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The solution to the opioid epidemic requires unconventional thinking

As we move on from the uproar over "three strikes and you're dead," it's time for EMS professionals to contribute ideas to solve the overdose epidemic


The overwhelming negative response to a Middletown, Ohio city councilman's inquiry into the “3 strikes, you’re dead” question has had at least one profound result: my faith in the underlying determination of EMS providers to unite in the name of good has been reaffirmed.

Now that we know an overwhelming majority of the truly EMS-committed agree the idea that would have 911 dispatchers refuse to send emergency resources to a patient who has already received two opioid overdose reversals is ludicrous, it’s time for some more serious reflection.

EMS, as a whole, bears the legal duty to respond to the needs of everyone who calls; without reservation, without hesitation and without regard for the beliefs, lifestyle or iniquities of the individuals who call. It is also widely known that EMS, historically and by no fault of its own, has been a mostly reactionary endeavor. It’s nearly impossible to stay ahead of the curves thrown down in front of EMS.

Unfortunately, with regard to the opioid epidemic specifically, simple math dictates that it’s only a matter of time before local demand for service outpaces resource availability and the crisis will become very real for all of us. So, what do we actually do?

The solutions begin with the kind of unconventional thinking that separates EMS from any other profession in our society.

With that, I wish to propose a few “what ifs?” for smarter people than I to consider, improve and implement.

What if … we recognize that EMS cannot solve the problem alone and that by the time EMS is called, it is way too late for solutions (other than naloxone)?

My attempt at writing sarcasm notwithstanding, we have to embrace the fact that on the timeline of this particular crisis, EMS is yet another victim; it’s not EMS’s fault, but it is EMS’s problem.

What if … EMS collaborated with the elementary education system to plant seeds that may prevent the middle schooler or high schooler from trying opioids in the first place?

I know; elementary school children are too young to hear about such things. Really? In 1985, maybe, but it’s 2017 and it’s never too early to plant ideas and have conversations. This is not a morality issue; it’s not sex education; it’s information that could marinate for a few years and maybe save a life or two.

What if … the idea of community paramedicine was expanded to include support for individuals participating in opioid addiction rehabilitation?

I don’t know what that means exactly, but the idea is there. Maybe community paramedics, who are already doing follow-up visits and checks, could follow up with and offer support to people who are trying to stay sober. Again, I don’t know exactly what that would look like in real life, but it’s an idea and it’s less expensive than treating and transporting an avoidable overdose.

What if … Opioid and naloxone manufacturers helped to subsidize opioid treatment and education programs aimed at reducing the number of overdose calls made to 911?

I know it is counterintuitive to the point of nonsensical to imagine a pharmaceutical company funding efforts to reduce demand for its product; I’m spit-balling here. But consider that in 1998, the major tobacco companies agreed to make payments for smoking-related medical costs, change their marketing practices and to fund anti-smoking advocacy groups.

What if … the big heads in Hollywood took a break from politics and focused some attention on the opioid epidemic with clever social media campaigns and public service announcements?

For some reason, people respond to Brad Pitt and other stars, so when they talk about the dangers and consequences of opioid addiction, maybe a few will listen … maybe.

As you can see, I really don’t have an answer and I don’t think there can be only one answer. However, there are ideas and innovations coming from EMS. If we generate enough of them, something will resonate and maybe even work.

Dan Picard, the Middletown City Councilman who proposed three strikes and you're dead, has had his 15 minutes of fame. It’s time to move forward on quelling the opioid overdose crisis before the next one – whatever it may be – rears its ugly head.

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