Student EMTs seek to reduce Conn. overdose deaths with grassroots effort
College students Livia Cox and Nick Wells co-founded Middletown Harm Reduction Initiative, hoping to equip those addicted to opioids with lifesaving tools
The Middletown Press, Conn.
MIDDLETOWN, Conn. — Two Wesleyan University student EMTs are on a mission to reduce overdose deaths with a three-pronged, grassroots effort to equip those addicted to opioids with lifesaving tools.
Livia Cox and Nick Wells are co-founders and co-directors of the Middletown Harm Reduction Initiative, a local, nonprofit organization launched in the fall 2019 that offers a syringe exchange program, twice-weekly resource distributions of safer-use kits, COVID-safety supplies and PPE and community education.
After witnessing a large number of overdoses at work, Cox realized that some could have been prevented if the patient had access to medications such as naloxone, which can reverse the effects of opioid abuse.
After 55 overdose deaths in 2020, Middletown saw 34 more people die from overdoses between Jan. 1 and Dec. 5, 2021, according to Acting Health Director Kevin Elak.
In all, 81 percent of overdose fatalities in Middletown (78 percent in all of Connecticut) can be attributed to fentanyl, Cox said.
Fentanyl, a synthetic opiate about 50 to 100 times more potent than morphine, comprised the largest share of drug overdose deaths in Connecticut between 2015 and 2021, according to state data.
The MHRI works to deliver "culturally cognizant, non-judgmental, non-coercive care to underserved community members who use drugs," Cox said.
Working as an EMT opened Wells' eyes to how prevalent overdoses are in the area, especially Hartford, which has one of the highest overdose rates in the country, he said. Last week, a 13-year-old Hartford seventh-grader died after overdosing on fentanyl at school.
"We don't have much funding, we don't have many resources, but we do have a lot of drive and passion," Cox said. "As EMTs, we have a true understanding of the way the overdose response system works, but also the ways in which it fails individuals who suffer from opioid and substance use disorders."
Over 70,000 people died of an overdose in the United States in 2019, more than four times the 1999 total, according to the Centers for Disease Control and Prevention.
The pandemic turned opioid and substance abuse disorders into an "all-encompassing, twin plague that has been exacerbated by COVID, exacerbated by housing crises, exacerbated by unemployment," Cox said.
Initially, the two worked with the Greater Hartford Harm Reduction Coalition (now the Connecticut Harm Reduction Alliance). Cox and Wells learned about the concept of harm reduction by shadowing others doing the work, she said.
The two eventually realized there was a great need for these efforts in Middletown, Wells said.
A $5,000 seed grant from Wesleyan in February 2020 initially funded the effort, part of a "series of events that worked out very well in our favor," Wells said.
MHRI now has more than 170 clients and over 25 volunteers, Cox said.
Cox said most clients get smoking kits and injection kits, which discourage sharing, and lower the risk of catching blood-borne diseases, such as HIV/AIDS and hepatitis. When people turn in used needles, she added, clients are given an equal number of clean ones, and volunteers dispose of them in a safe manner.
"Harm reduction is not about telling people to stop using drugs," Cox said. "It's not necessarily about addressing the root cause of addiction, which is a flaw in harm reduction, but it needs to exist because it helps keep individuals alive until they are ready to seek additional support — if ever."
Since the twice-weekly distribution inception began in early January 2021, there have been no overdose deaths attributed only to heroin, Cox said.
"Harm reduction brings about a sense of dignity and humanity to the overdose response system," she added.
For clients who eventually do seek help, there are medications, such as methadone, buprenorphine and suboxone, that can ease the symptoms of addiction, as can a stint in a detox facility, Cox said.
Recovery is based on individual choice she said. "Some individuals are not interested in the pursuit of recovery or sobriety, and we still treat them as individuals with complex sets of needs."
"The pandemic keeps sucking people back in [to addiction]," said Elak, who is in the process of forming an opioid overdose coalition with key community members, such as Middletown's Ministerial Health Fellowship President, the Rev. Robyn Anderson of Cross Street AME Zion Church, and the chamber's Middlesex County Substance Abuse Action Council.
"We've already started to recruit different stakeholders in town and we've had a great response," he said. "A lot of people are doing great things in town, but they all work in silos."
"The opioid epidemic is still incredibly close to the hearts of everybody," Wells said. "Hardly anybody in the country can say they don't at least know someone who's suffered from a substance abuse problem."
The decline of overdose deaths in Middletown "speaks a lot to the effectiveness of harm reduction and speaks a lot to the work that, not just us, but others people in the community and public health are doing to combat the opioid epidemic," Wells said.
"It also speaks to the increased understanding of the effect that COVID has had on the substance abuse world. It's been around for two years now, and I think people are now starting to understand how related the pandemic is to the opioid epidemic in the whole world, but especially in the U.S.," he added.
There is a degree of controversy surrounding the distribution of clean needles and medicines used to treat opioid addiction, Elak said.
"People think it's not a good thing, but it is," he said. "We still need to focus on services to help people overcome addiction, but we really want to save lives in Middletown."
(c)2022 The Middletown Press, Conn.