SMART Policy Podcast
Podcast by the UT SMART Initiative. Host Jeremy Kourvelas speaks with experts from across the recovery ecosystem - representing healthcare, prevention, law enforcement and more - about local, state and federal drug policy to find out what is and isn't working to make this fight against addiction a little easier.
SMART Policy Podcast
Listen to the Front Lines: Why Drug Policy Needs to be Bold and Flexible
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
You're listening to the Smart Policy Podcast, a production of the University of Tennessee's Institute for Public Service. West Virginia has often been described as ground zero of the opioid epidemic, largely because of the explicit targeting of the state by Purdue Pharma for its aggressive marketing of oxycontin. First responder Jan Rader, longtime champion in the fight against the overdose crisis and the first woman to serve as fire chief in West Virginia, disagrees. At the 2025 Synemic Summit held in Huntington, she said to the crowd, we were just the first to talk about it.
SPEAKER_01You know, our mayor at the time, uh Steve Williams, amazing leader. He actually took action and bold action and innovative action that had not been taken before. And he created at a city level of 46,000 people an Office of Drug Control Policy. Figure out how we can make positive change with what we're dealing with. How can we stop this? How can we combat this?
SPEAKER_00In this conversation, we discuss why naloxone remains important even as new drugs like metatomidine are found across the country.
SPEAKER_01When you have an opiate on board, you have the possibility of death within five minutes if you don't reverse that. You know, your policy goes down, okay, we deal with the most life-threatening first, just like a triage situation. I think we certainly need to keep our foot on the gas with naloxone, naloxenum, naloxenum.
SPEAKER_00How the importance of mental health for first responders is growing exponentially.
SPEAKER_01They weren't just going to overdoses, they were going to overdoses of their friends, their classmates, sometimes even a family member. And uh the burden was just so heavy.
SPEAKER_00And the policy issues that keep us from adapting to shifting drug trends.
SPEAKER_01I think that one of the things that I have seen over my 30-plus year career so far is a lack of flexibility of policy.
SPEAKER_00Among other topics.
SPEAKER_01Uh but I actually became interested in the fire service because I was working in the jewelry business and a lady had a heart attack in close to the doorway of the store where I was working, and I felt helpless because I didn't even know CPR. So I called 911, stayed on the phone. Some people stopped and did CPR on her, and then the fire department showed up, and there was a woman firefighter, and this was in the early 90s, and I didn't even know that was a choice back then. So um, I was a big runner and I ran with some firefighters and I mentioned it, and they said, Oh yeah, this would be good for you. And uh so that's how I got into firefighting.
SPEAKER_00You know, I I've I've heard similar stories across anybody who works in public health, healthcare, any any public serving, especially with a health component or uh a saving lives component, that um yeah, some sort of lead by example thing. Do you consider yourself leading by example as well?
SPEAKER_01Uh I hope so. Uh, you know, I don't know if that's for me to determine. That's fair. You know?
SPEAKER_00So I was just at a conference where a couple hundred people seem to see things.
SPEAKER_01Okay. Yeah. Well, you you probably spoke with them more than I did. So well.
SPEAKER_00Uh so i if you don't mind me asking, I understand time meant uh named you as one of the most influential people.
SPEAKER_01Oh yes. 2018. 2018, yes.
SPEAKER_00Yeah, I mean that's pretty substantial. Uh what what was the uh uh uh what what was the I guess their reasoning behind that?
SPEAKER_01Um I'm really not sure. I think uh it's our fight against the opioid epidemic uh here in Huntington, West Virginia, and uh it was uh right after the release of the short documentary Heroine that was released in September of 2017 uh that Netflix put out and it kind of went viral. And I think that probably had something to do with it.
SPEAKER_00You know, it you said something at the reception at the Sandemic Summit we were just at that um you don't necessarily see West Virginia as ground zero, you see it as the first place to talk about it.
SPEAKER_01Yes.
SPEAKER_00Yeah, I'd like to learn more about that.
SPEAKER_01So yes, um you know, we've been called by the media across the country over and over again, ground zero for the opioid epidemic, but I really do feel like this was going on in many different places. We were the first willing to talk openly about it and to try to try to draw attention to it because we felt like we needed help with what we were dealing with and what we were seeing. Um so you know, our mayor at the time, uh Steve Williams, amazing leader. He actually took action and bold action and innovative action that had not been taken before. And he created at a city level of 46,000 people, he created an Office of Drug Control Policy. And he asked me to serve on that. I at the time I was a fire captain. Uh, and I also I'm also a registered nurse. So I was working on my days off at one of the local emergency rooms, and he knew this because several times his parents who were elderly were brought to the emergency room in the middle of the night, and there I was, you know, so he knew he had somebody with a medical background that worked for the city. And so he took a retired police chief and asked him to stay and be the director of the local office of drug control policy. He asked me to serve on this, and uh he added the crime analyst for our police department. And we were three incredibly different people from three different backgrounds and um put us together and we were like, What do you want us to do? And he's like, figure out how we can make positive change with what we're dealing with. How can we stop this? How can we combat this? And um we took off in three different directions. We all, you know, between the three of us, we pretty much knew everybody in town, and we started talking to people on the front lines and and and you know, more heads are better than one. What do you think needs to happen? We I went to the health department, one of the first places I went and talked to the health department nurses, you know, and said, What are you seeing? You're on the front lines, what do you think needs to happen? We talked to police officers, we talked to firefighters, we talked to uh people working in homeless services, we talked to our health care providers, we talked to our libraries, we talked to a lot of many different areas, and you know, it was perfectly clear that we needed to do things like open a syringe exchange program. So we did that. We started the first syringe exchange program in the state of West Virginia. It opened September 2nd, 2015. We knew we had to get naloxone in the hands of all our first responders. It wasn't just okay for EMS workers to have it. And at the time there was legislation that said that you had to have special training before you could have it. Uh my friend Joe Murphy uh and uh his wife Susan, um, they were instrumental in helping us in that plight and uh getting around education, providing education very quickly so that people, just everyday people can learn how to use naloxone and give it out. So by the time we had the first big batch of fentanyl come through our town, all our first responders, police officers, firefighters, EMS workers had naloxone. We had an event no or it was actually August 15th of 2016, where we had 26 people overdose in less than a five-hour period. And we saved every one of them because our first responders had naloxone. Now we had a very big lesson that day. The first lesson was nobody was referred to treatment, and that was the piece that we had not focused on yet. And um so people who survived that event died in the in the next couple months because they couldn't get into treatment, were put on waiting lists, things like that. We needed to expand services. Uh, another big lesson from that was our emergency rooms. We have two level two trauma centers, we're not testing for fentanyl. So nobody that day tested positive for an opiate because in the panel at that time they were not testing for fentanyl.
SPEAKER_02Right.
SPEAKER_01So, you know, there was a study done on that event, and these events had happened around the country, but in in many cities who experienced them lost a lot of people. We did not lose people in that event during that event because we had thought about it and tried to prepare. Uh we've been able, because we're small, and partnerships and collaborations create a lot of innovative ideas. We had leadership that was willing to support ideas that we gave them. Uh we were not afraid of failure, you know. We felt like if we failed, so what? We're going to learn more from it and we're going to turn around and punt and find a different way. Uh we started, you know, both our emergency rooms were packed with people overdoses and it was very uh arduous to deal with and they did not have a system of referring people out. So we uh we got all the partners together and they came up with and competitors, medical competitors, went together and started a freestanding facility where people can go that ask for help. It's called Proact, and don't tell ask me what it stands for because I can't remember. Um, but they can go and be plugged into a system within two two hours to get the assistance they need. Um we have Project Hope is probably another extremely innovative program where a mother can get intensive inpatient therapy and keep her children with her. Even if she's pregnant, they'll help her with the pregnancy, they'll get her through the pregnancy. There's uh this is a facility with 17 apartments where women can live with their children. They have intensive therapy, the program is six months long, they have a step-down apartment afterwards. It is breaking the generational cycle of addiction, yeah, it is breaking the cycle of poverty, and uh it is transforming lives. So in Huntington, we have been able to do so because we had bold leaders. We still have bold leaders, you know. I'm I'm working for my fifth mayor now, and he's he's amazing too. Um, but you know, we have bold leaders that have been willing to take chances.
SPEAKER_00Yeah. That's there's so many things you touched on that I'd like to follow up on. Sorry about that. No, no, no, no. Don't apologize. These are excellent, uh, excellent points of discussion, I think. I I think first and foremost, thinking about Project Hope, the the the notion that a pregnant patient could keep her kids while receiving treatment. Um in Tennessee, we for a while had a law that essentially criminalized being pregnant and addicted at the same time. And it led to a lot of people foregoing prenatal care altogether because if they were detected as having a substance use disorder and being pregnant, if they weren't connected to treatment, which in and of itself is difficult and inaccessible for some people, absolutely. Especially once you add on that a lot of clinics don't want pregnant patients. Uh, because it turns out there's a lot of complications and and all sorts of things. But on top of that baseline difficulty, if they didn't get into treatment and establish it within a set time frame, they were liable for a crime and could go to jail. And so a lot of people were just avoiding treatment. That law died. That's called a fetal assault bill.
SPEAKER_01That's unfortunate that that even existed.
SPEAKER_00People still think it's around. You know, it left a stigma landscape. Absolutely. Was uh it it related to this and with the syringe exchanges, you said Huntington was the first to have one. We had to pass a law to legalize them in Tennessee. Was a situ similar situation.
SPEAKER_01We had to we had actually what uh syringes were listed as drug paraphernalia. Right. So we took care of that at the state legislative level level. Um, you know, now we're moving into a uh a different time frame politically where you know they might not continue to exist. Um you know, and that's unfortunate because you do have the spread of uh bloodborne pathogens when there's needle sharing and reusing, and you have people with severe uh infections becoming septic, um, you know, vegetation on their heart valves from endocarditis, you know, so there are a lot of medical complications from IV drug use, especially if they do not have access to clean needles. So, you know, it's it's just gonna be interesting to see where we go from here.
SPEAKER_00Is there anything you'd like to say in terms of uh other than you just laid out some excellent evidence behind why SSPs are a good strategy?
SPEAKER_01You know, I you know, I I I stay in my lane. I'm not a politician, nor do I aspire to be a politician. Um, you know, I I follow science and and I follow humanity. You know, uh first and foremost, I'm a humanitarian. And I think that we are here to support and uplift each other.
SPEAKER_00Gotcha. Gotcha. The drug paraphernalia angle in terms of legislative coding and and the like. Fentanyl test strips uh was another similar policy that's been we had to address that as well. Yeah, same in same in Tennessee, but uh and then xylosine. And xylosine, and now it's soon to be metatomidine.
SPEAKER_01Yeah, well we have those test strips now, and actually uh we have had clients uh share with us that their product is testing positive not for not only xylasine but for metatomidine.
SPEAKER_00Yeah, I believe that was in a recent we won't get into details, but there was a there's there's been a lot of talk of metatomidine across uh the country. On that same notion, though, I wanted to commend West Virginia. We did some research into drug paraphernalia laws. West Virginia did a blanket decriminalization of testing strips regardless of substance. Do you feel that that enables West Virginia to be more adaptive to shifting drug trends?
SPEAKER_01I hope so. I would hope so, and I would hope we would continue. You know, I I I think one of the problems that I have seen, and you know, I've I've kind of watched all this unfold. I've watched us, you know, go from pills to heroin to uh fentanyl to xylazine and whatever's neck meth, you know, you name it, and it's it's all polysynthetic now. And you know, drug dealers have a a fa fabulous business model. They're not going to give it up. You know, they're going to keep making money. And as long as we have people that are suffering, they're going to be rolling in the dough. So I think that one of the things that I have seen over this my 30 plus year career so far is a lack of flexibility of policy to deal with those trends. For instance, some of the the policy that was developed during heroin timeframe did not allow for the switch to other medication. You know, when we had built programs to deal with opioid use disorder, and then the product became methamphetamines, then we did not have the ability to use those funds for a changing drug market and um that we have no control over. So I think we, you know, that's probably my biggest takeaway is we need to be more flexible with our policy moving forward because we don't know what's on the horizon.
SPEAKER_00Which do you think is a more concerning threat? And this is a tough uh question, I I I may understand, because not to downplay lethality of any particular substance. But we are paying a lot of attention to opioids.
SPEAKER_01Yes.
SPEAKER_00We also have quite a number of tools at our disposal. This is it might be a pointless question because I don't know if I want to differentiate in a context of polysubstance use. But in terms of opioids versus stimulants, perhaps, I might say, w what are what are some challenges we should keep in mind? I don't know if I want to pit them against each other.
SPEAKER_01I think they're very different creatures and we should not pit them against each other, but we got to take them on face value. When you have an opiate on board, you have the possibility of death within five minutes if you don't reverse that.
unknownYeah.
SPEAKER_01That is something that you don't have to deal with with stimulants. Okay, you have other other medical issues as well as behavioral issues that you need to address, but the majority of the time they are not l life-threatening within the next five minutes. Right. So I think we certainly need to keep our foot on the gas with naloxone, naloxone, naloxone. And I I think they're very different creatures.
SPEAKER_00Right.
SPEAKER_01You know, but they're all mixed together. And you don't know what's in that concoction. So, you know, your policy goes down, you know, okay, we deal with the most life-threatening first, just like a triage situation in an emergency room. Triage first, okay? ABC, airway breathing circulation. So I think you can develop those patterns or what you should do regardless of what substance you're dealing with, you know, and um I feel very fortunate to be in an area where they took us seriously when we said naloxone, naloxone, naloxone, we need this. My buddy Joe Murphy created something called a one box to get around the the education needed before you can give naloxone or give out naloxone to somebody, and then right after he developed this one box, and it's basically like an AED, it walks you through how to give naloxone. In case you forget, you freeze in an emergency, you could you just open it up and a video plays guiding you through how to give this, and that was so innovative at the time, and then it turned to over the counter, but it still has so much importance to it, the one box, and there's all kinds of duplicates out there now. But my buddy Joe was the number one guy, he's just awesome. Um, and it's near and dear to his heart because he'd been working on this for over a decade. You know, how do you get he tried an app first and you know, all kinds of stuff. But I feel like the average person, you know, and I'm somebody who's jumped on a fire truck and run to emergencies for years, but the average person, you can teach them CPR, you can teach them how to give naloxone, but in the moment of the emergency, they're going to forget and freeze because that's something new first responders have to get over. So if you have a device that walks you through it, I mean that's key. You can save the life of a loved one, a stranger, and in the moment, you're saving their life in the moment. And saving their life in that moment gives that person an opportunity to choose a different path to get in the to the treatment uh facility that they need to get to help to change their life.
SPEAKER_02Yeah.
SPEAKER_01So um, I don't even know if I answered your question, Jeremy.
SPEAKER_00This was just great. And I I was I was gonna say we we have partnered with uh West Virginia Drug Intervention Intervention Institute, uh the maker of the one box, uh Gibson Gives, and then various uh city authorities, Metro National Police Department, uh Chattanooga Police Department, um Saving Lives. Yeah, uh drug coalitions, exactly. And I one of the managers were in we installed a one box. This is one of the music venues in one of our cities we've worked on. Uh he showed me the security footage, we covered this in an earlier episode, of an employee using the box to reverse the opioid overdose. And and five minutes later the EMTs were able to arrive. But it's like five minutes, like you just said.
SPEAKER_01Five minutes is is a long time.
SPEAKER_00Make or break.
SPEAKER_01Well, here's the other thing that we never discuss. And you know, I I still work on the front lines. I work on homelessness, substance use disorder, and severe mental illness for my city. And I'm trying to facilitate expansion of services and better pathways of how we can all work together to do better for our citizens and to make it safer for all of us. But uh, you know, I talk of uh one of my best friends is a is a physician in town and she she works with homeless individuals. She provides free medical care to homeless individuals, and uh she works for a place called Valley Health Systems, and they're amazing too. You know, they're an FQH and they they they believe in in dignity and and uh non-biased treatment of everybody. But we talk about all the time the fact that we deal with people who are in long term recovery, and they have effects of going without oxygen for three minutes or what however long they were gone. The I I I only On a regular basis, I work with people who have overdosed themselves. Now they're clean, but you know, there's anoxic brain injuries uh out there, and I think that a lot of those anoxic brain injuries we're not treating, and we're not even recognizing them as a part of the disease process itself. And that to me is another reason why naloxone has to be out there everywhere. Just flood the freaking United States with naloxone because even two and a half minutes without oxygen, you're gonna have some damage.
SPEAKER_00Yeah. Yeah. The um I wonder if you spoke with him about this. The writer Sam Cannone has mentioned this.
SPEAKER_01I have not spoken to Sam. I've met Sam a couple times. He's come to Huntington. I have not specifically talked to him about it, but you know, Dr. McElroy, Sidney McElroy and I talk about it on a regular basis, and we have for years, you know, because we're so busy keeping people alive that we, you know, you you know, you can't get down into the meat and potatoes all the time.
SPEAKER_00Right. And and for for those listening that don't have a medical background, anoxic brain injury is when uh the brain itself is deprived of oxygen for a sufficient amount of time that there is still tissue death.
SPEAKER_01Yes, you can have yeah, you have short-term memory loss, you can have long-term memory loss, you can, you know, so behavioral changes. Behavioral changes, you can have um impulsivity changes, uh frontal lobe damage. There are a lot of things that you can have. I mean, I'm certainly not an expert on it, uh, but but I see it. Yeah. And uh I and I always wonder about that because I don't know i each individual's background, you know, and what they went through. Um but but I think it's something we need to address at some point.
SPEAKER_00Aaron Powell Yeah, certainly. It's a valid concern because I mean, talk about we already have baseline difficulties with uh making sure people have stable housing, uh workforce training opportunities, uh continuing adult education, on and on. In this in this notion of just so many different pieces of the puzzle, uh the city having an office of drug control policy is is really still unique. I I think it was Pew who just came out. It was either Pew or Rand who came out with an analysis of presence or absence of Office of National Drug Control Policy. Could have been LAPA as well, I can't recall. And there not every state has one, let alone a city. So that's rather innovative.
SPEAKER_01Well, we had it for a little while and then we let it go because you know, we felt like our partners had, you know, I don't I I can't remember when it kind of basically just dissolved, but you know, we felt like our partners in every but we were all working so well together that we all went uh on the different areas. Um so it just kind of organically dissolved and um then COVID hit. And of course that changes everybody's you know focus. Um, it becomes you do you work with your own organization and how you survive there. And then as we emerge from that, but I will say this after the city of Huntington developed an Office of Drug Control Policy, the state of West Virginia followed, and they had an Office of Drug Control Policy, and they have had our state has had one ever since.
SPEAKER_00Yeah. Yeah. And and you mean you mentioned COVID. Yeah, that's we've seen similar efforts in Tennessee at local levels. There's a Knox County, Knoxville City jointly operated things called All for Knox, Health Department Medical Examiner, on and on, all breaking down data silos and the like. Hopping up to the state, you think probably added some preventative or some some protection against the COVID effect?
SPEAKER_01Absolutely. Um, you know, currently our um state director of Office of Drug Control Policy is Dr. Stephen Lloyd. Right. And he's phenomenal. He's a Tennessee boy.
SPEAKER_00Yeah, very fond of him.
SPEAKER_01Yeah, he actually likes to wear a Tennessee hat. I uh Is that getting him in trouble? No, I don't think so. He's been wearing uh other hats here lately. But he's he's such a a knowledgeable, incredible leader, you know. I I really enjoy him.
SPEAKER_00Yeah, we do too down down Tennessee. No lie, no lie.
SPEAKER_01Uh he shared between states as I as I see it.
SPEAKER_00I don't know how he has the energy for it. It's it's it's really impressive. Um I I something you had said near the beginning of this really stuck out with me. I was working on my day off. I mean, you're talking about working in the ER. You you didn't even realize you had said it, but it's just it's an interesting phrase. And I was wondering if you could speak to the notion of public service.
SPEAKER_01Well, you know, um, you know, as an old I was a paramedic for years and I used to work on my days off from the fire department as a paramedic. You know, they don't pay per or firefighters as much as other jobs, you know. And um, so as I got older, I thought, well, I I need uh do something a little more stable. So I went to nursing school, you know, at age 40 and then start working in the emergency room. And um, you know what I feel like we are here to serve others. I don't feel like I'm a helper, I'm not a fixer, I'm a servant to my community.
SPEAKER_02Beautiful.
SPEAKER_01I I feel like I have a servant heart, and um, you know, I'm not above anybody, I'm not below anybody, but I'm I'm here to serve when I can. You know, we don't cause these emergencies, but we're here to try to make them a little better and maybe ease the pain just a little bit.
SPEAKER_00Very well said. The ER is a rare place, a very unique place. It can be. I uh I won't get on the full moon effect. Uh but um what do you think the average person doesn't understand about emergency medicine?
SPEAKER_01It's it's uh a very chaotic just like a fire scene. Uh people look at it and they think, oh my god, that's chaotic and it's crazy. But we know exactly what we're doing, what we're supposed to do, and we orchestrate it very well. Um we just go into a mode and do our thing. Um it's kind of like a dance. We know each other's uh strengths and weaknesses. You know, if one nurse is dealing with a patient who vomited and that that nurse can't deal with vomit, you know, the rest of us rush in and clean up the patient for that nurse, and you know, it's vice versa. You know, if it's another bodily fluid involved that another nurse, you know, so we you know, it becomes like a a giant family where you take care of each other, you have each other's backs, and um it's it's a very unique place to work. It's very fast-paced.
SPEAKER_00Okay, feast or famine. Uh yeah, no kidding. Uh I I thank you for for giving such a humanizing story. The the uh the no I'm sorry about that. No, no, uh, we'll call it uh emetophobia. Uh well I used to work with a physician myself, and I I recall there was uh he really could not stand the sight of vomit, tremendous physician. And I'll just remember one day where we we didn't have a backup nurse who could do it for him, but he he needed to personally see what the contents of the vomit was. Is there blood? Is it coffee grounds? You know, the whole I just quick all right, I'm done. I just let's get out of here. Uh uh just it's it's they're they're people. They're people we're people.
SPEAKER_01We we all have quirks and things that bother us. Um we're not very good at taking care of ourselves. We're very good at taking care of other people. That's probably a trait that most people have in this business.
SPEAKER_00I would say so. I I this is this is something we've talked about before with a number of our guests in the past. How big a problem is compassion fatigue right now amongst public servants?
SPEAKER_01Um I think it's up there, but I think it's really empathy uh fatigue versus compassion fatigue. And um, you know, other people can explain that better than I can, but I will say this. Uh I think that we as uh like in Huntington, we were trying to fix that with our first responders. We started a program in 2018. We well, we we got a Bloomberg grant. I think we didn't start the program until 2019. We we won a Mayor's Challenge Bloomberg grant, and we decided to tackle compassion fatigue for our first responders. The city runs police and fire protection, the county runs EMS. So we focused on our police and fire department, and we build a program called Compass Navigating Wellness, and we're trying to normalize seeking out mental health services when you need that. Um, we are trying to make sure that our first responders take better care of themselves, and when they retire, they are a whole person, body, mind, and soul, versus being somewhat broken with PTSD and other things. Um in my career at the fire department, 27 and a half years, there were three suicides.
SPEAKER_00Oh my god.
SPEAKER_01And um two when I was younger on the job, and one while I was a chief. And um I I don't want anybody to go through that. Um it's um it's heartbreaking, it's heart-wrenching. So, you know, we take that seriously. We want people, we want to normalize seeking out mental health therapy. Just like you go to your doctor and get a checkup once a year, you should check in with a therapist, you know, every so often.
SPEAKER_02Yeah.
SPEAKER_01So I think police, fire, EMS, we're supposed to be the Caped Crusaders, and nothing bothers us, and and that's bullshit.
unknownYeah.
SPEAKER_01You know, because everything has the tendency or can bother you. It just depends on, you know, we have our own lives, we have things going on with our families, and um, so we're not immune from any of the things that other people see. But I, you know, one of the reasons why we went down this road of trying to develop a program for our first responders was because, you know, our our young people on our job, they were they weren't just going to overdoses, they were going to overdoses of their friends, their classmates, sometimes even a family member. And uh the burden was just so heavy. Um our number of calls increased. And um, you know, there's more of a focus on them. It's a a very neg it can be a very negative overdose in itself is an incredibly negative event. Yeah. It's it's negative for the the responder, it's negative for the person who overdoses. Um the only positive is you use a drug to reverse the overdose and you save their life in the moment. You know, they might cuss you and run off. And and uh, but you know, I'll take a cussing over a dead body any day, you know. I don't you know, I don't care. Um but you know, it's it's it's not a lighthearted event. And when you go on these over and over again, I mean it's it can be very problematic if you're not equipped with resiliency. You know, we do a lot of mindfulness training. I've become a mindfulness coach. Uh, you know, um we're trying to change the way we do business with our first responders in Huntington. We're giving them more attention. You know, I had a craziest thing. I um you know, I'm pretty compassionate, but I had a firefighter look at me with a tear in his eye and he said, You love addicts more than you love us, chief. Whoa. And it just it was like a dagger through my heart. It wasn't true, but the perception was there. Yeah, and it really changed the way uh that I interacted with my first responders.
SPEAKER_00Fascinating.
SPEAKER_01Yeah. Weird sh, huh?
SPEAKER_00Very real though. Very real. Very real. Do you have any advice for fire chiefs across the country uh uh for for uh navigating situations like this to both be compassionate too? Because right now a lot of first responders are burned out on helping what they see as the frequent flyers, the oh, I've I've already overdosed this person five, six times I'm tired of responding to this person. We hear stories about this kind of thing.
SPEAKER_01I I I get it. You know what? We have to be willing to listen to the front line and take their advice and ask them what do they need? What do you need? What can I do for you? I mean, that's how my mindset changed when I started working as a nurse. You know, I saw so many people that would be run off by other medical staff, and it's like they didn't want to deal with the difficulty. I mean, a lot of people suffering from substance use disorder are very difficult to handle. And um, you know, I wasn't taught a lot in nursing school uh about what we're dealing with, but you know, it you know, I just got frustrated with it and I started like asking my patients, I'm like, look, what I don't understand. Please, I I'm not being mean, I'm not being judgmental. I want to understand how I can help you. And I want to understand how you got to where you are, and please tell me what I do that makes this more difficult for you, and what is it I can do for you that will make your situation better. And just having those humanistic, uh compassionate conversations changed how I treated my patients.
SPEAKER_00Yeah, and and uh in that same vein, you mentioned something about the younger generation having a an especially difficult time entering this this line of work because they're so often responding to people they grew up with. Uh and that's just it seems like the weight of the numbers about when when this epidemic hit and what age groups and the like. Um do you have any advice particularly for Gen Zers who are looking at becoming a firefighter or police officer or nurse or a doctor or anybody on these front lines?
SPEAKER_01I I think you need to research your area. I mean, it's different in every area of the country, you know. Um just do your research. A lot of there's a lot of older people in the profession that are willing to talk openly about what to expect. I mean, and for all the negativity that I'm sharing with you, there are so many positives. You know, when I walk down the street and I see somebody that just five years ago I probably revived with naloxone a couple times, and they are clean and they have a great job, and they're back in college seeking out a degree, and they're thriving, and they're grateful for a community that helped them survive what they went through. That's more than any thanks anybody could ever give me. And I see that every day. And so I think another thing that we need to do is share the positives versus just negative, negative, negative. And there's so many, there's so many stories out there.
unknownYeah.
SPEAKER_00Yeah, at the RX summit most recently, they for the first time they had a uh a wall of hope. Whereas you they used to would display pictures of everybody who would overdose. Now they were showing pictures of everybody who uh had entered recovery, so it does seem an important uh tone shift these days.
SPEAKER_01Absolutely.
SPEAKER_00Yeah. One our final question is always what policies should we consider at the federal, state, or even local level to make this fight better? That's about the usual response, I guess.
SPEAKER_01Oh yes. Um Have you read the book Chasing the Scream?
SPEAKER_00Oh, Johan Hari.
SPEAKER_01Oh yeah.
SPEAKER_00Tremendous.
SPEAKER_01I think he probably nailed it. Okay. Don't know if we're gonna see that. Um I think that I will just end by saying this. You know, we can't make leaders change their minds any more than we can change get somebody who's suffering from substance use disorder to change their mind to go the they gotta figure that out for themselves. Right. And I think that's very important. So I think we support each other, we share education, we share what we've learned on the front lines, and that's how we move forward, and people will figure it out. And I encourage certain books. Um, I think all leaders should read the book Compassionomics. Stephen Tresiac and Anthony begins with an M, can't remember, but it's a book that systematically proves that compassion is the way through this. Better outcomes for your patients, better work environment for your healthcare workers, and the bottom line goes up. Everybody does better. I think compassion is the way out of this, not this divisiveness or violence. And I think that as a country, we need to share with each other, we need to have hard conversations and and just put the information out there for people to figure it out.
SPEAKER_00Beautifully said. Quite welcome. Really appreciate it.
SPEAKER_01Quite welcome.
SPEAKER_00For more episodes on in-depth discussions on Tennessee policies related to substance use disorder by a range of local experts. Please subscribe to us wherever you get podcasts and visit our website at smart.tenesse.edu. I'm Jeremy Corvellis. Thank you for listening, and see you next month.