On Opioid’s Front Lines - West Virginia Strong

On Opioid’s Front Lines

Digging Deeper By Dan Heyman

South Charleston, WV – “It doesn't scare me. Let me take that back – it scares me a little bit for my daughter, what she is going to have to grow up in.”

Ask firefighters like Matthew Neil how much of a problem opioids are, they will all say pretty much the same thing. “You can see it, the society degrading a little bit,” over the last few years, he says.

Neil just got a paid job with the South Charleston Fire Department, but he was a volunteer firefighter in Fayette County for fourteen years. “In our area where I lived there didn't used to be any anything like this. Typical drunks, You know. But now it's started to go more into the drugs.”

Neil’s daughter is four. “She's going to have to grow up into a world that's got a lot worse to deal than what I had to deal with. And society itself.”

According to drug abuse tracking at the National Institutes of Health, West Virginia has had the highest rate of overdose deaths in the county. But the really frightening number is the rate of increase – in 1999, the state had 1.8 overdose deaths per 100,000 people. In 2016 that was 43.4.

The firefighters in South Charleston say they never know when the call they’re answering is drug related. They see overdoses in the best neighborhoods and the worst parts of town, from all kinds of people of all ages.

Assistant Chief Bill Horton says they are seeing “at least” twice the number of overdoses that they saw in previous years. He says a few days ago they were called out to a fast food place for someone passed out in the bathroom, only to get called right back to the store across the street.

“Two guys were at McDonald's in Southridge. One guy had overdosed in the bathroom stall, but they didn't know he'd been there for like two hours. So they got him and took him to hospital.”

“But the guy that he was with,” he continues, “maybe 45 minutes later walked across street to Wal-Mart and overdosed in their bathroom.”

Horton says the first guy died, but they were able to save the second one. “It's amazing how many overdoses you actually run. I used to almost never see it. Now it's almost on a daily basis.”

West Virginia’s overdose problem began with a flood of prescription painkillers documented in a Pulitzer Prize winning series by the Charleston Gazette. The pill makers and wholesalers insist they can not be held responsible for the problem, arguing they were selling legal and medically useful drugs.

In the last few years, many people who began addicted to pills have moved on to heroin, often laced with fentanyl. The firefighters say strong additives like fentanyl and carfentanyl represent a worrying threat, because they can boost the potency of the dose without the user knowing.

As is typical with fire departments, South Charleston says about 80% of their calls are medical emergencies of one kind or another.

Another thing that worries them is the chance of someone nodding off behind the wheel. Captain Greg Carpenter says, “that’s the part that scares me the most. Our children, grandchildren, grandparents, our fire chief, people that I care about are out here driving around with these drug addicted people on the road. They’re putting themselves and ourselves and our friends and family in danger.”

Like most people in the trenches, the firefighters say no one they see wants to be an addict. Fire Chief Virgil White points out that maybe – maybe – the people they are reviving from an overdose today made a bad decision at some point in the past. But he says by the time the firefighters see them, their decisions are being made by their addiction – the user is controlled by the drug, not the other way around.

He says they try to handle the people they come into contact with as human beings, and even people they have to revive repeatedly.

Horton adds that they will try to get folks into a program that will help them change, but he says a big headache is that there is not enough long-term care. “They want to get treatment, a lot of them. But all we have to offer is a short-term. If that,” he says.

Horton says it’s a “real frustration,” to have someone who wants to get clean and not have anywhere to send them. “If you give them short term care, they get out and most of the time go right back to it. There's no treatment centers. There’s some treatment centers but nothing that really can get these people in and give them the help they need,” he says.

“They need an actual treatment facility where they can stay for six months or a year that they can actually have a proper chance.”

But according to Chief White they still try to get people help every time, even if it doesn’t work. He compares it to someone with a medical condition. “You have a person that's a diabetic and they don't take care of themselves. And you're always running them on a call because they let your sugar drop.”

White says, “you have to give them medication to bring their sugar back up you know that person is no different than a person that’s overdosing continuously.”

The firefighters say they see ways addicts will try to take precautions. Carpenter says they will sometimes chose to shoot-up in “a public area, like a public bathroom, where can be seen if they are fully unconscious.”

And he describes what are called “Narcan Parties,” where a group of users will get together with naloxone treatments on hand. They will take the drugs one at a time, and if one of them overdoses, the others can revive them with the Narcan.

As for what impact dealing with the crisis might have on the firefighters themselves, they are pretty matter of fact and pragmatic. Carpenter described one call where he was accidentally scraped with a needle in the hand of a man they were treating.

He says the man looked to be in his mid 60’s, and they assumed he had some other kind of medical issue. “We're rolling him over to do the type of medical treatment that we feel that this gentleman may need. But once we rolled him over, it's in a compact area of very small bathroom. He's a large gentleman also. So his arm comes across and he actually still had needle in his hand. That's when it come across my cheek.”

A used needle can be a source of serious infection, if someone sick had used it before. But Carpenter said he just had another firefighter check to make sure the needle hadn’t broken the skin.

As for dealing with seeing so much trauma, day after day, Horton says they “compartmentalize.”

He says they “treat it as part of the job,” unless it starts to impact them or their peers in a way that shows up in the firehouse.

White says they essentially live together during their shifts, so it’s natural for the to watch for changes in each other. Once they see someone acting different, they have a process for dealing with it – much of that due to changes backed by the union.

According to White, in past years firehouses had the same kind of tough, manly atmosphere as the military. He says no one worried about PTSD and firefighters under pressure from dealing with so much daily trauma were told to “suck it up.”

Until the International Association of Fire Fighters recognized that they had a problem. “Over the years they've taken a more serious look because you've had firefighter suicides, firefighters becoming alcoholics, firefighters becoming depressed and just leaving the job.”

He says with local governments and the union, fire departments put in place treatments and procedures for the staff.

Now, Horton says they worry more about their communities faced with the opioid epidemic. “That is a high level of frustration, which goes beyond us. Your health departments they try to do their best with what they have. The resources are so limited that it just cripples this whole state.”

He calls the politicians out for what he calls “lip service.”

“You see a lot of people, they'll say ‘yeah I want to help.’ But they don’t. Or they say ‘it’s not affecting me yet.’ Well, it's not in your back yard yet. So until it's presented to them in their face or to have a family member dealing with it, nothing will be done.”

Dan Heyman has been covering West Virginia politics and policy for more than two decades. He likes dogs but has trouble keeping kudzu from swallowing everything he owns. For more of Dan's WV Strong content, click here.

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