Firefighter training focuses on responders' role in battling opioid epidemic

"Addiction -- It's not a Choice, It's a Disease," was designed to give firefighters more insight into a problem they deal with nearly every day

By Susan Spencer
Telegram & Gazette

WORCESTER, Mass. — People tell their doctors about family history of cancer, heart disease and other common conditions that have a genetic link.

But when Dr. Matilde Castiel, Worcester's commissioner of health and human services, asked seven city firefighters attending a training on opioid addiction Tuesday whether any of their relatives had an addiction, none raised his hand. Yet there's a 50 percent chance that risk of addiction can be passed on, according to national research.

"That's part of the stigma of it," Dr. Castiel said.

The training, "Addiction -- It's not a Choice, It's a Disease," was designed to give firefighters more insight into a problem they deal with nearly every day as first responders to emergency medical calls in the city. It is part of a training series Health and Human Services is offering to city departments and community groups in an effort to spread potentially life-saving information about addiction and the opioid epidemic, according to a news release from the city manager's office.

Seven training sessions have been held each day, over four days, so that each crew could attend.

The training covers how opioids affect the brain, how physicians address substance use disorders, as well as the human aspect of helping people bridge the gap between active addiction and recovery.

"If you understand the brain, you can't say, 'It's their fault; it's their thing they did to themselves,'" Dr. Castiel said.

"Our goal is, how do we get the entire community engaged in looking at addiction and really giving people a hand? There's no question that it's affected everybody."

Even among a largely affluent population with access to good health care, such as 17,000 participants in a survey conducted in the San Diego, CA, area, 27 percent -- more than one in four -- reported a family history of substance use disorders, according to Dr. Castiel.

In Worcester, there were 1,156 overdose calls to 911, including deaths, in 2016, up from 1,023 in 2015, Marianne Sarkis, assistant professor of international development and social change at Clark University, told the firefighters. This year 821 calls had been projected, but as of July, there were already 551.

"Mostly, it's the fentanyl," Ms. Sarkis said.

The challenge for recovery, she said, was, "We're not contributing to the solution. We're just putting a Band-Aid on it."

Ms. Sarkis explained that on average, it takes a person eight or nine attempts at recovery before entering longtime recovery. "You're literally rewiring your brain," she said.

Which is why, despite frustrations among some first responders that people who are revived from an overdose might continue to use drugs and overdose multiple times, responders need to show some compassion and understanding to offer a brief intervention. Even a simple, "Hey man, do you need help?" might be the connection that could be a lifeline to treatment and recovery.

Nicole Bell, outreach specialist for Pathways to Change and founder of Living in Freedom Together, a nonprofit empowering survivors of commercial sexual exploitation, presented the face of recovery to firefighters, sharing her story of abuse and trauma as a teen, a suicide attempt, selling her body to get drugs so she could escape her mental pain, and then having no place to go to build a life after treatment.

"I haven't met anyone who said, 'I want to be a prostitute in Main South when I grow up,'" Ms. Bell said.

She found hope when she entered Everyday Miracles Peer Recovery Center downtown. "She looked at me for the first time like I was a human being," Ms. Bell said of the center's director at the time. "It's been a long journey and it's a lifetime of recovery."

Michael Earielo, program director at Everyday Miracles, said afterward, "We know the horrible side of addiction -- the death -- but we don't shine a light on success."

He sees 80 to 100 people who are maintaining recovery, holding down jobs and connecting with supportive family or friends.

"For some of us, we don't get it on the first try or the second try. We need compassion," Mr. Earielo said. "We're fighting strongly to change this."

Copyright 2017 Telegram & Gazette

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