A person born in 2017 has a greater chance of dying from an accidental overdose than in a motor vehicle accident.1 Substance abuse in our society has reached epidemic proportions. EMS stands on the front lines of this crisis—sometimes as the only line of defense.
Many of us see this epidemic for what it truly is: a disease. No longer pigeonholed as associated with poverty, project housing, or any other census-defined category, it’s bipartisan and now resides as much above the poverty level as below. It does not practice prejudice. Your race, gender, socioeconomic status, creed, or sexual orientation will not spare you its wrath. The suffering have names and identities—they are your mother, your father, your siblings, your children, your peers, and your friends. At one time it was me, clutching a needle in a rundown hotel room, playing Russian roulette with my life. Then fate stepped in.
Day of Reckoning
My day of reckoning came in October 2015. At 11 a.m. I checked into a hotel. By 11:30 I closed my eyes for what should have been my last time. Over the next 24 hours, I took approximately 2–4 breaths per minute. Housekeeping found me, almost lifeless.
Once in the ambulance, I was treated by a paramedic named Nastassia. She didn’t offer much in the sympathy department, but she did have some empathetic words for me. Even in the catatonic state I was in, I haven’t forgotten them.
Empathy is something we all fall short of sometimes. Not to be confused with sympathy, it’s the ability to understand and share the feelings of another. Sympathy is more difficult. We know most of the circumstances we encounter (particularly substance abuse-related) all begin to boil down to choices patients willingly made. Understandably, it can become challenging to have sympathy for each one we respond to. However, empathy should transcend sympathy. It does not require any overextension of skills or time on scene. Unlike our skills and procedures, though, one cannot simply learn empathy via textbook or lecture. It has to be felt to be relayed effectively.
I have chosen not to share Nastassia’s exact words, but they were very basic and humanistic. She didn’t earn anything extra, and it cost her nothing but a few moments of time, but that brief interaction, whatever its worth to Nastassia, became priceless for me. It was a glimmer of hope. Inch by inch and day by day, I began to take my life back. Empathy was my spark to recovery. Today I am a mother, wife, teacher, medic, mentor…and in recovery! Because of what empathy provided me.
I am also clinical coordinator of the Central Kentucky Paramedic Program, and that puts me in a position to help steward further change. In October 2019 my paramedic students began a clinical rotation, in coordination with Pinnacle Treatment Centers, that involved substance abuse. For many it lent a first-person perspective to an affliction with which they will become familiar in their new careers.
The feedback was overwhelmingly positive. Almost every student reached out to me afterward. Every one expressed gratitude to have received the opportunity to witness firsthand and better understand an affliction that goes largely misunderstood. Could that misunderstanding stem from the lack of exposure and/or misinformation about what a program of recovery truly entails? After our first full clinical rotation for addiction education (though relatively small in size), our feedback and data suggest it’s possible.
With a little luck and a basic willingness to practice empathy, I believe a seed has been planted in our students.
The healthcare systems in our state and country put far more time and resources into the care and treatment of maladies that carry a drastically lower death toll. Pinnacle Treatment Centers is changing this, working aggressively on an infrastructure to care for these patients acutely. If we can get a handful of facilities throughout Kentucky to participate, we can effectively change the protocols on a state level.
Much like with a stroke or heart attack, patients who suffer acute crises related to substance abuse can be transported to an authorized facility that specializes in the care they need—basically a Level 1 trauma center for substance abuse. Most community hospitals won’t participate, because they cannot afford to or are ignorant to the problems within their community, but it is reasonable to think a few larger systems can step up and allocate funding and facilities.
Together, oxycodone, hydrocodone, heroin, and fentanyl have killed more than 400,000 Americans since the beginning of this century. Those numbers don’t include alcohol, methamphetamine, or cocaine.2 How many more people have to die before we do something differently?
1. Mazzei P. Opioids, Car Crashes and Falling: The Odds of Dying in the U.S. New York Times, 2019 Jan 14; www.nytimes.com/2019/01/14/us/opioids-car-crash-guns.html.
2. Overdose Lifeline. The Opioid Health Crisis, www.overdoselifeline.org/news/the-opioid-health-crisis/.
Elizabeth Jade Harney, NRP, BBA, is a paramedic in Kentucky and clinical coordinator for the Central Kentucky Paramedic Program.