The national opioid crisis is now affecting fire departments as much, if not more so, than car accidents, fires, and other emergencies. As first responders, we have the responsibility to be prepared for most anything when called to a scene. Unfortunately, the number of calls to treat opioid overdoses is on the rise in many communities throughout the country. In 2016, tens of thousands of deaths resulted from overdoses and many were due to opioids like fentanyl, heroin, and other synthetic and non-synthetic drugs.
The Opioid Problem
Opioids first became popular as a pain management tool in the 1990’s after physicians stated they were reassured by the pharmaceutical companies that the drug was non-addictive and could be used regularly to treat pain (U.S. Health and Human Services, 2018). However, by 2016, those assurances were called into question as opioid use and deaths have taken a staggering toll on many communities. The U.S. Department of Health and Human Services has found that opioid usage during 2016 resulted in the following:
- Over 11 million people who were prescribed opioids misused them.
- An estimated 42,249 (116 people per day) died from overdosing on opioids.
- Roughly 2.1 million developed an opioid disorder and the same number of people misused the drugs for the first time.
- About 170,000 people tried heroin for the first time and 948,000 people used heroin.
- The economic cost for opioid usage reached $504 billion.
- Nearly half of all overdoses were the result of misusing opioid prescriptions.
Why Opioids are a Fire Service Problem
When someone finds an overdose victim, they typically call 911 for help. Usually, the first person on the scene is a fire service member (Hatt, 2018). The problem is not restricted to inner-city communities. The opioid epidemic affects upper middle-class neighborhoods, as well as small towns and rural areas. An overdose can happen at any time and in any community. This means firefighters everywhere must be trained to help save opioid victims and to minimize risks to their own safety.
The crisis is putting substantial demands on fire service professionals. In some states like Massachusetts, Virginia, Florida, Arizona, and South Carolina, governors have declared a state of emergency to address the public health emergency (ASTHO, 2018). And those numbers are expected to rise.
What Can Fire Departments Do?
As always, the best thing a fire department can do is train its firefighters to handle opioid overdose calls. This includes not only recognizing the signs of an overdose, but also what actions should be taken to treat the victim and increase their chance of survival. In some states and communities, firefighters are being trained to administer naloxone hydrochloride (also called Narcan or Evzio) to opioid overdose victims as quickly as possible (Owens, 2014). Naloxone hydrochloride reverses the effects of the opioid and significantly improves the likelihood that the patient will recover. Every active duty firefighter should know how to handle and administer the drug.
Firefighter safety is of prime concern when handling opioid emergency calls. The first step is to wear personal protective equipment to administer first aid. Opioid substances can enter the body through inhalation, injection, ingestion, or absorption through the skin. Firefighters handling an opioid call should do the following (Stumbaugh, 2017):
- Wear all first aid gear to opioid calls. This includes impermeable gloves, protective eyewear, and a HEPA mask to block aerosol droplets in case the drug is in an aerosol container or the victim vomits toward the firefighter’s mouth.
- Treat everything as if it is contaminated. A firefighter should act the same way they do when they are called to a scene with lots of blood.
- Develop a method to monitor firefighters during and after opioid overdose calls, especially if there is a suspicion they may have been contaminated.
The opioid crisis will not be going away anytime soon. It is imperative that fire departments prepare for the worst. That starts with gaining knowledge and training about the crisis and how to respond. After all, being prepared is what we do best so we can do our best when the time arrives.
How has the opioid crisis affected you and your department?
- S. Health and Human Services (2018). What is the U.S. Opioid Epidemic? Retrieved from https://www.hhs.gov/opioids/about-the-epidemic/index.html
- Hatt, K. (2018). Why the Opioid Epidemic is a Fire Service Issue. Retrieved from https://www.firerescue1.com/combating-the-opioid-crisis/ articles/379201018-Q-A-Why-the-opioid-epidemic-is-a-fire-service-issue/
- ASTHO, Association of State and Territorial Health Officials (2018). Emergency Declarations in Eight States to Address the Opioid Epidemic. Retrieved from http://www.astho.org/StatePublicHealth/Emergency- Declarations-in-Eight-States-to-Address-the-Opioid-Epidemic/01-11-18/
- Owens, K. (2014). Responding to Opioid Overdoses. Retrieved from http://www.fireengineering.com/articles/print/volume-167/issue-10/ departments/fireems/responding-to-opioid-overdoses.html
- Stumbaugh, S. (2017). Responding to Fentanyl Incidents: First Responder Safety Considerations. Retrieved from http://www.lexipol.com/resources/ blog/responding-fentanyl-incidents-first-responder-safety-considerations/