BRATTLEBORO — Brattleboro Memorial Hospital and the Brattleboro Fire Department are partnering to offer a public forum on opiates on Thursday, June 20.
“I hope people will come, ask their questions, and hear from the experts,” said Fire Chief Michael Bucossi, who said he understands that people feel overwhelmed by the opioid epidemic and that it can feel like it is worsening.
But there are “a whole lot of people doing a whole lot of things” in the community to ease the situation, he said.
“We're not going to beat it,” Bucossi said. “We're pooling resources to lessen the blow.”
The forum, which will take place from 6 to 8 p.m. at the Brattleboro Fire Department's Central Station at 103 Elliot St., will feature representatives from Brattleboro Memorial Hospital, Project CARE, Turning Point of Windham County, Groundworks Collaborative, the Brattleboro Retreat, and the New England High Intensity Drug Trafficking Area program.
They will speak about opiates in Windham County and take questions from the public.
'A bigger picture than people can imagine'
Taylor Wellington, director of emergency services at Brattleboro Memorial Hospital, said that she's witnessed “an amazingly intense uptick in overdoses.”
Bucossi said that the department is responding to more calls involving overdoses. The people needing help are “from all walks of life,” he said.
According to Bucossi, in 2018, the department responded to 109 overdose calls and seven deaths. So far this year, the department has responded to 66 overdose calls and two fatalities.
The pace so far in 2019 represents a 38-percent increase over the previous year.
Bucossi added that in 2018, 110 Vermonters died from opioids. Of those, 21 were in Windham County and seven in Brattleboro.
“Unfortunately, we are seeing an upward trend in Windham County,” Bucossi said. “Despite all of the efforts, Windham County, with the 21 deaths in 2018, had the highest number of opioid-related fatalities of any of Vermont's 14 counties. That number is up from 13 in 2017, and three in 2016.”
Most concerning, is the uptick in violent incidents to which the department is getting called, Bucossi said.
Wellington agreed, saying staff have experienced an increase in assaults in the emergency department. This crisis holds a higher level of desperation compared to other addictive substances, in her experience.
“It's such a bigger picture than people can imagine,” Wellington said.
The violence also ripples outward, similar to an accident caused by a drunk driver, she said, catching people “in the crossfire of other people's choices.”
One thing that makes opiates so dangerous is what dealers cut it with, including rat poison and horse dewormer, said Wellington and Bucossi.
Some of these substances can intensify the high, Wellington added, but they also make the drugs more damaging to the body.
The medical profession has changed how it handles opioids, Wellington said.
A decade ago, emergency departments prescribed opioids more often and in higher doses. Now, emergency medical professionals hardly ever prescribe the drug unless someone is in hospice care, dealing with cancer-related pain, or in pain from obvious trauma such as a broken bone, she said.
Even then, the amount given is very small - say, five pills - compared to the several week's worth that used to be prescribed, she said.
First, a public-safety issue
Bucossi said the fire department is involved in the panel because he views opiates as a public-safety issue first and foremost.
The involvement doesn't stop there, he added. The opiate epidemic affects emergency responders, too.
“They're seeing more death and conditions that are unimaginable,” he said. “When I have to put my guys in ballistic vests, there's something wrong.”
“We're all in” this situation, whether as emergency responders or citizens, Bucossi said.
A person who has overdosed is clinically dead. Emergency responders routinely revive the same person three, four, five times in a month, he said, and such situations take their toll, he noted.
Wellington agreed that it's hard to witness “the worst day of [a patient's] life over and over and over again,” she said.
“It's a little demoralizing,” she added.
For medical professionals who have trained their whole lives to help people, “it feels like a failure when you can't make a person well,” Wellington said.
Meeting people where they are
Wellington said overdoses, however, are just the tip of the iceberg.
Lurking beneath are cardiac infections, lung infections, skin infections that often require surgery, and long inpatient stays, she said.
The opiate epidemic “affects every piece of the medical system,” said Wellington, who believes that prevention is key to stemming the tide and cites how the country reduced tobacco use.
“We've got to get ahead of it [with prevention efforts], but we're already behind,” she said.
Other efforts in development at BMH are discussions about creating safe injection sites and needle exchanges. The hospital itself is in the process of creating a rapid access program to provide people access to Buprenorphine, a drug used to treat dependency.
“It's important that we meet people where they're at,” Wellington said. “Not everyone is ready to seek treatment.”