Noting people with cancer don’t get free chemotherapy from medics nor do people having heart attacks get a free heart bypass in an EMS run, Picard asked if there was a law that requires the city to respond to overdose calls.
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The city is on pace to spend $100,000 for Narcan when it budgeted $10,000 for the entire year, according to City Manager Doug Adkins.
Adkins said the city could privatize EMS services or not have them at all. He declined to comment on Picard’s suggestion until he receives an opinion from the city’s law department.
“John Smith obviously doesn’t care much about his life, but he’s expending a lot of resources and we can’t afford it,” Picard said.
He said arresting those who overdose only adds more costs to city taxpayers and strains the city jail and court system.
According to Adkins, most of those who overdose are transients and are not residents of the city.
“I want to send a message to the world that you don’t want to come to Middletown to overdose because someone might not come with Narcan and save your life,” Picard said. “We need to put a fear about overdosing in Middletown.”
Under Ohio law, there are few options in not supplying Narcan, and medics have to treat people for whatever condition they find, Adkins said.
“We’re making progress in many areas, but the problem is growing faster and is changing faster,” Adkins said.
Picard said he appreciates the efforts of what is being done, but added that “it’s out of control.”
“It’s a frustration issue,” said Middletown Fire Chief Paul Lolli. “I get it.”
However, he said the medics took an oath to take care of people who are hurt, sick, or injured regardless of cost.
Lolli said Picard’s suggestion of not responding to overdoses would open the city and the Division of Fire’s medical director to liability issues.
“This is our standing order,” Lolli said. “Our guys operate under standing orders and protocols set by the medical director. Unless directed otherwise, that’s what we have to do.”
When asked for comment about Picard’s comments about not responding to people who overdose three or more times, Robert Haley of Choices asked, “since when does a city start endorsing death and since when does a city develop a measure that would knowingly result in death?”
Haley is the Middletown regional director for Choices (Cognitive Healthcare Opportunities In Constructive Environmental Settings), which just opened in May. Choices is a medication-assisted treatment program that serves adults who have an opiate dependence. The center offers medication assisted treatment, individual therapy, case management services, intensive outpatient, substance abuse crisis intervention and drug testing.
“He (Picard) has a right to be frustrated. He’s right because the costs have skyrocketed and the results haven’t changed,” Haley said. “He’s not getting anything for his buck.”
Haley said the councilman has “projected the high level of stresss and frustration that’s present at this time.”
But government funding of agencies is part of the problem, he said.
As for multiple EMS runs to the same address or same person for an overdose, Haley said a reason is because “you cannot measure the appropriate dose of Narcan for fentenyl.”
“Opioid dependency is quite different than any other addiction that exists,” he said. “The reason why is that even if you eliminate all of the opiods, the level of addiction will remain the same.”
“It’s a medical and physical addiction. The approach is wrong because people have the mindset of having a ‘silver bullet’ to bring this to an end when they should have the mindset to stabilize and manage the this as any other health issue,” Haley said.
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