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Overdose overload: Addicts in distress put the strain on first responders

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The opioid and heroin epidemic has created a growing number of drug overdoses, which are taking their toll on first responders in southern Colorado’s urban and rural areas – first responders who are charged with administering initial treatment at the scene and transporting distressed addicts to hospitals. Brandon Costerison, who is a spokesman for the National Council on Alcoholism an…

The opioid and heroin epidemic has created a growing number of drug overdoses, which are taking their toll on first responders in southern Colorado’s urban and rural areas – first responders who are charged with administering initial treatment at the scene and transporting distressed addicts to hospitals.
Brandon Costerison, who is a spokesman for the National Council on Alcoholism and Drug Abuse and based out of the St. Louis area, says there are two trends coming out of the opioid and heroin epidemic. The first is positive: Hospitals, once overdosed addicts are brought to their facilities for initial treatment, have been more and more able to put those addicts into long-term treatment programs with the help of community support. Costerison likens overdoses to heart attacks in that essential follow-up treatments concentrating on “high blood pressure and all the other things that caused the heart attack” are needed for preventing heart failures in the future. He adds that not all communities, particularly those in rural areas, can offer follow-up treatments for addicts who overdosed and who often leave the hospitals and/or incarceration without getting the treatment they need to get off drugs and prevent future overdoses.
The second trend, though, is most disparaging: the high number of overdosing addicts has put a strain on first responders to get overdose patients through emergency room doors. Costerison says that emergency medical technicians have about two to three hours to get opioid addicts who overdose to the hospital. He adds that he has relatives in the Pueblo area and wonders about the toll put on EMTs in southeast Colorado’s rural areas, where the nearest medical facility could be as far as 45 miles away or even greater.

Third strike, and done?

As for the toll overdoses take on a community in terms of dollars and cents, Costerison refers to a June 28th story appearing on the USA Today website about an Ohio town that has suffered such financial losses from repeat opioid overdose calls that its city council morbidly discussed a three-strikes rule. Middletown, Ohio, which has less than half the population of Pueblo, actually ruminated over leaving a distressed opioid addict for dead if that person was treated and taken to the hospital by the city’s EMTs for an overdose two times prior.
The city council cited, among other things, the high cost of Narcan, the drug used to counter the effects of an opioid overdose. “That somebody’s life is only worth a few bucks is really disconcerting,” Costerison says.
A call last month to Middletown city media representative Shelby Quinlivan humanely revealed that the three-strikes discussion “went nowhere” and the councilman who brought up the idea did not get re-elected and will leave his post this month.
Thankfully, a discussion like the one had by the Middleton City Council would be highly improbable in Pueblo.
Pueblo Fire Chief Shawn Shelton explains that, although his firefighters are also trained as EMTs, they don’t take anyone to the hospital and in at least some cases don’t administer Narcan. He says the City of Pueblo contracts with a Greenwood Village-based national company called American Medical Response or AMR for those services. (AMR has a similar contract with Canon City.)

In AMR’s hands

In regards to opioid and heroin overdoses, Pueblo firefighters and police officers usually arrive at the scene first, then call AMR, which sends EMTs and an ambulance. The AMR EMTs in many cases administer the Narcan and then transport the overdose patient to the hospital. AMR then bills the patient or the patient’s insurance provider for the Narcan and services rendered. The only expense for the city is for the firefighters to call and observe the AMR EMTs, and those firefighters would be on duty anyway.
Also Shelton’s firefighters have observed that, like in Middletown, there have been a number of addicts in Pueblo who repeatedly overdose, but figures on just how many were not readily available.
As an aside, the fire chief says Narcan, which is also known by the generic name naloxone, is only a temporary fix that lasts a relatively short time before the negative symptoms of the overdose – vomiting, dizziness, seizures, etc. – return. Shelton says addicts often get angry after the Narcan is administered (to help save their lives) because it interrupts or ruins the heroin high for which they paid a lot of money to buy on the street.
Mike Lening is operations manager for AMR’s South Region, which serves Pueblo, most of Pueblo County (except for Rye and Beulah), and Fremont County. He says an increase in opioid overdoses across his region “makes it tougher” on his company’s resources (EMTs and equipment). As for the cost of treating overdosing addicts, who most often cannot pay for AMR’s services, Lening says his EMTs do not curtail their services based on someone’s perceived inability to pay for them. He add…
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