Narcan for Overdose: A First Responders Point of View

Police, Fireman and EMS crews throughout Bucks County are fighting an uphill battle against The Opiate Epidemic. By the time they arrive on the scene of an overdose, Narcan for Overdosedisaster has already struck. These First Responders are equipped with a drug called Nalaxone (Narcan) in hopes of saving someone’s life but it often requires someone to call 911. That could be you or someone in your world and we wanted to share with you what to look for.

An opioid overdose can be identified by a combination of three signs and symptoms referred to as the “opioid overdose triad”.

The symptoms of the triad are:

  • Pinpoint pupils
  • Unconsciousness
  • Respiratory depression. (Shallow or Slow Breathing)

If you see any combination of these three signs…CALL 911 as soon as possible.

We interviewed a paramedic from the Bucks County Rescue Squad for this post to help us all understand the severity of this Opiate Epidemic in Bucks County. Let’s see how Joe Tomczak answered a few of our questions.

Narcan for an Overdose Can Save a Life

When did you start carrying Nalaxone (Narcan) on your EMS trucks?

I became an paramedic in 1998 and Narcan has been around since 1971. The drug had been an essential part of our medical kits since I have been doing this job. Every EMT is trained on administering Narcan in school, it is a must!

How often were you administering Narcan back in 1998 and compare that to how often Narcan administration is required today?

Our use of Narcan when I started was only sporadic. Today I am using the drug at least 5 times per week and often we can administer Narcan over 10 times in a 40-hour work week. I’m only working 5 shifts per week. We run 21 shifts and have 4 trucks ready to roll at all times. It often depends upon the potency and quality of the opiates that are in our area at any time. If there is a bad batch out there, we can get very busy. Also remember that we are not the only EMS team in town and we only cover Bristol Township, Bristol Borough and down to Croydon. I can’t speak for other teams but hear the problem is widespread.

Do you believe that “Surviving an Overdose” encourages a user to use again or seek treatment?

From our point of view, we help the overdose victim get to the emergency room ASAP after trying to stabilize them as best we can. That is our first priority. It is usually at the hospital that a patient speaks with addition counselors and hospital staff about options. Willingness to get help is on the patient and that is where the rubber hits the road. It is not unusual for the patient to want to leave Against Medical Advice as soon as they get their wits about them. It’s CRAZY but many are not ready. Addiction to opiates is a VERY POWERFUL problem. We hope they get help every time but we are up against a monster. We often find ourselves going to the same addresses in a short period of time.

What is the risk period of an overdose to reoccur after administering Narcan?

It all depends on the potency of the opiate being used and what it is mixed with. Many addicts combine prescription drugs with street drugs and abuse alcohol too…all at the same time. It is often hard to determine what has been mixed together. The persons age, body weight and other physical conditions all affect the effectiveness of Narcan. The drug only works on opiate overdoses and has no effect on non-opiates. When we inject it, it acts within a minute and can last for 45 minutes. Sometimes we have to use a second dose because one was not enough or there is more going on than just heroin use. After administering Narcan, the patient can get violent and other symptoms are sweating, nausea, restlessness, trembling, vomiting, flushing, and headaches. I gets complicated.

In your opinion, how big of a problem is opiate abuse in Bucks County?

HUGH Problem and has grown exponentially in the last five years. We need reinforcements to fight this battle. (Chris C, another EMT added)…The term First Responder is actually a misnomer. We are often a few rungs down the latter. Police and Fire crews arrive first when 911 is called. Parents, significant others, family members, close friends are really the first ones on the scene.

What can the average person do to reduce the problem?

Education of the dangers of drugs should start with 4th and 5th graders and continue through the teens and early 20’s. I did the D.A.R.E. program when I was young and that is a GREAT program. But the education can’t stop there. The conversation needs to be brought into the homes, on the soccer fields, in extracurricular activities and continue through early adulthood. Temptation to try drugs for the first-time surrounds today’s youth and fear we are losing a generation. Keep the conversation going. Use the Public Service Announcements (PSA’s) and Bucks County Drug & Alcohol Commission has great tools you can use. We also need to help those already addicted to seek help. Livengrin can help you there by attending family sessions and using their drug education programs.

Who is most effected?

The problem is widespread and effects most families…although no one is comfortable talking about their problems when it is too close to home. Children from 11 to adults in their 70’s are affected by The Opiate Epidemic in Bucks County and all over.

We encourage our readers to share this interview on your Facebook wall and within your homes. Use the sharing buttons below ⇓, The Epidemic is real and we all need to have these tough conversations with your kids, families and friends. We are here to help those already addicted and want help. Although we would much prefer to see you not to have to experience the pain of seeing your loved ones go through the nightmare of drug addiction.

Have the Tough Conversations Today!

Teenage Drug Use Starts How

Medicine Cabinets Are Where Many Start Their Abuse

Our nation’s Top Doctor sent a letter to every doctor in the United States in August prescription drug abuse starts2016 asking for their help to solve, “The most urgent health crisis facing America: the opiod epidemic”. Abuse of prescription drugs can be even riskier than the abuse of illegally manufactured drugs. Synthetic (man-made) drugs are often more potent and create a higher overdose risk. This is particularly true of OxyContin and similar painkillers, where overdose deaths more than doubled over a five-year period. Read more

WHYY Voices in the Family

The news can sound dire. Opioid addiction is ruining families and taking lives at an ever increasing rate. In this roundtable discussion, Dr. Gottlieb brings together Livengrin Board member Bruce Murray and wife Ginny, a clinician, researcher, family members and individuals in recovery to go beyond the headlines and look at what is working to bring addicts into treatment. They discuss some interventions and evaluation of treatment as well as dealing with the grief of losing a loved one to the disease. Plus, a conversation with individuals who are in recovery and working to offer hope and help to others.

Livengrin's Center City Office will experience changes in hours and programs during The World Meeting of Families

World Meeting of Families Center City Schedule

Livengrin’s Center City Office will have a modified schedule during these events.

  • Wednesday, 9/23 & Thursday 9/24
  • Livengrin – Center City WILL BE OPEN
  • All services will be scheduled at their regular times.
  • Please plan accordingly, to accommodate the increased volume in the city due to the World Meeting of Families.
  • Friday, 9/25
  • Livengrin – Center City WILL BE CLOSED
  • Day GOP will be re-scheduled to Wednesday 9/23/15 at 10:00AM
  • All individual sessions and assessments will be rescheduled earlier in the week.
  • Monday, 9/28
  • Livengrin – Center City Office WILL OPEN LATE AT 1:00PM
  • Day IOP will be scheduled from 1:00PM to 3:30PM
  • Evening IOP will be scheduled at the regular time (6:00PM to 8:30PM). Individual sessions and assessments will be scheduled by appointment.

Download a flyer highlighting these changes.

Penn Medicine and Livengrin announce partnership

Penn Medicine & Livengrin Announce Partnership

Livengrin is pleased to announce the Hospital of the University of Pennsylvania (HUP) as its newest clinical training partner. With this new partnership, Livengrin will be participating in a ground-breaking program in clinical training for Advanced Practice Registered Nurses (APRNs), who will be learning how to provide the highest quality care for patients struggling with addiction.

“Growing the ranks of APRNs is an important way to increase the base of primary care providers in this country. In the past, the cost of clinical training has limited the ability of hospitals and other healthcare providers to accept more APRN students into their settings for clinical training. The primary goal…is to increase the provision of qualified training to APRN students. The clinical training included in this demonstration will provide APRNs with the clinical skills necessary to provide primary care, preventive care, transitional care, chronic care management, and other services…”

Read more about the initiative: Graduate Nurse Education Demonstration | Center for Medicare & Medicaid Innovation

Congressman Bob Brady visits Livengrin Foundation in support of drug and alcohol addiction recovery and treament

U.S. Congressman Bob Brady Tours Livengrin

On July 1st, U.S. Congressman Bob Brady (D-Pa.) toured Livengrin’s residential facility and learned about our various programs and initiatives. A champion of social issues throughout his 17-year career in the House of Representatives, Brady pledged to do whatever he can to assist Livengrin with growing and improving our programs to ensure that we reach as many families as possible who need our services.

From left to right: CEO – Richard Pine, U.S. Congressman (D-Pa.) – Bob Brady, FRAT Team Member Dennis Hallion.

U.S. Congressman Bob Brady tours Livengrin and talks supporting drug and alcohol addiction recovery with staff

From left to right: CEO – Richard Pine, Vice President for Development – Scott Blacker, Supporter – Mitchell Rubin, U.S. Congressman (D-Pa.) – Bob Brady.


Livengrin in Philadelphia Inquirer on Donovan McNabb DUI Arrest

Livengrin on Donovan McNabb DUI Arrest

McNabb arrest shines light on repeat DUIs

Last month, for the second time in 18 months, former Eagles quarterback Donovan McNabb was arrested in Arizona for driving under the influence. According to police investigators, McNabb was caught driving with a blood-alcohol concentration of 0.171 percent, twice the legal limit. In a video of his arrest, McNabb contends he was on cold medication.

McNabb’s arrest shines a spotlight on the issue of repeat DUIs.

“Anyone can have one DUI,” said Helen Weigand, director of DUI services at Livengrin Foundation, a nonprofit addiction-recovery center based in Bensalem, who lost her 22-year-old daughter 20 years ago to a crash involving a drunken driver. “You don’t have to be an alcoholic or have a drinking problem. You just have to make a bad choice.

“But more than one DUI, along with other behavioral problems – that’s when you need to seriously look at things.”
Experts say most people who drink and drive do so many times before they are caught.

Read the full article on The Inquirer’s website

Jim Nestor, Michael Parmenter and Mike Yaeger of Livengrin's First Responders Addiction Treatment visited Oso to speak with those affected by the mudslide

Livengrin’s First Reponders Travel to Oso

Three retired first responders who now work with communities struck by tragedy visited Arlington, Oso and Darrington to share advice with people affected by last year’s deadly Oso mudslide.

Jim Nestor, Michael Parmenter and Mike Yaeger are giving four private presentations, three for first responders and one for families. The speakers also are meeting with people one-on-one or in small groups.

Nestor, 62, spent 10 years as a police officer in Pennsylvania and 25 with the New Jersey State Police Employee Assistance Program. Now he’s the administrator of the First Responders Addiction Treatment Program under the nonprofit Livengrin Foundation. The program focuses on helping police, firefighters, emergency medical personnel, 911 operators and combat veterans address addiction, depression and other challenges.

Parmenter, FRAT program coordinator, was a New Jersey state trooper and retired as a lieutenant after 26 years. He worked for a time as a homicide detective and later with the employee assistance program.

Yaeger, 63, is a retired battalion chief from the Philadelphia Fire Department. He initiated a suicide prevention program there. He saw 49 line-of-duty deaths over 41 years and was one the firefighters rescued by helicopter from the roof of a blazing 38-story building during the 1991 Meridian fire that killed three firefighters.

“What happens after a disaster is the community gets a lot of help, and the first responders get kind of put to the side,” Nestor said.

“We learned from 9/11 that the first responders expand beyond the typical police and fire,” Nestor said.

At the World Trade Center, they were crane operators and iron workers. In Oso, they were loggers, heavy- equipment operators and neighbors. When disaster strikes, there’s no keeping people out, Parmenter said.

There’s a culture among first responders, Yaeger said: “You go down the hall.”

The phrase comes from row houses where, during a fire, the narrow hallways are hazardous. The danger doesn’t matter. First responders go down the hall.

That culture can lead to people feeling they are tough enough, or need to be tough enough, to not ask for help. They think they’re OK and keep pushing forward.

That’s denial, Yaeger said, and it can be dangerous.

People get “emotional hangovers.” Trauma lingers like a pounding headache. For first responders, every new emergency call can trigger memories of a disaster.

“You have to develop a network of people in that culture who want to talk about things,” Yaeger said. “You’ve got to get it going. Until then, it’s pull up the bootstraps, ‘I’m OK,’ another stone in the bucket until it overflows.”

“We’re here because, for these people, recovery is lifelong,” Nestor said. “It’s like grieving. You’re going to grieve for the rest of your life, hopefully in a healthy way.

For help
To learn about individual, group or family counseling related to the Oso mudslide, people can contact Kerry Fitzgibbons at 360-348-8148.

– Courtesy of The Herald of Everett, Washington

Read the complete article…

Time Magazine: Why America Can’t Kick Its Painkiller Problem

The June 15 issue of Time Magazine features a cover story highlighting a problem addressed and combatted by Livengrin Foundation for many years. Why America Can’t Kick Its Painkiller Problem is a stark look at the epidemic sweeping our nation. Time reports that “9.4 million Americans take opioids for long-term pain and 2.1 million are estimated by the NIH (National Institutes of Health) to be hooked.” Livengrin provides professional, accessible and successful treatment options for those suffering from the disease of addiction. Our team has intimate knowledge of the challenges facing persons addicted to prescription pain killers, with or without chronic pain, and we encourage these persons to contact us to receive the information and support necessary to live a healthy, productive life.

Read the Article: Why America Can’t Kick Its Painkiller Problem

Note: The Time Magazine article hyperlinked in the article is behind a pay wall, so if you don’t have a subscription to Time, you will have to pay to read it.