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

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Showing Revision 9 created 01/02/2019 by Brian Greene.

  1. For the past 24 years,
    I have been a firefighter

  2. in Huntington, West Virginia.
  3. As firefighters, my team and I
    are tasked with saving lives
  4. and property
  5. from such disasters
    as car wrecks, house fires
  6. and also life-threatening
    medical emergencies.
  7. I am a woman leading a department
    in a male-dominated profession.
  8. And 10 years ago,

  9. I decided to increase my medical knowledge
    and I received a nursing degree.
  10. That was because it became clear
  11. that the next big threat
    facing not only my city,
  12. but other cities around the country,
  13. was not the one-and-done disaster,
  14. where you can ride in
    like the cavalry, as a firefighter,
  15. put out the fire and leave,
    feeling like you have made a difference
  16. and everything is OK.
  17. The next big disaster in my city
    was and is the long, debilitating
  18. and lethal disaster
    known as opioid addiction.
  19. We now call this a health epidemic,
  20. and we have replaced the name "addiction"
    with "substance use disorder."
  21. To give you some perspective

  22. of how significant
    this epidemic has become,
  23. in 2017, in my county of 95,000 people,
  24. we saw 1,831 overdoses
  25. [and] 183 deaths from overdose.
  26. This is the job of my firefighters,
    as well as other agencies,
  27. to respond to that.
  28. (Coughs)

  29. Excuse me.

  30. So, watching this epidemic
    unfold for several years,
  31. I developed some insight.
  32. For this disaster, we need to redefine
    our job as a first responder.
  33. We need to be more than just the cavalry.
  34. We need to do more than just save a life.
  35. We need to find ways to rebuild that life.
  36. And it's going to take
    a lot of people to do that.
  37. And that is exactly
    what we are trying to do
  38. in Huntington, West Virginia.
  39. Now, let me give you some insight
    as to what we do.

  40. First, this is what happens
    when somebody overdoses.
  41. Imagine you are somebody who is suffering
    from the brain disorder of addiction.
  42. You are fragile.
  43. You're embarrassed, you're ashamed.
  44. And you overdose.
  45. Maybe a friend
    or a family member calls 911.
  46. And then all of a sudden,
  47. you are awakened by five or six
    total strangers in uniform.
  48. And they're rubbing your sternum,
  49. and they're saying, "Wake up, wake up!
  50. You overdosed, you could've died."
  51. Now, would you not be defensive and angry?

  52. Because I know I would be.
  53. And on top of that,
  54. those strangers gave you
    a dose of naloxone,
  55. which has sent you into withdrawals,
  56. or what is better known
    as "dope sickness."
  57. Dope sickness makes you feel
    absolutely horrible.
  58. Some say it's like the flu, times ten.
  59. Nausea, vomiting, diarrhea, body aches.
  60. So not only did we,
    as strangers, wake you up,
  61. but we also made you feel really sick.
  62. So in turn, you, the patient,
    are not going to be very kind to us.
  63. And you're going to refuse
    further medical treatment.
  64. OK, well, then that's going to frustrate
    the heck out of us,
  65. and we're going to be mad,
  66. because you're ungrateful
    that we just saved your life.
  67. This is not a good dynamic here.
  68. What we are dealing with
    is a brain disorder

  69. that changes your thinking.
  70. It convinces you
    that you don't have a problem.
  71. So, this might have been not only
    the first time you've overdosed,
  72. it might have been the third,
    fourth or fifth time
  73. that we, personally, have revived you.
  74. This is not a good situation.
  75. Second,

  76. first responders do not receive
    much education
  77. on what substance use disorder is.
  78. Neither does the medical community.
  79. We're not trained how to deal with those
    suffering from substance use disorder.
  80. I am trained to put out
    many different types of fires.
  81. I am trained to save a life in the moment.
  82. But I am not trained to deal
    with the intricate interaction
  83. between first responders,
    the health care community,
  84. social services
  85. and the wider community that is necessary
    to save a life long-term.
  86. Thirdly,

  87. and this hits home.
  88. As a first responder,
    I consider myself the cavalry.
  89. We're knights in shining armor.
  90. We want to swoop in, do our job
    and leave feeling satisfied
  91. that we've made a difference
    in somebody's life.
  92. But that just doesn't happen
  93. when we're dealing with somebody
    with substance use disorder.
  94. We leave feeling frustrated and useless.
  95. We deal with the same people
    over and over again,
  96. with no positive outcome.
  97. And you know what?

  98. At some point, I realized
    that it is up to us as first responders
  99. and as a community
  100. to solve this problem,
  101. to find better ways to deal
    with those that are suffering.
  102. So what I did is I started
    observing more on overdoses.
  103. I started talking
    and listening to my patients.
  104. I wanted to know
    what led them to where they are.
  105. What exactly are they experiencing?
  106. What makes their situation worse?
  107. What makes their situation better?
  108. I began experimenting with my words
  109. and paying attention to my own actions
  110. and how it affected those of my patients.
  111. The education that I have received
  112. and continue to receive
    on a street level in Huntington
  113. has been both eye-opening
    and life-changing for me.
  114. So, in Huntington, West Virginia,
    we have come together as a community,

  115. and we are changing the way that we treat
  116. those that suffer
    from this horrible disease.
  117. We have started many programs,
    and it's making a difference.
  118. I'll tell you about just a few of those.
  119. Last year, we started
    a Quick Response Team,

  120. QRT for short.
  121. The team consists of a paramedic,
  122. a police officer,
  123. somebody in the recovery community
    and somebody in the faith community.
  124. As a team, they go out
    and visit people who have overdosed
  125. within 72 hours of that resuscitation.
  126. They talk.
  127. They listen.
  128. They build a rapport with that patient,
  129. and they offer them treatment options.
  130. Right now, about 30 percent
    or up to 30 percent
  131. of those that the Quick Response Team
    have reached out to
  132. have accepted some form of help.
  133. And the wonderful thing about this
  134. is the first responders
    who are involved in this team,
  135. they actually feel
    like they can make a difference.
  136. Positive change where there wasn't any.
  137. This year --
  138. (Applause)

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

  140. for those suffering
    from substance use disorder.
  141. It's a one-stop shop, if you will.
  142. A patient comes in,
  143. they're immediately assessed
    by somebody who's an addiction specialist.
  144. They work with them
    to provide treatment options
  145. based on their own needs,
    individual needs.
  146. This does several things for us.
  147. It gives first responders a place
    to either take or refer our patients
  148. who are no longer
    in a life-threatening situation,
  149. that have refused to go to the hospital.
  150. And it also clears up
  151. the overwhelmed emergency rooms
    in hospitals that we have.
  152. The third thing
    that I want to tell you about

  153. is very dear to me
    and very important to my team.
  154. We recently started
    a first responders self-care program.
  155. More and more ...
  156. first responders are experiencing
    compassion fatigue and PTSD.

  157. It is not uncommon for the average
    firefighter in Huntington
  158. to deal with or see
    up to five young deaths per month.
  159. These are their friends,
    these are their classmates.
  160. So this much-needed program
    will not only recognize their hard work,
  161. it's going to give them a voice.
  162. It's going to provide them with training
  163. that will help deal with the stress
    that they are under.
  164. And it will give them
    more mental-health options
  165. that they desperately need.
  166. We now have yoga classes in fire stations.
  167. (Laughter)

  168. (Applause)

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

  170. (Laughter)

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

  172. like cooking classes for first responders
    and their significant other
  173. and pottery classes.
  174. So a couple of months ago,

  175. I walked out on the apparatus floor,
    where I had some firefighters.
  176. And half of them had had a massage,
  177. and the other half were getting
    ready to have a massage.
  178. And I saw 10 firefighters
    who were bantering
  179. in a very positive, relaxed manner.
  180. And I hadn't seen that in years.
  181. And that relaxed state is trickling down
    to the community, to the citizens.
  182. So a couple of weeks ago,
    I had a neighbor overdose.

  183. Twenty-two years old.
  184. So of course, I hurried down
    to help my firefighters and my neighbor.
  185. And what I witnessed
    was my firefighters being supportive.
  186. Talking in a non-judgmental way.
  187. I watched as one of my firefighters
  188. showed the father
    and another family member
  189. how to provide rescue breaths,
    should this happen again.
  190. And left him with a bag valve mask.
  191. Positive change.
  192. Positive change.
  193. Did I happen to mention
  194. the two things that firefighters
    dislike the most?
  195. The way things are and change.
  196. (Laughter)

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

  198. And I've seen what crack
    can do to a community.
  199. A lot of our critics think
  200. that this new compassionate response
    that we're doing in Huntington
  201. is because of race.
  202. That because the overdoses are happening
    so much to the white community.
  203. And I understand that criticism,
  204. because we as a country messed up.
  205. And we treated black people poorly
    during the crack epidemic.
  206. We can't forget that.
  207. And we must do better.
  208. But right now, what I know
    is people are dying.
  209. And we in Huntington deal with people
    suffering from substance use disorder
  210. of every color and every background,
    on the streets, every day.
  211. The job of a first responder:
    prevent unnecessary deaths.
  212. Period.
  213. So ...
  214. Obviously, I'm a stubborn
    firefighter and nurse.

  215. And I refuse to believe that there isn't
    a way around every barrier.
  216. One of the barriers that we have
  217. dealing with the opioid
    epidemic is stigma.
  218. So ...
  219. We in Huntington, West Virginia,
    are showing the rest of the country
  220. that change can happen.
  221. That there is hope
    dealing with this epidemic.
  222. Our current overdoses are down 40 percent.

  223. (Applause)

  224. Currently, our overdose deaths
    are down 50 percent.

  225. (Applause)

  226. This epidemic is far from over.

  227. But each and every one of us
    has a part to play in this epidemic.
  228. Just by listening
    and being kind to somebody,
  229. you have the ability
    to make a difference in their lives.
  230. Thank you and God bless.

  231. (Applause)