What Did You Take?

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My last post dealt with the Heroin epidemic and our response to it. I never intended to write a second piece about the same subject but I feel like I have more to say, so lets explore what else is burning up the deep reaches of my brain.

For those of us that are on the front lines of this public health conflagration, and by front lines I mean the actual interface between the system and the addict, we see some familiar scenes. I am speaking specifically of the moment when we as EMS, firefighters and police arrive at the call location to find the man or women or both unresponsive, blue and barely breathing. Those scenes basically boil down to a few scenarios:

  • Scenario 1: He, she or they are in a car that is in the way of the motoring public, in a parking lot somewhere or the car they were driving has gently wandered off the road into the trees. They have that familiar blue hue, are barely breathing and are unresponsive.passed out
  • Scenario 2: They are at their house or a friends house, half way on the bed, on the floor, on the ground outside, in the bathtub or on the bathroom floor blocking the door. They have that familiar blue hue, are barely breathing and are unresponsive.
  • Scenario 3: They are in the bathroom at McDowell’s fast food restaurant, the BK Oil gas station or in the bathroom at the Library and have that familiar blue hue, are barely breathing and are unresponsive.

There are a few variations of the scenario but you get the idea. It doesn’t really matter what the scenario is for us, we see each one multiple times each week. We all have the categories in our brains that the memories get filed into. These scenarios are no different. Sometimes we applaud the patient for finding a unique location or position to be found in. We want to give them a gold star but that may not be socially acceptable. It will, at the very least, get the afternoon talk show watching, minivan driving soccer moms in an uproar about how we are hurting the addicts feelings or damaging their psyche. The flurry of op-eds or mommy blog posts would be furious and frequent. Whatever….

So whichever scenario you find yourself in, it usually plays out a few ways. They are obviously dead and you go back in service; the patient happens to wake up on their own; you wake them up with Narcan or you work a cardiac arrest all the way to the hospital. Again, there are a few variations but that is pretty much it.

When the patient wakes up, we put them through the same line of questioning. We ask “What did you take”, “How much did you take” and “Is there any of what you took left over”? Like every other scenario, there are some variables and different questions asked like “Where are your kids”, “Why are your pants down” and “Who is the dead girl in the back seat”, but most of the time, the scenario plays out on script. There is some crying and arguing and denial but it all goes according to plan. 

 

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So when I ask the addict “What did you take”, I can’t help but have an internal dialogue with myself. As soon as the words come out of my mouth, my mind starts to run down a list. “What did you take” I bark and my brains list begins like the opening of a popular sci-fi movie.

What did you take? They took any hope of them having a normal life from now on. Like a smoker that quit smoking will always be a smoker who chooses not to smoke, they will always be an addict that chooses not to do drugs. They will always be that because that is who they are now. I know some of you will say that there is reform, that they can be normal humans again, that they can be made whole. I get it. The rehab community hangs their hat on that prospect. We all want to sleep better at night. I get it, but if you ask an old addict, they will tell you that they think about it every day. They will always be an addict who chooses not to be addict and they fight against the chemical changes that the drugs made in their brains every single day.

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What did you take? They took that moment in time away from the people around them. If it’s the first time they overdosed, they took away how they were perceived by their family and friends prior to the overdose. They took away a few heartbeats from their mom or dad. They took a few breaths away from their friends or whoever found them. They took away a positive thought about them from everyone who heard that they had overdosed. They took away the confidence people had in them to lead a normal life. They will always be seen as something different now. Not the same as they used to be. Never the same as they ever where.

What did you take? They took me away from serving the other citizens in my response area. They may have robbed my other customers of the opportunity to be treated in a timely manner. Those customers deserve the full attention of a seasoned, veteran responder that is not exhausted from spending 70% of his day dealing with the addiction crisis. I am not implying that the addict deserves lesser treatment. I am simply pointing out that had they not chosen to put themselves into the position they are in, we would not see the system being overrun with this particular public health crisis. Some believe that addiction is not a choice. I do not agree. The fact remains that we are the most likely interface between this public health emergency and the healthcare system so like it or not, we have to deal with the issue. That grants us permission to have an opinion about its cause whether you think we should or not.

What did you take? For most repsonders, the addict has taken nearly every ounce of our compassion and smashed it on the floor. Most of us have come to the end of our rope when it comes to the Heroin crisis. We were nice. We were compassionate. We were genuinely interested in finding these people the help that they need. We even, dare I say, patted the occasional hand and assured them that they could beat this monster if they only got in touch with the right support group. We really tried. We have lost most, if not all of our try. It is gone. We have each tried, on a personal level and professional level, to get our compassion back but by the tenth overdose only half way through a 24 hour shift, our compassion has evaporated. On this particular issue, we are burnt out. We are past the active fire stage and we are a smoldering pile of ash that once was a real, compassionate public servant. We are done. But we keep taking the calls because that’s what they pay us to do. All the while, we drop little bits of ash everywhere we go and burn everything and everyone we touch.

Some of you will read the previous paragraph and say that maybe we should get out of the business if we are that burnt. You might say that we should keep trying to be compassionate, no matter how many of these calls we take. You may say that it is such a shame that we feel that way. To that I say, come ride with us for a while. Keep in mind, this situation didn’t gradually get terrible. This epidemic hit us like a truck in the fast lane of the interstate. It seemed to us like everyone woke up one day and decided that it was a great day to try Heroin. Come see what we see and deal with the volume that we have been handling. See how many times you can get lied to about what, when and how much before you give up caring about how the addict feels. It has been my experience that the stones usually get cast by the folks in our profession that work in slower services or in this case, haven’t been hit very hard by this crisis. They simply don’t handle the volume. There is nothing wrong with that but realize that there are services that are taking way more calls than you with way less resources than yours and there are responders that are tired because of it. We all deal with the calls that are assigned to us so we can never really know what others are dealing with for sure without seeing it first hand.

That being said, I know that everyone handles their call volume differently. The 100 calls you take in a year could be the worst ones you have every seen. I get it and I understand. We are all doing the same work, but some of us are drowning.

What did you take? They keep taking pieces of the hope for a resolution to this epidemic. The more overdoses we respond on, the further away the possibility of a resolution seems. It is so far away now that I don’t think any of us can see it. It is scaring us. But we forge ahead.

So time marches on and we take the calls as they come. Some within our ranks are working to try to find a resolution to our part of this disaster. Lawmakers are working hard as well. We are all scrambling to find a solution that works but the bodies are piling up. None of us have the golden ticket yet but we try to hold onto hope.

What they really take is our belief in humanity and it’s ability to solve any problem. We need to solve this problem. We need to do it. There will be no white knight that rides in and has the magical cure. There won’t be a day when we wake up and the problem is solved. It’s not going to happen. We will have to fight it to the end. We will have to get dirty and we will have to get our knuckles bloody. Who we need to hit I don’t know. I would like to think that starting with the drug cartels may be a good idea. We have all accepted that the war on drugs is a joke so lets turn our energy and efforts directly toward the cartels and try to destroy them. That’s just my opinion and I am far from a geopolitical expert. cartel

It seems like a supply and demand issue. There is a huge demand but if we destroy the supply, maybe we will see progress. Who knows. I certainly don’t. I just hope for a solution before many of us decide we have really had enough and retire.

I don’t want to say that drugs beat me, I’m not even an addict but I can certainly see this crisis as a reason to find another line of work.

Stay safe and stay vigilant!

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