The opioid epidemic has become national news – you can’t turn on the TV without hearing a mention of the widespread issue.
But for first responders, the opioid epidemic is more than a 6 p.m. news story. It’s an everyday, around-the-clock problem that’s plaguing both large and small fire and EMS departments.
In St. Charles County, Mo., which is one of the nation’s fastest-growing counties, paramedic Lisa Cassidy took note of the amount of overdose calls crews with St. Charles County Ambulance District were running.
Ready to make the county aware of its problem, Cassidy spearheaded the #StopHeroin campaign.
“We started out by wearing T-shirts that had a #StopHeroin logo on the back and then we did a social media blast of statistics, including how many overdose calls we were running,” Cassidy explained.
What happened next, Cassidy said, was a domino effect.
“All this ever started out as was an awareness campaign – we wanted to make people aware that our county had a problem,” she said.
Campaign grows to help opioid overdose patients
Cassidy, who has been a paramedic for 20 years, has been at SCCAD for 19 years. She currently works at one of the busiest stations in O’Fallon, working 48-hour shifts with four days off in between. On her days off, she works on the #StopHeroin program.
The campaign, which Cassidy kicked off in August 2016, targets both teens and adults.
“A lot of people wanted to sweep it under the rug,” she said. “We started giving out information on how to lock up your prescriptions, using drug disposal bags and where to find drug disposal drop-offs.”
From there, the campaign blossomed and morphed with the help and backing of SCCAD’s administration and board members.
“It’s at a place that we never really thought it would be,” Cassidy said. “Our administration and board were always willing to go that extra step and everything we asked for they allowed us to do. Without them and their consent, we wouldn’t be doing anything that we’re doing now.”
As a matter of fact, hardly anyone is doing what SCCAD is doing. With the fast success of the awareness campaign, Cassidy wanted to start doing more education in the schools and outreach in the community.
In order to reach a wide audience, Cassidy teamed up with SCCAD employees to create a raw and emotional video about what happens during an overdose call.
“We have a paramedic at SCCAD that also has a film degree; he agreed to do it with us. I told them what I wanted to do, and because we all run a lot of overdose calls, it went pretty smooth. We did it all in almost one take.”
The 45-minute-long presentation is tailored depending on the audience.
“We have one for teens and one for adults, which talks more about prescription lockup,” Cassidy said.
In the video, there’s a clip of paramedics and police officers answering basic questions about what it’s like to have to tell someone that their child or family member has died from an overdose. There’s also a clip of a SCCAD board member who lost her son to heroin eight years ago.
At the end of the presentation, St. Charles County overdose call statistics are shown.
The presentation is now being offered to sixth, seventh and eighth graders at the Teen Drug Summit, which is put on every year by CRUSH – Community Resources United to Stop Heroin.
“They asked us to come back and be the keynote presentation. We want everyone to see what’s going on through our eyes as paramedics.” After the presentation is over, Cassidy said you can hear a needle drop in the room. However, she’s always glad to answer the teens’ questions.
“They have great questions at the end of the presentation. Some of them ask questions about their family members; they listen, they’re very intrigued. I think it helps that we’re paramedics. We run these calls we actually see these people for real. We’re not lying, we’re serious.”
Substance Use Recovery Response Team
Though the awareness campaign and community outreach helped, there was still a major component missing.
“I thought to myself, ‘OK we’re getting people aware and we’re talking to kids, but we have hundreds of people out there that are substance users. And we know where they are because we’re running on them, so why can’t we try to help these people?’”
Cassidy took the idea and ran with it – developing the Substance Use Recovery Response Team (SURRT) in March.
SURRT, which is a collaborative effort between SCCAD and treatment providers in the area, reaches out to patients who have been revived following an opioid overdose. The overdose patients are given a packet of treatment resources and offered a one-on-one discussion with Cassidy or another community paramedic to help them enroll into an in-patient or out-patient program.
“We give them these [the packets] if they consent or not,” Cassidy said. “If they do consent, we call them within the next 24 to 48 hours and motivate them to get into treatment. Some of them are ready, and some of them are not interested.”
The patients have to sign the consent form in order for Cassidy or other paramedics to reach out and try to get them help.
“With some patients, we meet at their homes, some in coffee shops and others we talk via phone or text. If they’re willing to get treatment, then we’re willing to help them out.”
And, with SURRT, Cassidy said that’s how the district’s harm reduction program came about.
“While we were doing this, our local National Council of Alcohol and Drug Abuse contacted us and said they had free Narcan through a grant and wanted to know if we’d be willing to distribute it to our overdose patient families.”
The Narcan, Cassidy said, comes in a bag with instructions and every SCCAD paramedic goes through training about how to instruct family members on using the opioid overdose reversal drug. They started the harm reduction program in July and have given out 84 kits already.
“We just want to make sure someone knows how to use these kits. That’s really the whole thing, from awareness down to harm reduction. One thing led to another, which led to another,” Cassidy said.
Because the opioid crisis is widespread, Cassidy said it’s important to help others get a similar program off the ground. “We’ve been in touch and have had meetings with our fire districts in St. Louis County. They wanted to know how to get started, because they want to do something similar. It’s spreading and that’s great.”
Opioid epidemic will get worse before it gets better
Last year, SCCAD ran 426 opioid overdose calls and Cassidy said they’re on track to run about 500 this year. “I do think it’s going to get worse before it gets better.”
Cassidy said the long-term difference-maker will be when other agencies start to work together. “It’s going to take a while to get out of it, but I think we’re all doing the right thing with more awareness, prevention and education.”
Education is also important when it comes to those running the program – the frontline first responders. “We’ve had a big culture change here,” Cassidy said. “We did more education with our EMS crew after we started this program.”
Prior to crews distributing Narcan, the NCADA provided additional training to SCCAD paramedics.
“There’s stigma surrounding mental health, substance use and addiction. We wanted to get ahead of that by providing additional training, and we’ve had a great response from our paramedics. More mental health training is really the best thing you can do for your employees.”
Cassidy said paramedics also have the opportunity to follow up with their patients once they are placed for in-patient or out-patient treatment.
“They wanted to find out how their patients were doing. It makes them feel good and realize that the program is working, that we’re getting them treatment.”
In the last two months, SCCAD has started following up with their SURRT patients to see where they’re at in their treatment.
“We want to see if they’re using still, if they’re sober, if they’re going to meetings. We’ve called some people and it’s a good thing we called, because they weren’t doing well. Follow up is hard, but we’re doing the best we can with the ones that we can contact.”
Getting that initial consent, however, is the first and hardest step. It’s the only way SCCAD paramedics can help their patients reach the next step in their treatment and recovery.
Of those who have consented on scene, Cassidy said the district has a 62 percent success rate in linking those patients to treatment.
“That’s unheard of,” she said. “It’s because we’re running on them, we’re in the field with them and we’re treating them. If you just show them you care, then they’re very receptive and thankful for the program.”
Cassidy, who was named Paramedic of the Year by the Missouri Emergency Medical Services Association, said it’s all about building a good rapport with their patients.
“It took a lot of people to get to this point. I tapped every possible person I could – all different people in every part of this. It was a team effort. At the end of the day, the district and the community won.”
