Recently the town of Middletown, Ohio have proposed a statute that would require 911 to hang up on a caller that is known to have been a heroin abuser. It has been reported in several news outlets and spread through social media like 
wildfire. Article. Another article.
I have received several inquiries as to my opinion of this purported practice. For those that don’t know I am a 25+ year paramedic and former dispatcher including being as a certified EMD. I figured that a blog post was required for this. What follows is my opinion as a citizen, a provider, and a human.
I will agree that the epidemic of heroin is still climbing now including cutting of the opioid drug with things like fentanyl and carfentanil. So let’s take a trip back in time – say 10 years ago. I might have used Narcan a half a dozen time at the most in a single year – and that’s on the high side. Now, it is nearly every trick I work. Narcan costs on the order of $45 per 2mg. 
With the end user not knowing what the drug was cut with, the dose to increase it’s potency the user may know that if they do one dime bag, they get a great high. With the added cutting agent, that dime bag may be five to fifty times as potent. This puts them into unconsciousness which is the precursor to death from respiratory arrest. If a responder get there in time, they may use Narcan, but increasing doses are becoming the norm.
Yes, this costs more money. Moreover, if this becomes a law, these people will perish. I understand that there is only so much money in the coffers for every FD, PD, and EMS agency. This is the cost of doing business. If you are a healthcare provider, you understand the hippocratic oath.
In NY, if you have a duty to act, you must do so or you will be held accountable in a court of law. Every EMS class is taught this. When I was cleared as a paramedic, I had to see my chief for his blessing. After a few minutes of words of advice, he said “go forth and do no harm”. And by doing nothing, is doing harm in this case – it’s called neglect. Any provider, citizen paying taxes, human being, and city hall dweller could conceivably think that “3 strikes” is a solution should be tried and convicted of any number of felonies. I question the abilities, education, and common sense of the people that are put in places of power. What kind of idiot, actually, what kind of human are you?
The 911 operators (who, by the way are always overlooked in saving lives) see an address that is flagged for multiple overdose calls are instructed to simply hang up. “What if’s” on this are so long – but here are a couple. What if the house was on fire? What if it was because a child was choking? What if there was an intruder? What if the user is having a heart attack? What if they OD’d again and could be saved by the regular response. They acknowledge this is not the solution, but a way to save money. ARE YOU FREAKING KIDDING ME? Funding and budgets are more important than a human life? I got news for ya, you’re wrong – DEAD wrong. I still can’t believe I am writing this.
Heroin is one of the worst drugs to ever try. It has a chemical hook that is nearly impossible to get clean from. In fact, counselors say that the person that does heroin will spend the rest of their lives fighting to stay away and off of it. It is that powerful. The treatments that are available – the most popular is suboxone, can become addicting as well.
There is no permanent solution. There are dealers making money.
Heroin was brought from Germany after the Civil War to combat the then epidemic of morphine abuse. It worked, or so the doctors of that time thought. Read that here .
I am appalled that another human being, would even fabricate such a policy, and then deliver said policy to the public. You numbskulls in Middletown should be fired immediately. Public safety is necessary. It is the cost of a community. I am sure you don’t charge for the rounds a police officer practices with and then God forbid uses. I am sure you don’t charge the fire department for the gallons of water used on your neighbor’s house to extinguish the fire. There are some ways to recoup monies from EMS use depending on your municipality.
I suggest that before you reach a solution as hairbrained as this you do some research. From multiple sources. As much as it makes me unhappy to respond to an overdose, I’d rather that than a deceased citizen.
Now, remove your craniums from your rectums and think like a human being. If you can’t, the fine citizens of Middletown should remove you from office.
Compassion, empathy, caring, kind, thoughtful and forgiving. This doesn’t affect just the user, it affects the friends, family, and employers as well.
Middletown, Ohio – I hope things work out for you.
