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

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    For the past 24 years,
    I have been a firefighter
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    in Huntington, West Virginia.
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    As firefighters, my team and I
    are tasked with saving lives
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    and property
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    from such disasters
    as car wrecks, house fires
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    and also life-threatening
    medical emergencies.
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    I am a woman leading a department
    in a male-dominated profession.
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    And 10 years ago,
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    I decided to increase my medical knowledge
    and I received a nursing degree.
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    That was because it became clear
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    that the next big threat
    facing not only my city,
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    but other cities around the country,
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    was not the one-and-done disaster,
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    where you can ride in
    like the cavalry, as a firefighter,
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    put out the fire and leave,
    feeling like you have made a difference
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    and everything is OK.
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    The next big disaster in my city
    was and is the long, debilitating
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    and lethal disaster
    known as opioid addiction.
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    We now call this a health epidemic,
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    and we have replaced the name "addiction"
    with "substance use disorder."
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    To give you some perspective
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    of how significant
    this epidemic has become,
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    in 2017, in my county of 95,000 people,
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    we saw 1,831 overdoses
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    [and] 183 deaths from overdose.
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    This is the job of my firefighters,
    as well as other agencies,
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    to respond to that.
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    (Coughs)
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    Excuse me.
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    So, watching this epidemic
    unfold for several years,
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    I developed some insight.
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    For this disaster, we need to redefine
    our job as a first responder.
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    We need to be more than just the cavalry.
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    We need to do more than just save a life.
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    We need to find ways to rebuild that life.
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    And it's going to take
    a lot of people to do that.
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    And that is exactly
    what we are trying to do
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    in Huntington, West Virginia.
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    Now, let me give you some insight
    as to what we do.
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    First, this is what happens
    when somebody overdoses.
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    Imagine you are somebody who is suffering
    from the brain disorder of addiction.
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    You are fragile.
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    You're embarrassed, you're ashamed.
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    And you overdose.
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    Maybe a friend
    or a family member calls 911.
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    And then all of a sudden,
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    you are awakened by five or six
    total strangers in uniform.
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    And they're rubbing your sternum,
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    and they're saying, "Wake up, wake up!
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    You overdosed, you could've died."
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    Now, would you not be defensive and angry?
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    Because I know I would be.
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    And on top of that,
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    those strangers gave you
    a dose of naloxone,
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    which has sent you into withdrawals,
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    or what is better known
    as "dope sickness."
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    Dope sickness makes you feel
    absolutely horrible.
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    Some say it's like the flu, times ten.
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    Nausea, vomiting, diarrhea, body aches.
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    So not only did we,
    as strangers, wake you up,
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    but we also made you feel really sick.
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    So in turn, you, the patient,
    are not going to be very kind to us.
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    And you're going to refuse
    further medical treatment.
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    OK, well, then that's going to frustrate
    the heck out of us,
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    and we're going to be mad,
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    because you're ungrateful
    that we just saved your life.
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    This is not a good dynamic here.
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    What we are dealing with
    is a brain disorder
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    that changes your thinking.
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    It convinces you
    that you don't have a problem.
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    So, this might have been not only
    the first time you've overdosed,
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    it might have been the third,
    fourth or fifth time
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    that we, personally, have revived you.
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    This is not a good situation.
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    Second,
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    first responders do not receive
    much education
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    on what substance use disorder is.
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    Neither does the medical community.
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    We're not trained how to deal with those
    suffering from substance use disorder.
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    I am trained to put out
    many different types of fires.
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    I am trained to save a life in the moment.
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    But I am not trained to deal
    with the intricate interaction
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    between first responders,
    the health care community,
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    social services
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    and the wider community that is necessary
    to save a life long-term.
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    Thirdly,
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    and this hits home.
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    As a first responder,
    I consider myself the cavalry.
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    We're knights in shining armor.
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    We want to swoop in, do our job
    and leave feeling satisfied
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    that we've made a difference
    in somebody's life.
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    But that just doesn't happen
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    when we're dealing with somebody
    with substance use disorder.
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    We leave feeling frustrated and useless.
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    We deal with the same people
    over and over again,
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    with no positive outcome.
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    And you know what?
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    At some point, I realized
    that it is up to us as first responders
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    and as a community
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    to solve this problem,
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    to find better ways to deal
    with those that are suffering.
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    So what I did is I started
    observing more on overdoses.
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    I started talking
    and listening to my patients.
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    I wanted to know
    what led them to where they are.
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    What exactly are they experiencing?
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    What makes their situation worse?
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    What makes their situation better?
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    I began experimenting with my words
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    and paying attention to my own actions
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    and how it affected those of my patients.
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    The education that I have received
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    and continue to receive
    on a street level in Huntington
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    has been both eye-opening
    and life-changing for me.
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    So, in Huntington, West Virginia,
    we have come together as a community,
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    and we are changing the way that we treat
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    those that suffer
    from this horrible disease.
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    We have started many programs,
    and it's making a difference.
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    I'll tell you about just a few of those.
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    Last year, we started
    a Quick Response Team,
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    QRT for short.
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    The team consists of a paramedic,
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    a police officer,
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    somebody in the recovery community
    and somebody in the faith community.
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    As a team, they go out
    and visit people who have overdosed
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    within 72 hours of that resuscitation.
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    They talk.
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    They listen.
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    They build a rapport with that patient,
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    and they offer them treatment options.
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    Right now, about 30 percent
    or up to 30 percent
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    of those that the Quick Response Team
    have reached out to
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    have accepted some form of help.
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    And the wonderful thing about this
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    is the first responders
    who are involved in this team,
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    they actually feel
    like they can make a difference.
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    Positive change where there wasn't any.
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    This year --
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    (Applause)
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    This year, we opened a free-standing
    specialty clinic, called PROACT,
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    for those suffering
    from substance use disorder.
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    It's a one-stop shop, if you will.
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    A patient comes in,
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    they're immediately assessed
    by somebody who's an addiction specialist.
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    They work with them
    to provide treatment options
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    based on their own needs,
    individual needs.
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    This does several things for us.
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    It gives first responders a place
    to either take or refer our patients
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    who are no longer
    in a life-threatening situation,
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    that have refused to go to the hospital.
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    And it also clears up
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    the overwhelmed emergency rooms
    in hospitals that we have.
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    The third thing
    that I want to tell you about
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    is very dear to me
    and very important to my team.
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    We recently started
    a first responders self-care program.
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    More and more ...
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    first responders are experiencing
    compassion fatigue and PTSD.
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    It is not uncommon for the average
    firefighter in Huntington
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    to deal with or see
    up to five young deaths per month.
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    These are their friends,
    these are their classmates.
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    So this much-needed program
    will not only recognize their hard work,
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    it's going to give them a voice.
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    It's going to provide them with training
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    that will help deal with the stress
    that they are under.
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    And it will give them
    more mental-health options
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    that they desperately need.
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    We now have yoga classes in fire stations.
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    (Laughter)
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    (Applause)
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    We've also provided on-duty
    massages, which is fabulous.
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    (Laughter)
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    And we have some off-duty programs
    that we've started,
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    like cooking classes for first responders
    and their significant other
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    and pottery classes.
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    So a couple of months ago,
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    I walked out on the apparatus floor,
    where I had some firefighters.
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    And half of them had had a massage,
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    and the other half were getting
    ready to have a massage.
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    And I saw 10 firefighters
    who were bantering
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    in a very positive, relaxed manner.
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    And I hadn't seen that in years.
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    And that relaxed state is trickling down
    to the community, to the citizens.
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    So a couple of weeks ago,
    I had a neighbor overdose.
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    Twenty-two years old.
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    So of course, I hurried down
    to help my firefighters and my neighbor.
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    And what I witnessed
    was my firefighters being supportive.
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    Talking in a non-judgmental way.
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    I watched as one of my firefighters
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    showed the father
    and another family member
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    how to provide rescue breaths,
    should this happen again.
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    And left him with a bag valve mask.
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    Positive change.
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    Positive change.
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    Did I happen to mention
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    the two things that firefighters
    dislike the most?
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    The way things are and change.
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    (Laughter)
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    You know, I recognize that there have been
    drug epidemics before.
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    And I've seen what crack
    can do to a community.
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    A lot of our critics think
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    that this new compassionate response
    that we're doing in Huntington
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    is because of race.
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    That because the overdoses are happening
    so much to the white community.
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    And I understand that criticism,
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    because we as a country messed up.
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    And we treated black people poorly
    during the crack epidemic.
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    We can't forget that.
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    And we must do better.
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    But right now, what I know
    is people are dying.
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    And we in Huntington deal with people
    suffering from substance use disorder
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    of every color and every background,
    on the streets, every day.
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    The job of a first responder:
    prevent unnecessary deaths.
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    Period.
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    So ...
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    Obviously, I'm a stubborn
    firefighter and nurse.
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    And I refuse to believe that there isn't
    a way around every barrier.
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    One of the barriers that we have
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    dealing with the opioid
    epidemic is stigma.
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    So ...
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    We in Huntington, West Virginia,
    are showing the rest of the country
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    that change can happen.
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    That there is hope
    dealing with this epidemic.
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    Our current overdoses are down 40 percent.
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    (Applause)
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    Currently, our overdose deaths
    are down 50 percent.
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    (Applause)
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    This epidemic is far from over.
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    But each and every one of us
    has a part to play in this epidemic.
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    Just by listening
    and being kind to somebody,
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    you have the ability
    to make a difference in their lives.
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    Thank you and God bless.
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    (Applause)
Títol:
In the opioid crisis, here's what it takes to save a life
Speaker:
Jan Rader
Descripció:

As a fire chief and first responder, Jan Rader has spent her career saving lives. But when the opioid epidemic hit her town, she realized they needed to take a brand-new approach to life-saving. In this powerful, hopeful talk, Rader shows what it's like on the front lines of this crisis -- and how her community is taking an unusual new approach to treating substance-abuse disorder that starts with listening.

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Video Language:
English
Team:
TED
Projecte:
TEDTalks
Duration:
14:31

English subtitles

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