Narcan – Three Strikes and You’re Out

It’s been an interesting week here in Middletown.  Let’s start with the facts.  Councilman Picard asked the Law Dept to investigate whether we had a legal obligation to dispatch to repeat opiate overdose patients.  If , after investigation, there was a legal and ethical path that would allow us to legally choose to respond or not to dispatch, he opined that there could be a system to be later considered that would divert overdosing addicts from jail and into community service and treatment.

There was no three strikes policy discussed by Council as a group, no change of policy voted on.  No change or request to change was made by the majority of Council to alter how we run police or fire calls on potential overdose situations.   We will complete the legal research requested and forward the information to City Council at some later date.

Councilman Picard’s comments went viral and we’ve received hate mail, national news coverage and overloaded voice mail and email in-boxes.

Except… nothing has changed… at all… whatsoever.    We are responding to every call and rendering aid as needed.   We give Narcan where it is appropriate.   Period.

Middletown has done everything we know to do to be as progressive on this issue as we can.  We get harm reduction.   We understand it’s a disease.   We have a drug court in the municipal court system with medically supervised treatment.  Our heroin response team (police officer/social worker/paramedic) has placed over 140 people into treatment in the past year.   We have had an operating needle exchange program in Middletown for over a year.

We are usually heavily criticized not for being too harsh, but rather for being too lenient with addicts.   No one has figured this problem out.  Cities,  States and the country as a whole all struggle to handle the epidemic.  It’s a national problem and we utilize the local resources we have to deal with the problem in our City.

One last time – we have not considered or adopted any change to our method of responding to opiate overdose calls.   We respond and render aid every time.

Have a good week!

 

 

47 thoughts on “Narcan – Three Strikes and You’re Out

  1. Thank you for this response. It is heartening to hear someone speak of addicts in human terms and not like they are something less. I don’t envy the city management their jobs these days, but thanks for continuing to treat people with compassion.

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    • this sherriff is trying to play god?and who LET Someone like this happen ? what if it was his kid?would he feel the same?no I think he would fire one of his officers for not administrating to one of his own kids ? that is if the poor s.o.b even has any kids ? doesnt look to promising anyways.but I really would like to know where he gets of not wanting to help someone overdosing n dieing?when his oath is to protect n serve the community correct ? but instead HES GONNA STAND THERE AND WATCH SOMONE DIE?AND COMMAND HIS OFFICERS DO THE SAME? WHAT HAS THIS WORLD COME TO BE?

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      • I stand with the sherriff. Although I would administer Narcan once. If you haven’t learned that it can happen to you, then what good are you to society.

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    • In America we won’t let people who comit violent crimes such as murder die. They rush the shooter in an ambulance to the hospital. I may disagree but that’s what we do! I CANT BELEIVE LEIVING SOMEONE TO DIE EVEN CAME OUT OF THE THE MOUTH OF THE COUNCILMAN. Not to mention legal complications.We don’t count the cost when we save lives.As far as jail time , that’s just pushing more financial burden on over taxed jail systems.Maybe you should get to the the root of the problem and get your police to do they’re job and get the drugs of the streets.

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  2. Without question, this is one of the most critical issues facing communities today, and no simple answer exists. The solution calls for cooperation and input from all sectors. It is counterproductive to engage in a polarizing rants which accomplish nothing. It is not enough to just criticize the ideas of others- suggest your own ideas instead. This moves the conversation forward and may help lead to a solution.

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  3. Seems to me like addicts can roll the dice and not worry about losing. Our society as a whole wants to blame others for our mistakes and actions then ignore any consequences for our actions. Students can cheat on tests then blame the teacher, addicts can get drunk, crash a car and kill someone then blame their parents, what have we become?

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      • We don’t count cost when we save lives.We don’t let people die when they roll the dice by not wearing seatbelts, we don’t let grandma die when it’s too expensive for her pacemaker.We don’t let people die at all. WE SAVE LIVES ANY WAY WE CAN NO MATTER WHAT THE COST! WHEN DO YOU PUT A COST ON HUMAN LIFE? ANSWER: WHEN YOU BECOME NO BETTER THAN A MURDERER.

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  4. Using drugs is NOT a disease. Using drugs is a CHOICE. I couldn’t believe you actually stated in your email that it’s a disease.

    These addicts make a choice to do the drug. They can also make the choice not to do the drug and get help.

    I do NOT support using tax dollars I pay for reviving these addicts. On my street alone 1 girl overdosed 2 times in the same week. The squad administered 3 doses the 1st time. 2 doses the 2nd time.

    This must stop.

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    • Your just an idiot! Do some research before you run your mouth. Maybe it will be your kid or family member next time, and you can save your community some money and let them die! If you think in that narrow, heartless mind of yours that these people want to be addicts then its you who has the problem. I’m just glad you live there!

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      • Ok, we’ll keep running the calls and administer the Narcan and you Mike yourself will pay for it. How’s that sound? Everytime we run an overdose call and Narcan is administered we’ll send the bill to you.

        What’s that? Crickets I hear.

        I see, all these “we gotta save em” bleeding hearts say as a society we should do EVERYTHING we can to save drug addicts…but when it comes down to who’s paying for it it’s silence.

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    • You are wrong. The DSM recognizes addiction as a disease, and you are literally suggesting condemning someone to death, which I believe would count as narcissism (also recognized by the DSM).

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  5. its a joke why waste money and time on someone that will keep using again and again.
    let them dig their own grave and die in it. exchanging needles? what a fucking joke like this city.

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    • What idiots, cold hearted, uneducated people you are. Don’t think for one minute this epidemic/disease can’t happen to someone you love. Use of drugs is an addiction just like any other addiction (alcohol,gambling,etc.). Addicts have a chemical imbalance in their brains, no fault of their own.
      Walk a mile in the families of these addicts before you give an opinion you know nothing about. Who are you to judge?

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      • i am more than qualified to judge. i am an ex smoker i am an ex drug user i am an ex drinker. none of it was a disease. it was all my choice to do it and to stop. quit giving people an excuse not to change behavior. it is a choice. it is total bs that people call it a disease. granted diseases are caused from these choices like liver disease heart disease cancer, but that is our own fault if we made these bad choices

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      • THE CHEMICAL IMBALANCES IN THEIR BRAINS AND BODIES ARE PUT THERE BECAUSE OF THE DECISION TO DRINK AND OR DRUGS. JUST BECAUSE THERE IS A FAMILY OF 10 WITH TWO WITH DEEP MENTAL ISSUES DOES NOT MEAN THANT ANY OR ALL WILL BECOME SERIAL KILLERS. SO IF THERE IS A HISTORY OF ADDICTION IN YOUR FAMILY YOU CANT JUST SAY WELL ITS NOT MY FAULT MY DAD WAS ONE AND SO WAS MY BROTHER AND UNCLE. THAT CREATES AN ENABELING SELF DESTRUCTIVE PERSON THAT THEN CAN GO ON TO HURT MAIM KILL OTHERS OR THESELVES BECAUSE THEY WERE ON DRUGS AND THEY COULDNT HELP HELP SOMEONE WHO IS TRYING TO RISE ON THEIR OWN DONT CARRY THEM AND SAY ITS OK YOU DIDN’T MEANT IT ITS NOT YOUR FAULT YOU HAVE A DISEASE. CAN THAT PHYCH BABBLE AND BE A TRUE HONEST LOVING PERSON TO THE PERSON IN NEED.

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      • Forget immunizations and basic health care for the millions struggling to get by on a very limited budget. Let’s keep spending tens of billions per year on those who CHOOSE to shoot up illegal drugs!

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  6. You ppl make me sick! Comparing money to a life! Your caring ways speak of your heart, your soul. I wouldn’t want to be in your inner circle. You need to read your Bible. Regardless of what a person has done, God is the judge, not you. You may find yourself in this very situation with family, friend, whomever, will you still feel the same way?? SMH! Shame on you all! Cold hearted!

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    • i have seen it in the family… the family member also died…. sucks they died but they were warned many times… still dlnt feel sorry for them… which is why we chose ro cut them out of our family when they chose not to stop

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    • i have a grandson that i love very very much who is a drug addict. this was and is his choice. if i could make him make another choice i would. i cant and neither can you. he and his family will pay the consequences for his choice. no one else should be responsible nor should he be made to feel that it is not his fault. it is

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    • I HAVE BEEN IN THOSE SITUATIONS AS HAVE OTHER MEMBERS OF MY FAMILY. WOW IS ME WILL NEVER HELP TO CREATE A STRONG MORAL RIGHEOUS PERSON. GOD DID NOT JUST KEEP DOILING OUT FISH HE TAUHJT THEM HOW TO FISH SO THEY COULD BE SUCCESSFUL ON THEIR OWN. ANYONE COLLECTING STATE BENEFITS THAT IS PHYSICALL ABLE TO WORK SHOULD BE WORKING 40 HOURS PER WEEK FOR THEIR HOUSEHOLD TO RECEIVE FOOD, SHELTER, CLOTHES ETC. MAKE A REAL PROUD HUMAN AGAIN QUIT KNOCKING THEM BACK DOWN ON THE GROUND AND SAY ITS OK ITS NOT YOUR FAULT

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    • Sherri God is judge I agree! But when we step in we take that role on ourselves. I don’t consider myself uncaring nor uncharitable and I have always tried to help where it was needed, but I have to agree with the guy who says this is choice. I not five minutes ago read where two men just had a baby…HUH! the story was a woman who decided to become a man, but waited so her and her boyfriend could have a child first. How damned crazy are we going to get before we stop. Tell me God intended any of this, I don’t think so.

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  7. Its so interesting to see how people speak of heroin addicts like they are babies that need to be coddled… However when one of these people break into your house or hurt one of your children to get their next fix, will you feel the same way? They don’t have to worry about jail or anything. They know they aren’t going to have to change because there’s no punishment for it. It’s sickening and annoying. Why should they change of there aren’t any consequences ?

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  8. all this narcan is doing is telling users its ok to do drugs!! if you would just stop responding then maybe they would think twice before they stick a needle in their arm!!! and its not a diease its a choice… they choose to do drugs!!!! if i ever see anyone overdosing dont except me to stop an help them bc i wont!!!!

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  9. I cannot believe City councilman Dan Picard still has a job! He has no idea what it is like to be an addict or an alcoholic. Do you really think an addict said, “oh I think I know what I want to be when I grow up. I think I’ll be an addict”. Why doesn’t this country realize addiction is a mental illness. Why don’t we have an overdosed person taken directly to a treatment center to get clean?

    Mr. Picard, I happen to be an alcoholic/drug addict in recovery. I’ve been clean and sober for 23 years. It took 11 years for me to be desperate enough. I am not a homeless hobo. I am a retired Contracting Officer for the federal government. How did I get started?? By a prescribed medication.

    Remember when there were treatment centers in the early 1900’s? I do most of them were shut down due to lack of funding.

    I sure hope you or one of your loved ones do not get addicted by accident and be out on the street. Be careful who or what you judge. It may come back to bite you!

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    • I KNOW WHAT IT IS EXACTLY LIKE AND I AGREE WITH HIM TO A DEGRREE,. IF THERE IS ONLY CONTUINED BAD DECISIONS TO USE THE IM NOT WILLING TO KEEP PAYING FOR IT. THEY HAVE DECIDED WHAT THEY WANT QUIT MAKING THE REST OF US SUFFER FOR YOUR BLEEDING HEART ATTITUDE. IT HELPS NO-ONE ESPECIALLY THE ADDICT

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  10. Although I fully sympathize with addicts and their struggles, where is the personal accountability when there is NO money to keep saving individuals from themselves. As a taxpayer, do I have a right to say, no I am not willing to continue to help you kill yourself? Either get the help you need or deal with the results.

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  11. […] I believe that the answer to the question lies in approach to treatment for heroin addiction. Because recent research done has described addiction as a treatable disease of the brain, I believe that the answer lies in changing practices around heroin and subsequent opioid abuse disorders, and never in cutting off treatment to patients. [4] Of course in Middletown, patients that have ODed on heroin are continuing to get treatment, but Dan Picard had brought up a valid salient point- has opioid use grown into an epidemic? (Picard’s comment on his blog: [5]) […]

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  12. Addiction is a disease and should be treated as such. Using drugs/alcohol/tobacco is a choice and and a mistake and should be discouraged. Most of the most serious problems caused by drugs are the result of drugs being illegal. Think about the results of the 45+ years of the “war on drugs”. What have we done? The horror is too much to contemplate. This will not improve until the madness of drug illegality ends. Get over your puritan instincts and advocate for legalization. Or, continue to live with the consequences.

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    • such utter bullshit. i have used a lot of drugs. i have had friends and relative die on drugs. i have relatives who are drunks. i have relatives and friends who died from drinking. they made their choices. this disease crap is utter crap to get insurance money. when you take drugs longterm you change your brain.

      i have an addictive personality, yet I managed to just be a weed smoker and not do serious harm to myself or the community. if you do heroin or fentanyl or whatever else that is string enough to kill you, or you start slamming shit in your veins, no one is to blame but you.

      if you OD your friends and family will actually go through LESS pain with your dumb ass dead.

      i have done and still do (certain) drugs, and I agree, no more narcan except for medical personnel and police who get ‘poked’ on the job. the rest is just a darwin award and humanity is better off without the weak shit.

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  13. One problem with Narcan. It’s not magical. One of his possible side effect is … death. It happens.

    Sure, the person doing an overdose could die without Narcan.
    But if things gets wrong, and he dies from your injection, YOU killed that person.

    And as your not a medic, you coudn’t legally judge the necessity of the injection.

    You are in deep toubles. You’ll probably be judged, and if you are a deputy, the whole departmetn will pay a huge fine to the familly of the addict.

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  14. Attn: Middletown City Manager Douglas Adkins – Please Read

    Portugal has already solved this problem. Google : Portugal Drug Reform

    http://www.independent.co.uk/news/world/europe/portugal-decriminalised-drugs-14-years-ago-and-now-hardly-anyone-dies-from-overdosing-10301780.html

    “Why hardly anyone dies from a drug overdose in Portugal”
    https://www.washingtonpost.com/news/wonk/wp/2015/06/05/why-hardly-anyone-dies-from-a-drug-overdose-in-portugal/?utm_term=.e0be8f0c736f
    ———————————————————————————————————————————————-

    Please do not listen to Councilman Dan Picard or Butler County Sheriff Richard Jones.
    Narcan saves lives.

    Sweden hasn’t had a heroin overdose in 10 years. We had 10,000 last year alone. That’s not a coincidence. I keep hearing people say “no one has figured it out.” That’s not true. We just have to devote a little time and energy to research the solution.

    Portugal used to structure their drug policy like we do now, with 90% of drug funding going to Law Enforcement and 10% going to treatment. They had one of the highest rates of heroin overdose in Europe. They eventually realized it wasn’t working. Now 90% of their drug funding goes to treatment and 10% goes to Law Enforcement (Law Enforcement won’t like this, by the way). They now have one of the lowest rates of heroin overdose deaths in Europe. That only took 15 years and a reevaluation of policy. You need to stop going to Law Enforcement for solutions. Their solution will always be more funding for Law Enforcement. Just like it has been for the last 50+ years.

    Politicians endlessly running for office with the “Get Tough On Drugs” trope has gotten us into this situation to begin with. We keep approaching this problem with solutions sourced from politicians, not public health experts. That is the problem. Politicians and police will not solve this problem.

    “No one has solved this problem.”

    YES THEY HAVE. We just need to stop acting like we are the only country on earth and the only country dealing with this. Another 50 years of “Get Tough on Drugs” will do nothing. Jeff Sessions suggesting we get “Tough on Drugs” and re-institute mandatory minimums will not solve this problem. They haven’t before, why would they now?

    Butler County Sheriff Richard Jones has no medical degree, but is negatively impacting this situation with his ignorance.
    Middletown Councilman Dan Picard does not possess a medical degree, but is negatively impacting this issue.

    Their words embolden people to ignorantly condemn addicts.

    “Let them die” is basically what they say. Typical authoritarian response. No empathy, just dehumanize them and remind yourself that you are “better than them.”

    90% of heroin addicts stop using heroin on their own. When you save someone with NARCAN you give them one more day for them to make that decision.

    If it was your child, would it be a waste?

    D2A2 VS. D2A1

    “It’s a CHOICE! Not a Disease.”
    NOT TRUE. That is the voice of ignorance.
    If someone inherits the wrong dopamine D2 (DRD2) gene. They are automatically at a heightened risk to experience drug or alcohol addiction. If you inherit the D2A2 variant, your dopamine system is less likely to be susceptible to drug and alcohol addiction. If you inherit the D2A1 variation, you are much more likely to end up abusing drugs or alcohol. If you inherit the D2A1 variation, you are also at a heightened risk for experiencing depression, bi-polar disorder, schizophrenia, and ADHD. And addiction.

    Just because you inherited the wrong gene variant.

    All of these disorders have to do with the dopamine system and dopamine distribution in the body. Dopamine is a naturally occurring chemical that controls pleasure, the “reward system”, movement, control of attention (that’s why we prescribe Adderal for ADHD, Adderal is amphetamine salts), and lots of other functions. The D2A1 dopamine gene variant often can cause what is called “dopamine dysregulation.” Dopamine dysregulation is usually exhibited in the form of dopamine deficiency. Drug and alcohol users are more likely to be dopamine deficient from birth due to inheriting a D2A1 dopamine gene from their parents. They are dopamine deficient, so when they use substances that boost dopamine production in the body (like heroin, opiates, cocaine, cigarettes, sugar, marijuana, alcohol, methamphetamine) they have a different chemical experience than people who inherited the D2A2 gene variant. Their reward system is triggered in a more powerful way than those with the D2A2 variant. Those with the D2A2 gene variant do not experience as powerful of an urge (addiction) to use dopamine-boosting substances because they have naturally occurring higher dopamine levels.

    It is not a choice to develop schizophrenia, depression or bipolar disorder.

    If one parent has bipolar disorder, you have a 10 percent chance that one child will develop it. If both parents have bipolar disorder, you have a 40 percent chance of developing the illness. (http://www.healthline.com/health/is-bipolar-disorder-hereditary)

    We aren’t told whether we inherited the D2A2 or the D2A1 gene variant. But, if we have parents or family members who use drugs or alcohol we are more likely to be carriers of the D2A1 variation.

    The largest risk factors for addiction are genetics and environment.

    If you inherit the wrong gene, you are at a higher risk. If you are raised by parents who abuse drugs or alcohol, you are at a higher risk. If you are born into a family or raised in a home where drug or alcohol addiction already exist, you are at a higher risk. This is scientifically proven.

    Now, who get to pick their genes? Who gets to pick their parent? Who gets to pick the family and household they grow up in? No One. So for the people who so ignorantly claim that “This is a CHOICE!.” No, by and large , it is not. It is predominately effected by genetics and environment. Yes, personal choice factors in, but that is a smaller statistical variable than genetics and environment.

    There is a solution to this. Someone has solved this. It is not hopeless. Please do not listen to those saying we should just let them die. Someday, it will be someone you care about. Addiction cuts across all social and racial strata.

    Those who say we should let them die are callous, heartless, angry people, who are tired of having to put out the extra energy to find the solution.

    Please listen to the science on this issue. Please do the research (you can figure out much of it in 20 minutes).

    Google: Portugal Drug Policy
    http://www.independent.co.uk/news/world/europe/portugal-decriminalised-drugs-14-years-ago-and-now-hardly-anyone-dies-from-overdosing-10301780.html

    Why hardly anyone dies from a drug overdose in Portugal
    https://www.washingtonpost.com/news/wonk/wp/2015/06/05/why-hardly-anyone-dies-from-a-drug-overdose-in-portugal/?utm_term=.33163acfb1cf

    Law Enforcement will not come along willingly. Many will act like Butler County Sheriff Richard Jones and suggest that they deserve to die. He is wrong.

    If they are religious, please remind them of Matthew 25:40
    And the King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers of Mine, you did for Me.’

    If it were Dan Picard’s child, or Richard Jones’, would they help? Or would they judge and condemn?

    If they think help should be refused, they are deciding who is worth saving and who is not. This is not their choice.

    If an officer responds to a call and finds their own child in an overdose, and they don’t have the NARCAN, what will their feelings be?

    We don’t refuse medical attention to the person who is obese and has a heart attack. We don’t refuse medical attention to a smoker who has cancer. We should not refuse medical care for the homeless (most of whom suffer from mental illness – D2A1 gene carriers). We should not refuse to revive the addict.

    Thank you,
    M. Hinrichs

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  15. Let the worthless dregs die. AT BEST, they will clean up and become useless broken nobodies, whos biggest service to society is talking to the hundreds of people who will never clean up. Again, let them die. Its what they apparently want, why would you think you are a good person for denying someone what they want? Why would you say they need to be saved before they become burdens, but then pay to revive them dozens of times?

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  16. Addiction is a disease of the brain just like schizophrenia or OCD. It’s mind boggling to me that people are so willing help treat some people with brain diseases and let others die in the street. These are human beings we are talking about, people with families and children. Police are at the front lines of this epidemic and are in a unique position to change the way addiction is dealt with. They can choose to view the addict as a piece of garbage worthy of lying dead in the gutter or as a human with s brain disease. The only thing this sheriff is enforcing is old stereotypes that add to societies problems.

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