Concord Firefighter: Patients Will Always Get Treatment - But We Aren't Social Workers

CONCORD, NH — Having always been a leader that would like to light a candle rather than curse the darkness, I wanted to provide solutions to the past article written a few days ago. Let’s start off by clearing up any prior misconceptions to my previous post.

To start, firefighters always put patients first, going into harm’s way anytime it is possible to save a life. We all know that when we take this job, it comes with inherent risks and that is just the nature of the beast. So with that being said, any patient that decided to come to a fire station with a medical issue is immediately and professionally attended to without hesitation.

The article I wrote a few days ago was highlighting the new need for individuals to seek firehouses for means of drug addiction services. As we all know, our staff are trained medical professionals, not social workers. This would be a process that would take some development to safely implement. The U.S. drug issue has been going on as long as almost any of us have been alive. If we look at the problem like we do economics, we can simplify it. There are two ways to attack the drug problem, being either the supply side or the demand side.

Since the Reagan era, we have been putting most of our money into the supply side. Law enforcement has been battling for years to get drugs off the streets. We have made interdictions across our borders to even attack certain sources. I think it’s pretty safe to say that this has been a losing battle.

Our prison system has the most inmates in the world and there are just as many drugs on the streets, if not more than ever before. This is not a poor reflection on law enforcement, we are simply asking them to do an impossible task. This game of whack- a-mole, meaning arresting one dealer while another takes his place, is a lose-lose situation, no matter how wonderful our police departments are.

The alternative attack is the demand side, which is far more complicated. This requires money going to many different places. It’s safe to say that the bulk of the money would need to go to mental health or treatment facilities. The best option being the treatment center lasting more than 90 days. As we know, New Hampshire fails miserably in regards to treatment centers for drugs, and it shows with our numbers regarding addiction. While we work to catch up with the problem, we try to formulate better ways to get addicts into rehab. Often, these folks are very paranoid about law enforcement, so they will avoid using a police department as a means for drug addiction help.

Enter stage left, the idea of the “Safe Fire House.” This is a place where someone seeking recovery can come 24 hours daily to be directed towards treatment. Right now, we have a slogan rather than a solution, “Come to the Firehouse, we will help.” Having spent 10 years in the mental health field before entering the fire service, it is easy to see where firefighters will have issues.

First example, the basic rule we are taught as an EMT is “Is the Scene Safe”? If it is not, then we do not enter, we wait for police to arrive and clear the scene, making it safe for entry. This basic rule of thumb would now longer be pertinent, “Safe Place” making it obsolete. This will take lots of new training, as well as a host of other aspects. If we are to try to look at how this can be accomplished in a safe manner for both the patient and the firefighters, we have to do this right.

ALSO READ:

• Concord Firefighter: Safe Place Heroin Program is a 'Feel Good Measure'
• Safe Station: Manchester Fire Chief says critics from Concord should mind their business

Let’s take a look at what we need to make a program like this be successful for everyone involved. I want to make it known that my last article clearly spelled out that I personally felt that firehouses were not the best suited location for such a program, but let’s entertain that idea.

1. Training will have to be completely revamped. We must retrain our employees in many aspects, preparing them for all types of scenarios. We will need training in crisis intervention, verbal de-escalation, and aspects of counseling on addiction and dealing safely with addicts. We will need to be trained on how to handle this person, should they become violent, needing to know the safest way to avoid being assaulted and how to not hurt the addict. This may lead to the introduction of training on how to safely operate non-lethal tools, like a Taser.
2. We will need to change the entryway in many of our fire stations. Most stations in Concord do not have a good waiting area or safe area for this addict to occupy. In my particular station, you enter via the lieutenant’s office. It is a very small room that is not suited at all for any potential violent outburst or issue. We will also need some type of button to alert the Police, should an incident occur while in the office.
3. Concord will need to find a destination for this person to actually start receiving in-depth treatment. We cannot send them to the Emergency Room unless they have an actual medical emergency. Again, we are talking about someone seeking treatment for addiction, not someone with a medical emergency. Because of this, an E.R. is not the most appropriate destination. We will need some sort of halfway house for individuals to stay at while they wait for an opening in a treatment program.
4. We will need to assess how the stations themselves are affected by this new occupant. For instance, we have taken in a young man who is looking for treatment and a call to a mental health facility has been made. We are waiting for the next steps in this process and an emergency medical call or fire comes patched into the station. What do we do? Do we kick the gentleman out until we return? Do we leave him alone in the station? The only acceptable idea is that we are out of service until we can have the young man picked up. Think about those repercussions when a long-time Concord resident is having a heart attack two streets down from the fire house that is handling an addict issue. That fire house is out of service, meaning that the resident has to wait for another ambulance across town to take the call and drive a longer distance to reach them. We all know that in cases like these, seconds determine life or death.
5. Exploring the need for an extra firefighter to be at the station when the units are out on another call. So often in Concord, between calls and training, we are not at the station.
6. New standard operating procedures for our employees. Remember, this is a completely new role for our firefighters. They will need guidance on how to handle different situations that occur.

Firefighters like plans. These bullet points are just the beginning steps toward a safe implementation of “Safe Place” to Concord firehouses. I cannot speak for other cities, but I would think many of these issues would apply to them as well. Can this be done? Of course, but it will take some time to properly implement. The fire service has always been staffed with trained employees you call when you have no idea what to do. A firefighter will figure out how to fix any issue. They are available 24 hours a day to give you the helping hand you need. Patients will always come first. Let’s give those patients, or in this case addicts, the best possible chance at a successful outcome.

Jim Duckworth is president of Professional Firefighters of Concord NH - Local 1045