Addressing substance abuse includes following up on overdose calls
Published 9:50 am Friday, July 28, 2023
BY FIONA MORGAN
Writer’s note: This is the second in a series of stories that takes a deeper look at how Boyle County is addressing substance abuse, what has been successful, and what else is needed. Boyle County was named as Kentucky’s first ‘Recovery Ready Community’ in May. During the certification process, the Recovery Ready Council was impressed with the new EMS outreach coordinator.
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First responders, no doubt, are heroes when it comes to saving lives in many different situations. However, their role usually ends after a call is complete, leaving some to wonder what happens to the person they help, especially in cases of substance abuse.
Boyle County Emergency Medical Services Director Mike Rogers said that in responding to overdose calls, it never sat right with him not being able to further help an overdose victim after they leave a scene.
“After we see our patients who overdose, all we can do is fix the current problem; we have no resources to help after we leave,” Rogers said. “There was a run I went on one time and it was two grandparents dealing with their grandson who had overdosed in the bathroom. They said if we could just keep him alive until we can get him into treatment, and all I could do was get an IV and fix the problem right now, but after we left it was like, ‘good luck, we’re hoping and praying,’ and that never really sat well with me.”
Following up after those calls is now taken on by Terry Dunn, the new outreach coordinator for EMS. In 2021, Boyle County EMS received a grant from the Healing Initiative Study by University of Kentucky’s Healing Communities, to fund the new position of outreach coordinator.
A different person started out in the position before Dunn came on. Dunn started in June 2022, for the final six months of the grant funds. When the grant ended in December 2022, the county wanted to keep the position going.
So the Fiscal Court voted to use opioid settlement funds to cover the cost. But as of July 1, the position is now funded through the Fiscal Court’s general budget. Rogers said they are looking for grants and opportunities to not only continue the program, but expand.
Dunn’s main responsibility is to follow up on calls related to substance abuse and mental health, but he also goes on 9-11 calls behind an ambulance. Rogers explained that when a call comes, an ambulance and supervisor responds immediately, then Dunn comes out in his own non-emergency vehicle.
“His job is to comfort the family, explain what they’re doing, how they’re treating the patient, and once the patient is treated, then he may leave Narcan with them, follow back up, whatever they need,” Rogers said.
Dunn said that on follow up visits, he talks with the person to make sure they’re okay; provides them with resources; talks through whatever they’re willing to open up about, and is able to empathize with their situation.
“Some of my job is just being a support for a lot of individuals out there who may not have a support system in place,” Dunn said. “Some don’t have family, or people in the area or people who care and show empathy and compassion; we just try to show all those things.”
On a typical day, Dunn looks at the EMS run sheets for any new cases related to substance abuse or mental health, gathers information, looks at previous follow up cases, and makes a schedule for follow ups. In some cases, Dunn goes on many follow-ups on a person, but the average number is about two to three follow-ups.
“It varies and depends on the need that’s there; there are some individuals who I’ve been following for a year since I’ve been here, and it’s sometimes periodic like once a month,” Dunn explained.
Sometimes he runs into problems finding people, like if an individual has an emergency at a place other than where they live, or if a person moves, goes to jail, or runs into other issues.
Some may not be willing to talk, or aren’t ready to commit to treatment. But Dunn said he has helped some people get into treatment and that they’re doing well. He said it doesn’t always work out, and some end up quitting treatment; but if someone quits, Dunn starts following up on them once again.
The total number of visits and referrals he made from July 2022 to June 2023 are below:
• Total number of case individuals: 306
• Home visits made: 581
• Cases involving substance use disorders: 174
• Cases involving mental health issues: 132
• Narcan distributed: 112
• Referrals for some type of treatment for SUD: 68
• Referrals for mental health services: 35
Another important part of Dunn’s visits is to distribute Narcan, which is a nasal spray that reverses an opioid overdose. Narcan is a big initiative for EMS, as well as other organizations in Boyle County like the Agency for Substance Abuse Policy (ASAP). Dunn said they’re all trying to get as much Narcan into the community as they can.
On follow up visits for substance abuse calls, Dunn gives out a little kit containing a double dose of Narcan, and he explains how to use it. The kit also includes his contact information along with a Boyle County Resource Guide with lots of information about local meetings, help resources, brochures from treatment facilities and health providers.
Lastly, the kit has fentanyl test strips, which allows people to see if a drug that’s not supposed to contain fentanyl actually contains fentanyl. Some drug traffickers lace their drugs with fentanyl in order to produce those drugs more cheaply.
“Those fentanyl test strips will hopefully come in handy for those who aren’t ready to seek treatment yet and are still using,” Dunn said.
EMS currently gets their Narcan for free from the Kentucky Opioid Response Effort. Rogers said that since organizations in the county have been distributing so much Narcan, many citizens have used Narcan on overdose victims before EMS arrives.
“More often than not now – with the Healing Communities, and everything else that the ASAP group and everybody’s done – by the time we get there, the patient’s already waking up because someone’s already given them Narcan, which is good,” Rogers said. “I would say 3/4 of the time, they’ve already received Narcan.”
Rogers explained that when people administer Narcan, usually it’s enough of a dose to get someone breathing on their own. However, he said people should still call 9-11 because that person could still need more of a dose or more treatment.
Dunn said he knows they’re doing the right thing in distributing Narcan, as he’s had one experience where a child saved their parent’s life who had an overdose.
“I don’t know how, but [the child] had enough wit to find the Narcan and administer it to her parent and save their life,” Dunn said. “It’s situations like these that let us know that what we’re doing is helping to save lives, and we’re definitely on the right path. There’s a lot of proponents out there that say we’re wasting taxpayer dollars on all this Narcan, but how can you put a value on somebody’s life?”
Mental Health calls
For the month of June 2023, Dunn said the EMS calls for mental health cases were double the number of substance abuse cases. He responds to calls regarding anxiety, panic attacks, depression, suicidal ideation, and suicide attempts.
During mental health follow ups, Dunn makes sure the person is seeing a mental health provider, he finds out who the provider is, and asks if the person is doing their medications properly and regularly.
“Some aren’t taking any medicine at all … a lot of people will tell me they don’t like how it makes them feel, so a lot of times they’ll stop taking them,” Dunn said.
He’s also able to engage with the individual and provide support, and gives them his number for them to call if they need to talk.
“I want to be careful that I don’t burn myself out, or take on too much where I’m always getting calls and I’m never off work, so one of the other big things I’ve been sharing is about 988,” Dunn said.
The 988 phone number is a nationwide mental health crisis hotline, and Dunn said he has people who utilize it regularly. Dunn is a trained social worker, and when talking with people, he helps them to focus on the positive aspects of their life.
“As a social worker, I operate from a strength perspective; I don’t need to know about all the negatives, how you’ve come up short; I want to know about your strengths, something you can hold onto right now,” he said.
Another way he connects with others is through his own story of recovery and faith. Dunn explained that he struggled with drug addiction for many years, and went through recovery in 2006. He said a big part of his recovery journey was through his relationship with God.
“Getting through to someone spiritually is where I make the biggest connection; just the fact that God is there, he’s aware of our situation, knows what you’re going through, and if a person is spiritual or religious that’s always one of the first places I will look to to get them to rely on their strengths, because that’s where my strength comes from,” Dunn said. “It’s not something I force on people, but it’s usually something I ask in my initial interview if they’re a spiritual or religious person.”
Dunn’s journey of recovery
Dunn explained that his journey of recovery has helped him connect with others who are struggling. After years of struggling with substance abuse, Dunn said that he was tired of that life and tried several times to get treatment. But nothing stuck until 2006, when he went to one facility for 13 months.
He said that after four times of going to 30-day or 60-day treatment facilities, he kept relapsing. On the fifth time, Dunn spent 13 months in a treatment facility, and went to many support meetings like Narcotics Anonymous.
He said that in any given treatment center, not everyone is there to actually recover and to never do drugs again. People could be there because of court orders, trying to save a marriage, trying to please a child, save a job, etc.
“One of the things I did differently that last time was that I linked up with the individuals who were serious about recovery, and there were about four of us out of a group of 15,” Dunn said. “We stuck together, clung together, we were determined, and we went to 120 meetings in 90 days.”
Dunn said his sponsor wanted him to do 90 meetings in 90 days, but they went above and beyond that.
“Our thought process was that we’ve got to chase our recovery harder than we used to chase after drugs, as we had put a whole lot of time and effort when we were out there trying to find means to use,” Dunn said.
Another different thing was the length of time he spent in recovery. For the first four times, he had gone to 30-day and 60-day programs, which was long enough for him to feel better physically and mentally, but then he was back out on his own.
Living in Harrodsburg, he had less access to resources such as in a large city. In the early 2000s, Dunn said many of the shorter-term treatment facilities didn’t have follow up programs for when patients left, but that there’s many more local resources nowadays.
After Dunn’s 13 months in treatment, he went back and got involved in meetings, and started some NA meetings. In 2010, he announced his call to ministry.
“In all of that time, 13 months and beyond, my relationship with God went to a whole other level,” Dunn said. “I had done a lot of things in my life that I wasn’t proud of and was pretty ashamed of. So finding forgiveness for myself, the only way I was able to do that was to know that God had forgiven me as well, and wasn’t holding me to this person I had become.”
Also in 2010, he was back in school at EKU studying social work, and he got married. After graduating, he helped keep his family’s BBQ catering business running. Then he worked in health care for four years, then came to Boyle County EMS.
Since Boyle County does not have a residential treatment facility, Dunn said his top referral is to Isaiah House. He believes a residential treatment facility would help people in the county, along with a homeless shelter.
“I have around five calls a month at least, for different people who are homeless and in need of emergency shelters,” Dunn said.
Rogers said their hope is to expand the outreach initiative with a second person. Since Dunn does not work nights or weekends, he said they would like to have a second person to help cover the duty every day from 10 a.m. to 10 p.m.
The next articles in this series will feature other entities that help combat drug use.