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

100,322 views ・ 2019-01-22

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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)
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