Recently completed program to deal with opioid overdoses may have saved lives
A program that trained emergency medical personnel to leave a life-saving drug in the hands of people dealing with addiction, may have reduced deaths throughout Butler County.
Deaths from overdoses in 2020-21 dropped to 66 people, compared with 92 in 2017, according to the Butler County Drug Task Force.
The program, which ended in April, was developed through University of Pittsburgh Medical Center. SCOPE, or Strategies to Coordinate Overdose Prevention Efforts, focused on making Narcan more available to prevent overdose deaths and worked to reduce the stigma that surrounds addiction.
The program also targeted “compassion fatigue,” a condition common among professionals who deal in trauma that can reduce their capacity to care. Such efforts reduce emergency workers’ risk of judging overdose survivors, especially when people navigating addiction might depend on paramedics to save their lives more than once.
The program sought to combat the stigma that surrounds addiction and encourage overdose survivors to form healthier bonds with their rescuers, which — ultimately -- may help the survivors recover from addiction when they are ready.
Narcan is a life-saving drug which is effective at reversing overdoses and has played a major role in the opioid crisis.
Dan Swayze, chief operating officer at UPMC’s Center for Emergency Medicine of Western Pennsylvania, said confusion and alienation often surrounds the immediate aftermath of drug overdoses. Even though paramedics may have just saved a life, the person who has overdosed may respond unpredictably.
“Be empathetic with that person and understand that they are confused and scared and struggling right now with a lot of things going on in their life,” Swayze said he advises paramedics. “And the best thing a person can do, in those moments, is to be the person that got them into health care, into EMS in the first place, and just be compassionate and understanding.
Swayze added that first responders need to realize that the interaction with an overdose survivor might not initially be one of gratitude.The survivor may not even be happy someone saved them.
“But being supportive, being understanding, that can help make sure that the person is able to think clearly about what it is they’re going to do after the resuscitation has happened,” he said.
SCOPE included a Narcan distribution effort, so people who overdose again in the future have supplies to save their lives after first responders leave. It incorporates screenings, so people who feel ready for recovery have the option to seek treatment, without judgment, shame or intimidation from the law, Swayze said.
Most importantly, it humanizes the addiction experience by illustrating the neurological forces behind addiction in a way first responders can relate to. Personnel receive the chance to hear from people who have been through addiction and become well, leading rich, flourishing lives.
“People don’t choose opioid addiction,” said Garrett English, a counselor at the Ellen O’Brien Gaiser Addiction Center in Butler. “It’s not something fun to go through, and there’s a chemical imbalance that’s the same as any other disease. So understanding that it is a disease that nobody would choose is what I see as the most misunderstood aspect of addiction.”
English, who recently celebrated his seventh year of recovery, said trauma and substance use disorder are overwhelmingly linked. He said all the patients he had helped treat at his previous inpatient unit experienced some kind of trauma.
“We see that trauma is closely related to addiction, but trauma is not necessarily the fundamental cause of addiction,” he added in a text message.
Robert Evans, who directs continuing quality improvement at Butler Ambulance Services, said their team’s caring attitude toward addiction survivors is a cornerstone of their outreach.
Evans noted that overdose survivors are not always ready to hear the message the first time.
“It’s probably like our caring attitude toward those patients, because if you meet them with resistance, and like we don’t care, a lot of times they’ll be turned away, where if you offer them some kind of help, we hope to plant a seed,” Evans said. “They might reject it this time, say, ‘Hey, I don’t want anything to do with this.’ But maybe the next time it happens they say, ‘Yeah. I’m ready for treatment.’ It might take a second or a third time to get them to go into some kind of treatment or to get the help that they need.”
Swayze said Butler Ambulance Service’s prompt embrace of the SCOPE Program attested to that team’s dedication to their work and openness to new ideas.
English said that some of those first responders, who once administered care to overdose survivors, have often found themselves recovering from addiction too, experiencing that event from a different perspective.
“It’s been incredibly powerful to watch somebody who has a background in law enforcement or first responders or people that are typically on the other side of addiction, helping or reprimanding individuals who have addiction, on the other side, experiencing it for themselves and having their perspective change while in treatment,” he said.
“That is an extremely powerful and extremely encouraging type of process to witness, and I’ve been able to see that a few different times.”