The problem with overdose saves

By Jeff Linville -
Jeff Linville News Editor -

At the county commissioners’ meeting Monday night, an interesting tidbit came up during discussions on health issues in the county.

Out of 279 ambulance transports for overdoses, half of the people had overdosed on opioids and were candidates to have the effects counteracted by the drug naloxone.

According to the World Health Organization, pain medications like Vicodin, Percocet and heroin can cause unconsciousness and slowed breathing. Take enough, and the drug(s) will stop breathing altogether.

Pain pills were reportedly the cause of death for such household names as Prince, Tom Petty, Heath Ledger and Philip Seymour Hoffman.

County officials are trying to do what they can to combat this. The sheriff’s office is working hard to catch drug dealers. The commissioners hired an opioid response director specifically to address the problem with pain pills. State laws have tried to address pain pills from the point of how they are prescribed by doctors.

And yet, the number of overdoses continues to rise. The EMS already has run more OD calls in less than nine months of 2018 than in all of 2017. And 2017 was ahead of 2016.

Mark Willis, opioid response director, explained two weeks ago that Surry doesn’t have the infrastructure in place to handle drug users who can’t stop on their own. A patient who overdoses could be held at the local hospital temporarily as an involuntary commitment, but then what, he asked.

In some areas of the country, the use of naloxone has come under fire. Rather than the drug user taking responsibility for his or her own actions, the user just takes drugs until there is an overdose, and the EMS comes along and takes that responsibility.

Commissioner Larry Phillips said that even though these people are addicts, their lives still have value and are worth saving. However, he added, there is still a fine line for the county to walk between helping its citizens and enabling bad behavior.

Last year a city in Ohio was discussing a policy to limit the number of times that the EMS would use naloxone to save the same person. The drug is expensive, and the city or county giving it often doesn’t recoup that expense.

“First responders are reaching a new level of frustration responding to multiple calls for repeated victims, and they just don’t feel like they are making progress,” Middleton, Ohio, Mayor Larry Mulligan Jr. said at the time. “We can’t just keep reviving people.”

Leana Wen, Baltimore’s health commissioner, didn’t care for that kind of attitude and countered, “If this was any other illness, we would never accept rationing of an antidote.”

Illness? You want to equate taking a pill with getting prostate cancer, breast cancer or ALS — three things my own family is dealing with right now?

A person is born with a bipolar disorder but is way more ostracized than someone who willingly takes enough pain pills to become addicted.

How about this? John Shelton, emergency services director, told me that there have been multiple times when his crews have run two calls to the same location in one day. The paramedics find some guy who has overdosed and use naloxone to save his life. Then the guy gets mad that his “high” was ruined. So once he is released from the hospital and goes home, the guy takes more drugs and winds up overdosing again.

Paramedics across the country have even reported being assaulted by drug users. The people were so angry at having their high stopped by naloxone that they attacked the medical personnel saving their lives. Talk about ungrateful.

One healthcare professional told me about an instance where the same person was treated for drug overdoses five times in one week.

These are people who don’t value their own lives, but we’re supposed to?

In medicine there is something called triage. When multiple patients come into the ER at the same time — or when several soldiers are injured on the battlefield at once — medics have to quickly assess the situation and try to determine who is the most critical case. The least-injured person can wait.

But, here’s an important point on the battlefield: if the medic takes a look at the fellow and sees that he is too far gone, the medic doesn’t waste valuable time. Maybe the medic provides a shot of morphine for the pain, but then it is off to the next patient. Save those that can be saved.

If a person is overdosing, obviously that is critical situation and would take precedent over lesser afflictions. However, what if that call pulls paramedics away from someone else who needs help desperately, too, and didn’t do anything to harm themselves?

What if your mother had a heart attack and was lying on the floor? Maybe you are on the phone talking to 911 while a relative gives CPR. Then you find out that the nearest ambulance can’t help you because they are busy with their 12th trip to a known drug house this year.

How would you feel if your mother died waiting for an ambulance from further away to arrive while some junkie was taking a swing at a paramedic for saving his life with yet another dose of naloxone?

Would your perspective change then?

Jeff Linville News Editor Linville News Editor

By Jeff Linville

Jeff is the news editor and can be reached at 415-4692.

Jeff is the news editor and can be reached at 415-4692.