FIRST RESPONSE CAN­NOT BE FEAR

StarMetro Vancouver - - COVER STORY - PER­RIN GRAUER

As first re­spon­ders in­creas­ingly come into con­tact with opi­oids in their jobs, the dan­gers such drugs pose is gen­er­at­ing dif­fer­ent ways of han­dling the prob­lem — and dif­fer­ent views on whether there is ac­tu­ally a sig­nif­i­cant dan­ger.

There are three in­stances of Van­cou­ver po­lice of­fi­cers ad­min­is­ter­ing nalox­one to a col­league on duty since the force started car­ry­ing the opi­oid an­ti­dote in 2016.

All three in­ci­dents oc­curred in 2017, said Const. Jason Doucette, be­cause of “ac­ci­den­tal ex­po­sures to an opi­oid dur­ing the seizure of con­trolled sub­stances,” dur­ing which “the of­fi­cer or their co-worker be­lieved the mem­ber was ex­hibit­ing signs of an over­dose and ap­pro­pri­ately ad­min­is­tered the nasal nalox­one.” All three of­fi­cers made a full re­cov­ery. Doucette, me­dia re­la­tions of­fi­cer for the Van­cou­ver Po­lice Depart­ment, said pri­vacy con­cerns pre­clude the re­lease of fur­ther de­tails, and no VPD of­fi­cers were made avail­able for in-per­son in­ter­views.

Ques­tions re­main: What risks do first re­spon­ders re­ally face while re­spond­ing to over­doses and con­duct­ing drug busts? And what do we still not know?

OC­CU­PA­TIONAL OVER­DOSE

The rise of dan­ger­ous and potent syn­thetic opi­oids such as fen­tanyl in the illicit drug sup­ply is a huge driver of the over­dose cri­sis tear­ing through Cana­dian com­mu­ni­ties. More than 1,400 over­dose deaths oc­curred in B.C. in 2017, ac­cord­ing to a re­port from the BC Coroners Ser­vice, with fen­tanyl de­tected in more than 1,200 of those.

With mul­ti­ple over­doses oc­cur­ring daily around the province, first re­spon­ders come into fre­quent con­tact with in­di­vid­u­als who have used opi­oids, and po­ten­tially with the sub­stances them­selves.

But the risks these en­coun­ters present is much-de­bated. Fire and am­bu­lance re­spon­ders in Van­cou­ver have re­ported no ex­po­sures to opi­oid-re­lated sub­stances in the course of duty.

In April, Capt. Jonathan Gormick of Van­cou­ver Fire and Res­cue Ser­vices said his staff had ad­min­is­tered nalox­one 403 times since they be­gan car­ry­ing it in 2016. Dur­ing that pe­riod, VFRS re­spon­ders re­ported no ac­ci­den­tal opi­oid ex­po­sures.

A spokesper­son for the Pro­vin­cial Health Ser­vices Au­thor­ity said paramedics with BC Emer­gency Health Ser­vices have not used nalox­one on one an­other.

“Gen­er­ally, ac­ci­den­tal over­dose isn’t an is­sue for first re­spon­ders — peo­ple don’t over­dose by touch­ing fen­tanyl pow­der, for ex­am­ple,” she wrote in an email.

A re­port by the BC Cen­tre for Dis­ease Con­trol found “There have been no ver­i­fied cases of over­dose or sick­ness in first re­spon­ders … who have given first aid, medical care or ad­min­is­tered nalox­one, de­spite thou­sands of over­dose re­ver­sals.” The same re­port con­firms that no B.C. health-care work­ers have suf­fered an over­dose or ill­ness be­cause of ac­ci­den­tal ex­po­sure to opi­oids at work.

FEAR AND THE FA­CIL­ITY

In Const. Doucette’s email to Starmetro Van­cou­ver, he sug­gested the risk of of­fi­cers be­ing ex­posed to fen­tanyl is one of the rea­sons why the VPD is build­ing a new $700,000 drug con­tain­ment fa­cil­ity.

“This new fa­cil­ity will al­low for an even safer en­vi­ron­ment to fur­ther re­duce the risk of ac­ci­den­tal ex­po­sure for our em­ploy­ees,” he said. “Al­though I don’t have an ex­act date for this new fa­cil­ity, it’s a pri­or­ity for our depart­ment.”

Fund­ing for the fa­cil­ity was granted through the VPD’S 2018 bud­get. It will be built on the site of the cur­rent VPD of­fice on Glen Drive.

VPD Sgt. Jason Ro­bil­lard said the fa­cil­ity will al­low po­lice of­fi­cers to process large vol­umes of drugs for anal­y­sis and court pur­poses safely. The site will in­clude fume hoods, emer­gency show­ers and self-con­tained pro­cess­ing ar­eas.

Harm-re­duc­tion work­ers, how­ever, say this fa­cil­ity sim­ply isn’t nec­es­sary for the safe han­dling of drugs.

Aiyanas Or­mond, a spokesper­son for the Van­cou­ver Area Net­work of Drug Users (VANDU), said fen­tanyl has be­come com­mon­place at the VANDU over­dose-pre­ven­tion site, yet none of its staff

have been ac­ci­den­tally ex­posed to the drug.

“We’ve got lots of ex­pe­ri­ence of peo­ple work­ing in close con­di­tions with folks who are us­ing fen­tanyl every day,” he said. “Peo­ple should take rea­son­able mea­sures to pro­tect them­selves, but in these dayto-day con­di­tions there just doesn’t seem to be any risk.”

Or­mond said wear­ing ni­trile gloves is a cheap and ef­fec­tive way to pre­vent ex­po­sure to opi­oids, even in emer­gency si­t­u­a­tions.

Const. Doucette was un­able to con­firm what pre­cau­tions had been taken in the in­ci­dents dur­ing which VPD of­fi­cers were given nalox­one.

It’s in this en­vi­ron­ment of un­cer­tainty and am­bi­gu­ity that fear is able to grab hold of pub­lic dis­course and twist de­ci­sion-mak­ing at both the in­di­vid­ual and gov­ern­men­tal level, said Daniel Cic­carone, pro­fes­sor of Fam­ily and Com­mu­nity Medicine at the Univer­sity of Cal­i­for­nia, San Fran­cisco.

“Fear is our worst en­emy in this epi­demic,” he said. “Fear makes peo­ple act in mil­i­taris­tic ways … Fear puts de­lay in the sys­tem, makes peo­ple want to wear HAZMAT suits ... which de­creases the time response to get­ting to some­body, to get­ting to a vic­tim.”

“FEAR MAKES PEO­PLE ACT IN MIL­I­TARIS­TIC WAYS.”

Daniel Cic­carone

JENNIFER GAUTHIER FOR STARMETRO VAN­COU­VER

Lit­tle in­for­ma­tion has been re­leased about a re­port from the VPD that three of its of­fi­cers have been ad­min­is­tered nalox­one on duty due to fears of over­dose from ac­ci­den­tal ex­po­sure to opi­oids. Po­lice say they come into con­tact with drugs in un­ex­pected ways, while health care ex­perts say the risk of ac­ci­den­tal over­dose is over­stated.

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