Concord firefighters grapple with how to handle the opioid crisis

Monitor staff
Published: 6/12/2021 4:06:09 PM

The best way to understand a firefighter’s experience during the opioid crisis is to imagine working as a lifeguard, saving people from drowning in the deep end.

Except in this pool, every time you pull a flailing body out of the water, they jump right back in.

Derek Martel, an officer with the Concord Fire Department, said this is how it feels to revive people from the brink of death with Narcan, only to turn around and do it again the next week.

“So that frustration is, I can pull the same person out of the deep end three times in a day and all I can do is get back up in my chair and watch that deep end,” he said.

This week, the department brought in Ginger Ross, the founder of Choices, Peer Recovery Support Trainings, to work through these feelings. Five officers, triumphant from a successful duckling rescue, marched into the classroom on Thursday morning.

As Ross went around the room to poll what they would like discussed in the lecture, almost all of the firefighters recounted this same feeling, widely known as ‘compassion fatigue’ in the industry.

The term is sort of a misnomer, Martel said. It’s hard to describe the feeling but it’s better categorized as a systemic frustration than a lack of compassion, he said.

Firefighters are “catch-all fixers”— they respond to unexpected childbirths, car accidents, and stuck ducklings. It also means that many of the calls involving substance abuse, which don’t fit neatly into a police officer’s realm, fall to the firefighters, exposing them to the nasty underbelly of addiction day after day.

Responding to these calls became one of their primary responsibilities around 2017, when the opioid crisis in New England started spiraling out of control and fatal overdoses reached a record high. In 2018, Concord Fire Department alone treated about 220 opioid overdoses.

The next year, the N.H. Department of Safety awarded them a grant to train their staff on how to respond to addiction and administer Narcan, a drug that jolts overdosing people back to life. With just a couple months left of funding, Martel, who heads the department’s addiction training, wanted to get as many trained as possible. Though optional, nearly 80% of the 80 on-shift members attended the two-hour course.

Ross, who has been in recovery for alcohol addiction for 10 years, called on each firefighter to trace back when the fatigue started setting in.

“When did you start to lose the compassion?” she asked the class.

Dave Currier, a veteran in the department, said it didn’t happen all at once. It was a slow erosion that came while helping the same people over and over.

“The first time we go to the alcoholic because he fell down, it might not be a big deal,” he said. “We might help them out, get them up, get them a drink. By the 10th or 11th time going at three in the morning because of the same old thing, we kind of lose interest in helping the individual because he doesn’t help himself.”

The others in the room knew who Currier was referencing. An older man with an alcohol addiction has been calling the fire department for over a year, often at odd hours of the night, to get help with trivial matters, like getting into bed or getting a glass of water.

The first couple of times he called, the firefighters happily arrived at his apartment to help. As his calls started coming in more frequently— sometimes he called three times during a single shift— the officers found it more difficult to muster the sympathy for his addiction.

“That’s where the compassion fatigue for me comes in,” Martel said. “Like, help yourself and stop drinking. But it’s a disease, you know, I get it. It’s not that cut and dry.”

Everyone in the room agreed that to a certain extent, addiction was a combination of personal choice and disease. Many said that they considered the initial decision to try the drug was a choice that sometimes spun out into an involuntary disease.

Ross agreed, punctuating their point with a slideshow of statistics highlighting the strong genetic and trauma components of addiction.

Perspectives about the nature of addiction have not always been so nuanced in the emergency personnel community. Decades ago, when Martel went through his own training, it was widely accepted that addiction was comprised of a series of bad choices, brought on by a lack of willpower.

The way he used to handle addiction is very different from how his department is trained to handle it now.

“I was not kind,” he said. “I was just pissed off.”

Justin Kantar, a young firefighter and paramedic, said he wants to help people with drug dependencies — he was drawn to the job to serve his community. But addiction sometimes feels unsolvable.

“It’s not necessarily the individual. It’s how we feel after dealing with them,” he said. “Then if it’s repetitive, that’s hard to shake. It’s like getting slapped in the face each time.”

Martel said the firefighters know exactly how to rescue someone trapped in a car, how to split a fracture, how to put out a fire. There is no playbook for handling addiction.

“It’s a house that’s on fire and they don’t even know it’s burning,” he said.

Concord Fire Chief Sean Brown said over time, these experiences wear down his officers.

“We want to help but sometimes it takes an impact on our folks when they literally bring somebody back to life three times in 36 hours,” he said.

Teddy Rosenbluth bio photo

Teddy Rosenbluth is a Report for America corps member covering health care issues for the Concord Monitor since spring 2020. She has covered science and health care for Los Angeles Magazine, the Santa Monica Daily Press and UCLA's Daily Bruin, where she was a health editor and later magazine director. Her investigative reporting has brought her everywhere from the streets of Los Angeles to the hospitals of New Delhi. Her work garnered first place for Best Enterprise News Story from the California Journalism Awards, and she was a national finalist for the Society of Professional Journalists Best Magazine Article. She graduated from UCLA with a bachelor’s degree in psychobiology.

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