hospital.

And it also clears up

the overwhelmed emergency rooms in hospitals that we have.

The third thing that I want to tell you about

is very dear to me and very important to my team.

We recently started a first responders self-care program.

More and more ...

first responders are experiencing compassion fatigue and PTSD.

It is not uncommon for the average firefighter in Huntington

to deal with or see up to five young deaths per month.

These are their friends, these are their classmates.

So this much-needed program will not only recognize their hard work,

it's going to give them a voice.

It's going to provide them with training

that will help deal with the stress that they are under.

And it will give them more mental-health options

that they desperately need.

We now have yoga classes in fire stations.

(Laughter)

(Applause)

We've also provided on-duty massages, which is fabulous.

(Laughter)

And we have some off-duty programs that we've started,

like cooking classes for first responders and their significant other

and pottery classes.

So a couple of months ago,

I walked out on the apparatus floor, where I had some firefighters.

And half of them had had a massage,

and the other half were getting ready to have a massage.

And I saw 10 firefighters who were bantering

in a very positive, relaxed manner.

And I hadn't seen that in years.

And that relaxed state is trickling down to the community, to the citizens.

So a couple of weeks ago, I had a neighbor overdose.

Twenty-two years old.

So of course, I hurried down to help my firefighters and my neighbor.

And what I witnessed was my firefighters being supportive.

Talking in a non-judgmental way.

I watched as one of my firefighters

showed the father and another family member

how to provide rescue breaths, should this happen again.

And left him with a bag valve mask.

Positive change.

Positive change.

Did I happen to mention

the two things that firefighters dislike the most?

The way things are and change.

(Laughter)

You know, I recognize that there have been drug epidemics before.

And I've seen what crack can do to a community.

A lot of our critics think

that this new compassionate response that we're doing in Huntington

is because of race.

That because the overdoses are happening so much to the white community.

And I understand that criticism,

because we as a country messed up.

And we treated black people poorly during the crack epidemic.

We can't forget that.

And we must do better.

But right now, what I know is people are dying.

And we in Huntington deal with people suffering from substance use disorder

of every color and every background, on the streets, every day.

The job of a first responder: prevent unnecessary deaths.

Period.

So ...

Obviously, I'm a stubborn firefighter and nurse.

And I refuse to believe that there isn't a way around every barrier.

One of the barriers that we have

dealing with the opioid epidemic is stigma.

So ...

We in Huntington, West Virginia, are showing the rest of the country

that change can happen.

That there is hope dealing with this epidemic.

Our current overdoses are down 40 percent.

(Applause)

Currently, our overdose deaths are down 50 percent.

(Applause)

This epidemic is far from over.

But each and every one of us has a part to play in this epidemic.

Just by listening and being kind to somebody,

you have the ability to make a difference in their lives.

Thank you and God bless.

(Applause)