The forgotten front line in the opioid crisis

By Patrick Burles - @PatrickBurles on Twitter
July 12, 2017 - 5:32pm

LETHBRIDGE – Sitting at a large table in the breakroom next to the main bay at the Lethbridge Fire Headquarters, I find myself surrounded by veteran and relatively new firefighter/paramedics alike.

The original plan was to interview a few of them one-on-one for this story, but as I quickly discovered, that’s not how they do things. If there was a time to quote ‘The Three Musketeers’, this would be it.

In recent years, the use of illicit opioids – and fentanyl in particular – has spiked across Alberta and the rest of the country, to the point where it’s been declared a health crisis.

During a recent media event, representatives from ARCHES (AIDS Outreach Community Harm Reduction Education Support) in Lethbridge, explained that in 2016, Alberta lost an average of one person everyday to overdose. Based on results from the first quarter of 2017, they anticipate that number could climb to more than two drug overdose fatalities everyday.

When talking about the opioid crisis, the focus generally begins with those struggling with addiction issues, and the strain that can put on their families and the community as a whole. What doesn’t get discussed as often, are the men and women who are called in to help those individuals.

On the front lines of that battle are the emergency personnel who are increasingly being called in to help those who have overdosed, by providing a drug called Naloxone or Narcan, that counteracts the deadly effects.

In Lethbridge, where our fire and paramedic services are integrated – meaning all members are trained in both disciplines – the increase in calls to help people suffering from an overdose is extremely evident.

“I'm in my 17th year here, and in the first 15-years I used Narcan, maybe two, three times at the most. I took a two-year term position off the street, and I came back in December, and we routinely use it,” stated Patrick Misura, to start the interview. “In that two-year period, we went from using it twice in my career over 15-years, to my last set, we had one every day-shift and every night-shift. That's five times in just the week.

“It's almost unbelievable to see, because lots of times, it's the same person over and over again,” he added.

Capt. Shawn Folk with David Skilling and Greg Gaudette inside the ambulance

With the ice broken, Jason Racz joined the discussion, saying what makes opioid overdoses stand out compared to those associated with other drugs, is the spectrum of people they’re having to treat.

“There's obviously the demographic that you would typically go to, but then there's that other part of the demographic that you wouldn't normally see that are also using [fentanyl],” says Racz. “You're seeing it from – and I haven't done any real young kids – but, like the teenage years to 50-year old stay-at-home moms.”

Building on that answer, David Skilling brought up the youngest person he’s had to treat, and why it seems the problem isn’t going away.

“Sixteen years old, third time doing it, third time that child's parent had to do CPR,” explained Skilling. “And I mean, that right there, for a parent to have to do CPR on their child, there's no words to describe that.

“Talking with a lot of the users on the street, a lot of guys will say that if they know someone that's overdosed or had to administer Narcan... whoever they bought that from, that's the fentanyl they want, the fentanyl that causes the overdose, because that's the good stuff, that's the strong stuff, that's going to get you that high.”

The impact of the battle on them

“People forget that we're human too, that we feel these raw emotions, and sometimes they do catch up with us.”

– Firefighter/Paramedic David Skilling

“Last night I was freaking out because the spaghetti wasn't ready,” says Capt. Shawn Folk, when asked if the increased strain is showing up in their day-to-day lives. He notes that it takes more work than it used to for him to unwind and not let the pressure follow him home.

“The meat and sauce was ready, and one of my family members just hadn't made the noodles yet. I'm like, 'Are you kidding me! You're going to make the sauce but no noodles!?'” Folk barked. “She just got up and made the noodles, and then I went to the washroom and realized, 'Gee man, you're not at work, it's just noodles.'”

Racz echoed those comments, saying it can be challenging to empathize and relate to people who aren’t in their line of work, family included.

“I just got called a piece of garbage, and all I was doing was trying to reverse this fentanyl overdose, and my wife's saying, 'I had a bad day at work because the girls weren't getting along,' and it's like, deal with it, I had to deal with a guy that now thinks I'm a piece of garbage because I killed his high.”

The comments start to come more freely, and at times without even a question to prompt them, as everyone seems to reach a new level of comfort with the interview.

“People forget that we're human too, that we feel these raw emotions, and sometimes they do catch up with us,” Skilling adds. “We go home and our spouses and our friends forget maybe why we're a little grumpy today, so, I think we can see some frustration there.”

What adds to the issue, according to several members of the team, is a lack of closure. When they respond to a fire, they see the end result when it’s been extinguished. That’s rarely something they get on an overdose call.

“In our business, it's a real short-term window that we see patients,” says Misura. “We go to the scene, we deal with whatever issue there is there, we take them to the hospital and the nurses and the doctors. So, we see them for a very short-term window, and we hope what we did effects the outcome in a positive way, but we don't see that… We don't know where these people end up.”

Why they press on

After hearing about the issues at home, as well as some of the potential risks that can come with dealing with individuals who are intoxicated in some way, the obvious question is why do they keep doing it?

Folk pointed out that with the proper steps, the job doesn’t have to weigh you down. He says spending time with family, exercise, and talking with their Critical Incident Stress Management Team can provide a great deal of relief.

Their greatest support however, comes from each other.

“I'll tell everyone that doesn't work in this industry that asks me why I do it: I get to come to work everyday with my family. We sit down and we eat together, we laugh and joke about stuff together, and we go on calls together. We do everything together. I don't leave the firehall by myself ever,” said Racz.

“I love coming to work,” chimed in Skilling. “It's going to be different everyday. Thirty seconds from now the tones could go off and we could go on the craziest call of our lives, and then turn around, and half-an-hour later, go on something completely different… and I get to come to work and hang out with my best friends. I have 150 brothers and sisters that have my back everyday.”

Of course, there’s one more key reason that has them all wearing the same uniform.

“When the tones go off, you know somebody's having a bad day, and you get the opportunity to help them. The feeling that you get when you do your job that you've been trained to do, and you do it properly, and you help somebody, is pretty exceptional,” stated Misura.

“No matter what happens, the tones go off and we'll come to you, anytime, doesn't matter. Could be the 500th time. We'll be there.”

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