Overdose calls becoming more frequent for first responders

© 2017-Rochelle News-Leader

Main focus for local EMTs is saving lives and getting addicts help

This is the second in a series of articles about the rising opioid epidemic in the area.

ROCHELLE — The opioid crisis is no longer in someone else’s backyard and communities around the country are coming to grips with that, including Rochelle.
Dave Sawlsville, Rochelle Fire Department Chief, said there has been a significant increase in opioid overdoses in Rochelle. The numbers started climbing about four years ago and now, on average, the department responds to two or three overdose calls each month.
Although the majority of overdoses are related to heroin usage, some are due to prescription medicine, cocaine and methamphetamines.
Sawlsville, who has been with the fire department for over 30 years, said there are many scenarios that could lead to opioid overdoses including taking prescription medications for legitimate reasons, such as following a surgery. If someone becomes addicted and their prescription runs out, unless they face the issue it could lead to an even bigger problem if they turn to the streets for illegal drugs. Even worse, illicit drugs are now being “cut” with others such as fentanyl, an extremely potent painkiller.
Cutting refers to the means by which illicit drugs are diluted, often to expand the volume and stretch the supply or to increase the potency.
Power of addiction
Sawlsville explained what he has seen can be attributed to the stronghold addiction has and to what lengths people will go to get high. Often the first response from an overdose victim after being revived is anger.
“They wake right up, they usually know what happened. Sometimes they are mad… they just spent money to get that experience and you took that away from them,” Sawlsville said. “Within a minute, they wake up, you start asking questions and they frequently lie right to your face.”
Sawlsville said people are not truthful for a variety of reasons. Some are embarrassed, want to avoid getting in trouble, or do not want their friends or family to know. He has also seen situations where innocent children are involved.
“We ask them what they are doing here… their license says they live in the suburbs. They’ll say, ‘I’m here visiting a friend’ — and you end up here in a parking lot with a needle and your kids are in the backseat?” Sawlsville said. “That’s just the power of that addiction to the point where they will drive an hour to buy the drugs and they can’t wait to drop off their kids someplace safe. They have to do it right then and there, kids in the back with the car running.”
Sawlsville has had repeat calls, including an instance where the victim had to be intubated (insertion of breathing tube). He explained on the way to the hospital, the victim regained consciousness in the ambulance. Upon arriving, the emergency room doctor removed the breathing tube.
“The victim told us this was the second time that week this has happened,” Sawlsville recalled.
He has also had victims’ spouses or significant others not forthcoming with information — delaying the administering of the life-saving drug.
“We ask what happened and the significant others won’t tell us, then we will administer the Narcan and they will sit right up and start talking,” he said. “Their significant other is literally seconds from being dead, but stigma is so strong they will lie.”

Saving lives
Opioids act by attaching to and activating opioid receptor proteins, which are found on nerve cells in the brain, spinal cord, gastrointestinal tract and other organs in the body, effectively inhibiting the transmission of pain signals.
An overdose from an opioid can lead to respiratory depression and respiratory arrest where the brain and body tissues do not get enough oxygen.
“Normal respiration rate should be between 12 and 20 per minute,” Sawlsville explained. “After taking too much of an opioid, such as morphine or heroin, the breathing starts to slow down… a person could be breathing only two respirations a minute which is not enough to sustain life.”
Sawlsville said when the brain is starving for oxygen, a person could start having seizures, foaming at the mouth, or worse, the heart could go into a fatal arrhythmia and stop.
In an effort to save lives, first responders are now allowed to carry Naloxone, commonly known as Narcan, which reverses the effects of an opioid overdose almost immediately. When administered, Narcan blocks the drug from entering the nerve receptor at the receptor site.
Often times, first responders do not immediately know why a person is unconscious. Sawlsville explained standard protocol for emergency personnel includes testing the victim’s blood sugar to determine if the person might be in a diabetic coma. During that time, medics are simultaneously assessing vital signs and administering the appropriate methods to stabilize the patient.
“Our first priority is to support vital signs. If they are not breathing, we need to get them breathing, either with a bag, a mask, or putting a tube down the throat,” Sawlsville explained. “Now they have a pulse and they are breathing, this will give additional time to assess the situation.”
Sawlsville explained Narcan only works on opioids. Once the drug is administered, if a patient regains consciousness, he said the overdose would have been from opioids.
“If it wasn’t from that, there is no side effect. There is no downside to giving Narcan,” Sawlsville said. “If they overdosed from meth and we give them Narcan and they don’t wake up, the Narcan is not going to hurt them.”

Challenges
“One of the things we see is because Narcan works so quickly, people wake up and don’t want to go to the hospital. They are alert and oriented and have the legal right to refuse to be transported,” Sawlsville said. “So they never get the help they need. It is an addiction… some feel shame, the stigma, they tell themselves they are a bad person because they are addicted.”
Just the same as with any other substance used, the person suffering from addiction has to want the help. Sawlsville said his department does not want to get addicts in legal trouble.
“We try not to cross those lines. We want people to feel like they can reach out to us. We don’t necessarily call the police… we are not required to,” Sawlsville said. “We treat them, take them to the hospital. The hospital refers them for additional help, such as Sinnissippi.”
First responders, including Sawlsville, want the public to be aware the stereotype of drug abuse only happening in the inner cities or in abandoned buildings no longer applies. It crosses all socioeconomic lines and involves people in all occupations, including professionals.
Sawlsville said he believes the latest news regarding Gov. Bruce Rauner’s Opioid Prevention and Intervention Task Force is a positive move. The task force has embarked on a listening tour across the state in an effort to gain information and potential partners in an effort to curtail the growing epidemic in Illinois.
“I think it’s a good first step. The state is just trying to find out what the problem is, how big it is,” Sawlsville said. “You know when it is significant when it starts repeating enough and you start to see a pattern. When you look at a patient and see it enough to recognize it. For our crews, for them to be able to recognize a pattern, they would have had to see it enough times. You don’t recognize patterns from something you see every three to five years… you recognize it when it becomes something you see over and over. Our job is not to judge, our job is to treat and get them the help. Don’t hesitate… call. We will get you where you need to go and get you the help you need.”

Proactive
The Rochelle Police Department is taking a proactive approach, addressing the opioid crisis at the source — the drug dealers and suppliers.
“We have certainly had several fatal overdoses in Rochelle over the last few years,” said Rochelle Police Chief Eric Higby. “Our department has a K9 unit and we are involved with the Stateline Area Narcotics Team (S.L.A.N.T.) in an effort to combat the abuse of prescription medications and illicit drugs.”
Higby said his department is trained to administer Narcan, if needed. The police department also has a drop box for unwanted prescription medications, including narcotics to keep them from being misused.
Ogle County Sheriff Brian VanVickle said the Supreme Court is mandating problem-solving courts, such as Veterans Court Program, drug court, or DUI court to address the underlying issues rather than just punishment with incarceration.
“We are seeing a shift to special courts to deal with specifics,” VanVickle said. “This will help to figure out what the root cause is, and to get them help for their problem. In general, in problem-solving courts, after completion they typically don’t have that charge on their record anymore. They can be successful members of the community and be able to provide for their families.”






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