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Opioid grant project focuses on attitudes, resources during first training

St. Louis County Officer David Meyer tests pushing the Narcan nasal syringe hard enough to create mist instead of dribbling out.
File Photo | Camille Phillips | St. Louis Public Radio
St. Louis County police learned how to use the opioid overdose antidote in February 2016. Since then the department has saved more than 40 lives.

The St. Louis-based agencies coordinating Missouri’s federal grant to prevent opioid overdose deaths are training their first batch of first responders Monday afternoon.

Officers and EMTs from the Warrenton and Wright City fire protection districts and the Eureka, St. Charles City, Marthasville and Columbia police departments will be taught how to administer the overdose antidote, naloxone, before collecting a supply of the life-saving drug to bring back to their jurisdictions.

A good portion of the $5 million, five-year grant is earmarked for naloxone, often known under the brand name Narcan. The price of the antidote has risen in recent years, and can be expensive for law enforcement and fire departments to purchase.

The first responders will also be coached in how to talk to drug users and connect them to addiction treatment, said Brandon Costerison of the National Council on Alcoholism and Drug Abuse, who is managing the grant project for NCADA.

“We're educating them on opioid use as a substance use disorder, as a mental health condition,” said Costerison. “So that when a friend or family member, or even someone who was just revived says ‘Okay, you know, I don’t want this anymore. What can I do?’ the officer has a response, they have information that treatment works and recovery is possible.”

A big part of the training will address perceptions about drug users and give the first responders the context they need to have buy-in on the project, said Rachel Winograd, an assistant professor at the University of Missouri-St. Louis overseeing the grant for the Missouri Institute of Mental Health.

“Using naloxone is incredibly easy. It takes 30 seconds. You could teach a four year old to do it. The bigger piece is getting at where people stand with it and if they want to do it,” Winograd said. “People have very different opinions about people who overdose on drugs.

“You know, ‘Are they worth saving multiple times? Is this their own fault? If we save them does that give them a safety net? Do I believe in this? Do I think it’s the right thing to do? Is this my job, even? Shouldn’t they just figure it out for themselves?’ So all of those pieces are not simple,” Winograd said.

Winograd said the training will explain that addiction is a chronic disease, and relapse is expected.

“It’s not indicative of a moral failure,” Winograd said. “It wasn’t a choice to get there.”

A kit containing the opioid overdose antidote naloxone.
Credit File Photo | Camille Phillips | St. Louis Public Radio
A kit containing the opioid overdose antidote naloxone.

“People cannot pursue treatment or a meaningful life if they’re dead. And so that is that attitude piece that we hope to get to in (training) — that you can be the hero in that moment,” she added. “We’re not saying you are going to turn someone’s life around absolutely automatically when you administer naloxone, but from a harm reduction and from a public health standpoint it’s our duty to keep people alive as long as we can and give them a chance to pursue the life that they have the potential to pursue.”

The training comes as the St. Louis region is on track to outpace last year’s record of more than 500 opioid overdose deaths.

“As of the beginning of October we were already over 400 fatal overdoses for the region, and that’s with a six to eight week delay in reporting for toxicology reports,” said Costerison. “In fact, the most recent numbers we’ve seen from the city of St. Louis — they have already exceeded last year’s overdose number by close to 30.”

NCADA keeps a count of the number of opioid overdose deaths recorded by the coroners of seven area counties: Lincoln, Warren, Franklin, St. Charles, St. Louis, Jefferson, St. Clair, Madison and the city of St. Louis.

The region could also soon have a better record of the number of non-fatal overdoses through a smartphone app the Missouri Institute of Mental Health is creating.

In exchange for a supply of naloxone, first responders will log the use of the drug in the app. Winograd said St. Louis County also plans to make use of the app, and MIMH hopes to gain the participation of the city of St. Louis.

St. Louis County police and the St. Louis Fire Department have their own supply of the antidote.

Follow Camille on Twitter: @cmpcamille.

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