Libraries throughout the country find themselves reacting to the consequences of the opioid abuse epidemic. There have been overdose deaths in Hennepin County, so it is important that we prepare for what may come.
I was trained in administering Naloxone (AKA Narcan) and it is very easy - easier than an AED! If you don’t have Naloxone you should do rescue breathing but NOT chest compressions while waiting for EMTs. Sometimes you can’t tell if someone has overdosed or having a heart attack. We are not medical professionals so don’t feel you have to make that call. Always call 911. But if you see clear evidence or witnesses know the person is using opioids, this is helpful information. The Free Library of Philadelphia did inadvertently administer Naloxone to a heart attack victim last year. Good Samaritan laws protected them. It is generally recognized that there are no serious side effects of naloxone.
Context: In Minnesota there were 2074 nonfatal overdoses and 395 fatal overdoses in 2016. 2 deaths at Franklin Library in Minneapolis in January 2018.
Nationwide there has been a 30% overdose increase in 14 months from 2016-17
I attended the Public Library Association conference in Philadelphia, PA, which has been very heavily hit, especially at one of their branch libraries.
Here are my notes from the former librarian Chera Kowalski at the McPherson Square branch, and Joe Benford, Deputy Director of Customer Engagement:
McPherson Square branch in the Kensington neighborhood in Philadelphia has been the epicenter with 1200 deaths last year. They tried taking ID for bathroom use, then time limits. They still saw needles in the bathrooms. Overdoses started to occur outside and inside the branch. In 2016 they had an overdose and emergency services were taking too long to respond, but they got Prevention Point to come to the library faster and reverse the overdose. After a bout of negative media attention, Narcan was approved. Librarians volunteered to be armed with the medication and saved 7 lives last year. They saw more overdoses in warmer weather. Security’s assistance was vital. When the city started sending police there was a decrease in overdoses in the park, but the overdoses moved to other parts in the neighborhood.
They offer training to any staff member who wants it as well as trauma and therapy for staff affected.
The library sits on a task force that has cleaned up an encampment with 100,000 used syringes. They had 1200 overdose deaths last year.
The Richland Public Library system in Columbia, SC is starting to see an increase in overdoses - 50 last year. They are starting support groups - NA and AA at their libraries. They are trying to keep ahead of the PR issues associated with the epidemic.
How to talk to the media about this? Stay ready so you don’t have to get ready. Always tell the truth so you don’t get caught in a lie. Be honest, concise, be open. Know who to talk to and who not to talk to. Don’t say “no comment” instead say “I don’t know the answer and I’ll get back to you.” Or say “The safety and health of our patrons is our first concern.”
Denver Public Library - 200 overdoses last year which for them was not an increase. Seeing heroin mixed with amphetamine. They say that heroin in the west is powder, liquid on East Coast. Had 14 Narcan reversals last week.
Social worker perspective: What harm reduction strategies work for this crisis? Provide syringe access (instead of calling it needle exchange). Can you get people to switch substances they are abusing? When people feel safe, they tend to use fewer substances. What can libraries do? Be a safe place with nonjudgmental access to resources and information. Stigma and shame do not work.
Listen to Johann Hari’s TED talk - Everything you know about addiction is wrong. In his TED talk he states that the opposite of addiction is connection.
Middletown Ohio
200,000 patrons in their service area. 3 of the 10 worst cities for overdoses are in Ohio. (Read “The Opioid Diaries” Time magazine issue). In 2017 Middletown spent 2.3 million on opioids; police spent 1.92 million which was a 50% increase.
2017
966 overdoses
45,000 people in the city
The city councilperson was frustrated with the problem and became overwhelmed, was accused of saying “let addicts die”. There was negative news coverage. A Yahoo news reporter went so far as to feign dehydration and then asked EMS professionals for inside information while reporting on response times as related to delays caused by overdose calls.
They are now starting to see a decline in overdoses. After people are released from the hospital for overdose addicts are taken to rehab and given a social worker - this is the “heroin response team.” The teams use library meeting rooms for office hours.
Sharps containers - most of the libraries have them or are getting them. You can use a detergent bottle as an improvised device.
Check your safe and local laws regarding Narcan. Most libraries using nasal spray. Nasal spray will not hurt someone. Fentanyl misinformation is out there
Indiana county coroner is partnering with high school students to provide training.
Medical examiners, child protection, as well as local health nonprofits can help.
Minnesota:
In Minnesota law enforcement officers have more restrictions than in other states, and more than civilians:
in order to obtain, possess and administer Naloxone, law enforcement (peace) officers and emergency medical responders need to be authorized to do so by a physician, APRN or PA. A standing order or protocol needs to be in place and the peace officer or EMR needs to have had training. Most likely the MD, PA or APRN will obtain the Naloxone and provide to the peace officer or EMR.
But….
“(c) Nothing in this section prohibits the possession and administration of Naloxone pursuant to section 604A.04.
Subd. 2.
Authority to possess and administer opiate antagonists; release from liability.
(a) A person who is not a health care professional may possess or administer an opiate antagonist that is prescribed, dispensed, or distributed by a licensed health care professional pursuant to subdivision 3.
(b) A person who is not a health care professional who acts in good faith in administering an opiate antagonist to another person whom the person believes in good faith to be suffering a drug overdose is immune from criminal prosecution for the act and is not liable for any civil damages for acts or omissions resulting from the act.”
SourceHandouts:
--Amanda @GLCL
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