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 For the Cataldo Ambulance Service crews outside Boston on the front
lines of the U.S. opioid epidemic, the flood of overdose calls is a
grim daily reality, despite expanded access to overdose reversal
drugs.
"When I started, this was a rare thing. You did one or two here and
there. Now, we do quite a few," said Dave Franklin, 44, a supervisor
at the private service that contracts with cities who has worked in
the field for more than 20 years.
In Massachusetts, EMS opioid overdose calls hit 20,978 in 2016, up
from 8,389 in 2013, according to a state report.
Amid wider use by bystanders and police of naloxone, a drug that
reverses overdose symptoms, state figures showed a small drop in
opioid deaths in the first nine months of 2017 compared with 2016.
But Franklin does not yet see a turning point.
"It's not going away anytime soon. People are still dying
regularly," he said.
In the United States, deaths from drug overdoses have surpassed
deaths by firearms and motor vehicle crashes, according to a 2017
Drug Enforcement Administration report.
President Donald Trump has declared a public health emergency over
opioid abuse, promising to increase treatment but initially
dedicating no money for it.
Opioids, primarily prescription painkillers, heroin and synthetic
drugs like fentanyl, a pain medicine 50 to 100 times more powerful
than morphine, are fueling the crisis. Opioid-related overdoses kill
91 people in the United States each day, the Drug Enforcement
Administration said.
On Thursday, the Centers for Disease Control reported, based on the
latest available figures, that the U.S. rate of drug overdose deaths
in 2016 grew 21 percent from the prior year.
"It's hard to watch, and it's devastating," said Domenic Corey, 27,
who has seen the evidence up close working as a Cataldo paramedic.
Mornings before starting his shift, another Cataldo paramedic,
Andrew Simpson, grabs his stethoscope, intravenous supplies,
scissors and pen light.
At the ambulance, he checks to make sure there is enough naloxone.
They carry more than double the amount they once did because
stronger opioids mean that multiple doses of naloxone are often
required for someone who is barely breathing.
Simpson, 34, works at least two 24-hour shifts a week in a
high-turnover job that can be stressful and where pay starts at $14
an hour. Just touching Fentanyl can send an EMS worker into
overdose.
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Simpson's radio crackles with calls. Difficulty breathing. Person
down. Unresponsive. Overdose. They turn on the lights and roll. From
experience, they know it might be a man who overdosed into
unconsciousness while driving, a teen or elderly user passed out in
a park or an already stiffened corpse in a hotel room strewn with
needles and powder.
On arrival, they spray naloxone up the nose or inject it into the
user, pump oxygen into lungs and wait. Some respond gulping for air
or vomiting and confused.
“Why are you in my house? What's going on?” Simpson recalled as a
common question from recipients of his aid. Some people are grateful
and repentant, crying, shaking hands and promising to get treatment.
Others deny they took drugs at all.
The calls often come in waves when fentanyl too potent for users
hits the streets. Time of day matters, too.
"If it's in the afternoon, there's a much better chance they are
still alive," he said. "If we get the call at 7 a.m., they probably
shot up the night before."
The paramedics say they often see families torn apart in front of
their eyes or bereaved parents.
"You see the parents, they're crushed; just the look of defeat, you
know? They lost the most important person in the world to them. I
can’t even imagine. But you see it over and over again," Corey said.
The cost of naloxone has risen with demand, eating into the
service's budgets, Franklin said. But they are also using their
steady overdose runs to help some cities map drug hotspots and for
police to visit users to urge them into treatment.
"In the back of the ambulance, you talk to them and hope they get
treatment," Simpson said, explaining that most agree they need to
get help. "But then at times I'll see the same person three months
down the line and they have overdosed."
Related photo essay at http://reut.rs/2BiUBvD
(Reporting by Chris Kenning; Editing by Toni Reinhold)
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