Ohio EMS contemplating 3 strike policy for OD response

[Ooh-Rah]

Not sure what to make of this.

Ohio city considers three strike policy on responding to overdoses

MIDDLETOWN, OH (WLWT) — A controversial proposal has been made in Middletown to deal with heroin overdoses.

Middletown is considering whether people with addiction should only be given two strikes before they’re out of chances at Narcan.

Middletown is struggling to deal with the heroin problem.

“We are faced with stress on our services, particularly the EMS services where we can do six to eight opioid overdose runs a day,” said Paul Lolli, fire chief of Middletown.

The number of overdoses jumped this year. Last year, there were 532 overdoses. So far, only halfway through 2017, there are already 577.

Also last year, the department spent more than $11,000 on Narcan. This year, $30,000 has been spent on it.

This is a result of more overdoses and the increasing strength of the drugs addicts are using, officials said.

The number of deaths from overdoses is on track to increase, as well. Last year, there were 74 deaths. So far this year, there are 51.

Leaders are frustrated trying to find a solution.

City council member Dan Picard is proposing a three strikes system. After the first two overdose rescues, the person would perform community service for the equivalent amount of money used on the lifesaving response.

The third strike is a bit more controversial.

“If the dispatcher determines that the person who’s overdosed is someone who’s been part of the program for two previous overdoses and has not completed the community service and has not cooperated in the program, then we wouldn’t dispatch,” said Dan Picard, Middletown city council member.

@policemedic @Muppet

 

[DA SWO]

Disagree with not dispatching, they are setting themselves up for a lawsuit.
I think three strikes your dead isn't too extreme though.

 

[policemedic]

I actually tweeted about this...

Long story short...it's bad public policy and to a large extent it's impractical.

 

[policemedic]

Disagree with not dispatching, they are setting themselves up for a lawsuit.
I think three strikes your dead isn't too extreme though.

Yeah, I get it. But the thing is, paramedics and police officers have an inescapable moral duty to preserve life--and they don't get to place a value on that life before saving it.

 

[Kraut783]

if you call, we have a duty to respond....be it Fire, Paramedics, Police....it's what we do.

 

[TLDR20]

Yeah my response is WTF? I get it to an extent, but remember the outcry over "death boards" during the ACA debate? Now we are giving a literal life or death decision to a flowsheet in the dispatch room? Fuck off. Think about some of the people who have turned their lives around after an OD... even in the SOF world we have a SEAL with a bestselling book who overcame addiction to be a productive member of DEV... from a first responder medical standpoint I cannot believe this even got traction. Our job is to save lives, PERIOD. Narcam isn't even that expensive...

 

[Frank S.]

This might not be much more than "spitballing", trying to get some kind of grasp on the issue, but this bothers me:

“If the dispatcher determines that the person who’s overdosed is someone who’s been part of the program for two previous overdoses and has not completed the community service and has not cooperated in the program, then we wouldn’t dispatch.”

This is putting a hell of a burden on dispatchers to make the determination whether the person at the end of the call is too expensive to save, and that, as usual, is a little bit fucked. There is no "we" in this.

 

[TLDR20]

Yeah and dispatchers are minimum wage workers in many places with a high school education.

 

[TLDR20]

Disagree with not dispatching, they are setting themselves up for a lawsuit.
I think three strikes your dead isn't too extreme though.

Lol at this thinking. It doesn't apply to anything else that is deemed a medical problem. Addiction is a medical problem, whether you think so or not.

God forbid you ever have a problem and have someone without that problem say "fuck it, three strikes you're out." In our day and age it is too easy for even the strongest of folks to become addicted to opioid pain medicines, some of my best friends included.

I have a good friend who was shot in the head in Afghanistan, by a dragunov, he has horrible headaches, neck pain, and seizures related to his brain injury,he took his prescribed opioids and became addicted. He suffered horrible sieizures on withdrawal, and turned to illicit drugs to ease the transisition. Had he OD'ed a couple of times does he deserve to die due to a fucking high school diploma holding dispatcher? The answer is absolutely fucking not..

It is a slippery slope, soon it is ," well he has already had one CABG, he probably doesn't deserve a second one..." or " well he has diabetes, so he doesn't deserve that heart transplant..."

 

[AWP]

I'm all about "big boy rules" but even this is beyond my Mongol approach to accountability.

 

[Ooh-Rah]

Similar to what @TLDR20 was saying, I cannot even imagine the lawsuits that would be brought on but such a program; not to mention once they started breaking it down by race....forget about it.

 

[Muppet]

Yeah, fuck no. In 18 years as a paramedic in urban/suburban settings, places with a very high rate of trauma and overdoses, the area @policemedic and I work and live, in is known for top grade heroin, so they call it. I used to work 24 hour tours, fuck that, now 12 hour tours. In any 12 hour tour, even in the slower areas now, I get 3 to 4 O.D.'s for MY medic unit, not counting surrounding medics. If it gets dispatched as a cardiac arrest, 2 medic units and a fire truck are sent, along with P.D. P.D., fire and E.M.S. a all carry narcan. Hell. My first in medic bag, that carries out I.V., cardiac / arrest drugs, intubation, CPAP and B.V.M. has an outer large pocket, lined with narcan, 8 brista-jets, normal par is 2. The back up drug box in medic unit has 6 to 8 more, option to get more from pixus at any E.R. It's bad. It gets tiring, waking em up, getting attacked and punched, getting cussed at, having knives pulled but fuck. We have a professional and legal obligation to respond, treat and transport these O.D.'s with in out paramedic SOP's. I can't tell you the answer to the problem, but this ain't it. Oh, Middletown E.M.S. I work P.A.'s version of Middletown E.M.S., just north of Philly.

M.

 

[Muppet]

And, since when are we fucking judge and jury on some junkie dipping on the stoop of a trap house. Pissed me off that a person can even think of this. I am getting tired of E.M.S. and seeing good people die while junkies get resuscitated back to back to back but WE are not the ones to be doing this.

M.

 

[CDG]

I like the theory of it. Not everyone deserves to have time and resources utilized to keep saving their worthless life over and over. There's no way to practically implement it though. And so it goes.

 

[SpitfireV]

It's not about deserving. Local government should not have the option to choose life or death for someone.

 

[Devildoc]

If it wasn't for the ODs, I wouldn't have gotten all the intubations I did. #skillslab

In all seriousness, bad policy. I get the frustration, I do, but the end does not justify the means here.

 

[Red Flag 1]

My $.02.

 

[pardus]

I've always despised junkies from afar. Now I get to work them quite often in the ER. I still can't stand the "junkie" who is there drug seeking, blatantly abusing the system, moving from one hospital to the next, and just criminal minded.
However, I've also seen average people, (i.e. YOU AND ME) have a legitimate injury, suffered a lot of pain and became addicted to opiates, prescribed to them by a medical provider.
We have a few people that are frequent fliers with Sickle Cell Anemia. Sure they're a pain in the ass while they are there, but my attitude is, these poor bastards are dying over years from a debilitating, excruciating disease, give them as much Dilaudid as they want, when they want it.
I've talked to them and listened to them about their pain and the management of it. They know how much they need, and they don't try to get more than what they need. They are aware of the addictive nature of opiates and try extremely hard to fight that addiction.
So I'm in two minds really...

That rambling bullshit all said, this proposed policy is utterly ridiculous. It should not and will not be enacted.

 

[Devildoc]

We have a few people that are frequent fliers with Sickle Cell Anemia. Sure they're a pain in the ass while they are there, but my attitude is, these poor bastards are dying over years from a debilitating, excruciating disease, give them as much Dilaudid as they want, when they want it.

SC is no joke, and their pain is for-reals. The damage that occurs in vaso-occlusive crisis is significant. On the NRS their pain is 3 when ours is 9. Some of the people in that community are a real pain in the ass and some are junkies but for the most part they are doing the best they can.

 

[policemedic]

If it wasn't for the ODs, I wouldn't have gotten all the intubations I did. #skillslab

In all seriousness, bad policy. I get the frustration, I do, but the end does not justify the means here.

Yeah, ODs did yield a good number of oral and nasal tubes. So did CHF, but now we know better.