Opioid Solutions: Huntington Fire Chief on Harm Reduction Strategies
Opioid overdose numbers are down in hard hit Huntington, West Virginia. Chief Jan Rader talks about harm reduction strategies and critical support for first responders.
When I spoke last year with Chief Jan Rader of the Huntington, West Virginia, Fire Department, she was realistic about the circumstances her department faced with the growing opioid crisis. At that time, data showed that West Virginia had the highest per capita rate of opioid addiction in the United States, and more than 41 overdose deaths per 100,000 population.
Huntington, a city of about 50,000, was at the center of this crisis. Call volume between 2016 and 2017 had risen more than 10 percent, mostly due to medical response to overdoses. In 2017, there were at least 132 overdose deaths in Huntington and the surrounding county, an area with a total population of only about 100,000. With limited resources to address the problem, department members -- from firefighters to the chief -- were understandably discouraged and exhausted.
What a difference a year can make.
But mostly she was proud of results in Huntington. After a terrible year in 2017:
- Overdoses in the community are down by 40 percent.
- Overdose deaths are down 50 percent.
- New cases of Hepatitis B and C are down 60 percent.
We as a community came together and broke down the silos, rolled up our sleeves and did what was necessary to move us forward,” Rader said.
New Programs Combatting the Opioid Crisis
Several new programs have contributed to these positive results.
- Harm Reduction Program. “The Harm Reduction Program has been instrumental in those numbers going down,” Rader noted. This program, started by the local health department, provided first responders with free naloxone until the state took over to supply it. The program also provides training and free naloxone for families and friends of those suffering from substance abuse disorder. “A lot of people in the community have had their lives saved not just by first responders, but also by friends and family,” Rader reported. This program also assists those dealing with addiction with access to treatment programs.
- Quick Response Team. Another community program, new this year, is a grant-supported Quick Response Team (QRT). This program employs a team approach to visit, within 72 hours, those who have survived an overdose and to offer them services. “The team is made up of a paramedic, someone from the recovery community, an undercover police officer and also someone from the faith community,” Rader explained. “We’ve found that has been extremely helpful.” About 30 percent of those contacted immediately accept help; the remainder continue to be regularly contacted by the team.
- Free-standing treatment facility. A third new solution is a free-standing treatment facility where people can be assessed and triaged. First responders can directly refer patients to this centrally located facility at the initial point of contact.
The Opioid Crisis Toll on First Responders
In addition to helping community members deal with addiction issues, these new programs also help the caregivers. “First responders are so frustrated,” Rader observed. “We deal with the same people over and over, and then we find them dead. We’re built to help people. These new tools empower first responders to take action.”
Rader is committed to helping fire department members manage the stress and pressure they face, especially associated with the opioid crisis. This year, the city was awarded a Mayor’s Challenge Grant, which provided seed money to create a prototype program for firefighter wellness and self-care. The department has since been awarded a much larger Bloomberg grant to keep the program going for at least the next three years.
“This will be huge, because PTSD, compassion fatigue, mental health with first responders, these things are just as stigmatized as the opioid crisis,” Rader said. The program includes education, classes on strategies like mindfulness and yoga, massage and an embedded mental health counselor for the police and fire departments.
The psychological toll the opioid epidemic has had on first responders is “what concerns me more than anything,” Rader said. “We had a young firefighter commit suicide in October. The opioid crisis has exacerbated mental health issues. 2017 was the first year that more firefighters died by their own hand than died in the line of duty. Our first responders are in a war zone.”
All communities dealing with the opioid crisis have had to manage dramatically increasing needs on fixed or sometimes diminished resources. Huntington is no exception. The department operates at less than full staffing and even had layoffs a few years ago, a situation that unfortunately is not directly remedied by the recent influx of earmarked grant money. Still, the grants have been enormously helpful in addressing specific needs and have allowed the department to redirect limited resources. The grant awards have also brought attention to the community and the good work being done there, as well as the opioid crisis generally.
One of the reasons that Huntington has been receiving so much attention this year was due to a Netflix short documentary about the community called Heroin(e), which profiled Rader and two other female community leaders engaged on the front lines of the opioid crisis. The film was nominated for an Oscar. On attending the awards ceremony, Rader described the experience as “surreal.”
“I never dreamed I’d get to do something like that,” she said. In further recognition of her efforts, Rader was named one of TIME’s Top 100 Influential People of 2018 as a pioneer for raising awareness about opioids.
Rader pointed out that “the documentary starts the necessary conversations to move us forward. We didn’t turn a blind eye. We admitted we had a problem. But now I feel like we’re becoming the epicenter of solutions instead of the epicenter of the problem itself.”