Drug overdose treatment common at Westfields emergency room
New Richmond Police Chief Mark Samelstad says his department encountered heroin for the first time within city limits in fall 2013. The emergency room at New Richmond’s Westfields Hospital, on the other hand, began dealing with the drug several months earlier.
According to statistics provided by Laurie Harvieux, the hospital’s communications manager, Westfields treated one person for a heroin overdose in 2013, and that was in February.
“We averaged roughly seven drug overdoses a month in 2013, with peak activity occurring in May and August,” Harvieux wrote in an email. “In addition, we also saw approximately five alcohol-related overdoses per month in 2013.”Those statistics are in line with ballpark estimates from Westfields emergency physician Dr. Martin Richards.
“It’s multiple times per week that we see people come in with some type of intoxication or ingestion,” Richards said. “It’s not necessarily heroin. It could be prescribed medicines that they overdosed on, either intentionally or accidentally. Alcohol is also something that we see in fairly high frequency. We do see narcotics and opiate medication overdoses on occasion, but they haven’t been on a great frequency.”
Dangerous situations Medical care for drug overdose patients often begins before they reach the emergency room. EMS personnel work the front lines.
“Our EMS crews are very good at recognizing and implementing some strategies for figuring out when somebody is unconscious or responding minimally,” Richards said. “If they suspect it’s due to a narcotic overdose, they can, in the field, give some medications to try to counteract that.”
Richards said that because of efforts by EMS personnel patients can show improvements in their condition before they even arrive at the emergency room.
But those are the lucky ones.
“In extreme cases, narcotic overdoses are lethal,” said Richards, who serves the area as HealthPartners’ regional medical director for emergency services. “We’ve heard of it more in the Hudson community recently with accidental deaths related to narcotic overdose. Even short of dying, people can become quite ill because of the respiratory suppression.”
In layman’s terms, what Richards is saying is that people who are suffering a narcotics overdose simply stop breathing.
While Richards points out that some narcotics overdoses accidentally occur when a patient’s body can’t handle the amount of medication it receives, many times overdoses occur when people are trying to harm themselves or get high.
“Those people sometimes don’t know what their threshold might be,” Richards said. “With narcotic prescription drugs there can also be a lot of Tylenol that’s involved. And that in itself can be a disaster, because Tylenol at high doses can be toxic to the liver. In some people, if it’s not caught soon enough, can die from liver failure.”
While Richards said he has not personally dealt with any deaths at Westfields Hospital due to recreational drug use, he suspects overdose deaths have occurred in the community. He said EMS personnel are savvy enough to not bring people to the emergency room if they are obviously already deceased.
“We don’t hear the full story,” Richards said. “Calls go out to the ambulance or the coroner for people who are relatively young. I don’t get the Medical Examiner’s reports for people who don’t come to the emergency department, so that would be speculation.”
While Westfields staff stabilize overdose patients and bring them out of the haze, the hospital cannot cure drug users of their addiction.
“It’s tricky,” Richards said. “There’s not a great mechanism to get people chemical dependency help, other than referring them to county. And those resources are very limited.”
Working with law enforcement Richards said that there are specific statutes in place that dictate whether law enforcement needs to be involved with a patient.
In cases of intentional overdoses, where a person is trying to harm himself, law enforcement officials direct the evaluation with social workers and mobile crisis workers to determine whether further mental health stabilization is required.
For patients who are just intoxicated, another set of patient privacy rules applies.
“The way our policy is written is that if they have drugs on their person we can report that as a crime,” Richards said. “But really, if someone just came in by ambulance and law enforcement had not been involved, there’s no reason for us to involve law enforcement unless they are thought to be a potential harm to themselves or others.”
From Richards’ point of view, drug laws have forced police to get involved into matters that fall more into the public health realm.
“It’s a healthcare issue that law enforcement is being mandated to help manage,” Richards said.
Samelstad agrees, and he recognizes that police can’t just arrest away drug problems in the community. He believes that the issue must be attacked from multiple angles with all sorts of community resources.
“It’s a society problem, and law enforcement is not going to solve the problems of society by itself,” Samelstad said. “We want to arrest the dealers, but we also want to provide assistance to the people that are using the drugs.”