FIRST RESPONSE CANNOT BE FEAR
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?
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.”
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.