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
Training and Empowering Musicians To Prevent Overdoses
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. Live music venues might not be the kind of place that pops into mind when you think about preventing overdose deaths. And that's even if you're a musician, a fan, or a venue owner. And even if you do think there should be naloxone at concerts, there might be concerns of legal liability or a fear that you might promote drug use at your club, or maybe even it's as simple as the nasal spray, is just too expensive.
SPEAKER_01Naloxone is not always easy to find. One of the first things we do when we go on site at a place like Monero is we reach out to the security, and nine out of ten times they don't have naloxone on their person.
SPEAKER_00This is why Gibson Gibbs, the nonprofit wing of Gibson Brand Guitars, a personal favorite of mine, joined up with numerous other music-themed nonprofits to create Tempo, training and empowering musicians to prevent overdose. Tempo has recently made waves in Nashville with a pilot program in partnership with Hickma, the manufacturer of Clix Auto, as well as OneBox, to distribute high-tech overdose reversing first aid kits to music venues at no cost.
SPEAKER_01They call it the Purple Box, and you know, look for the purple box when you try to save alive. And so it runs a video that walks you through saving somebody's life in real time.
SPEAKER_00We at the Smart Initiative were impressed by their immediate results, so we reached out to see about launching a similar program in Knoxville. Within a week of distributing some of the boxes ourselves, I got a call from one of the venue managers that they had already reversed an overdose, and they had used one of these purple boxes to do it. In this episode, I interviewed both Dendy Jarrett, the executive director of Gibson Gibbs, about Tempo and this program, as well as the manager of the Knoxville venue where that life was saved. Being a musician, a fan, or a venue employee in the age of fentanyl is unpredictable. And as a musician myself, this project means a lot to me personally. You don't want to miss this episode.
SPEAKER_01You know, we focus mainly on music education and music wellness. And out of the reimagination in 2019 of the Gibson Foundation to Gibson Gibbs, I got a call uh from a family friend. So my father was the commissioner of the Department in Health and Environmental Control in South Carolina. So I grew up in a household uh where public health was a supper time conversation just about every night. And so I got a call from a family friend who owns a nonprofit in Charlotte and just said, Hey, you're a musician. He did not even know I was at Gibson. He just called because I'm a musician. And they his uh nonprofit provides drugs like insulin to families who need insulin and can't afford it. So they they but he'd kind of gotten into the overdose space and he just said, Why why are we seeing such a spike in music in the music community and overdose? And I said, Well, you know, as a musician, personally, it's just never a scene that I related to. I've never done drugs, but I've seen others do it, and I think it's because you're just in the environment. So you are putting yourself in a position to be exposed to it when you're a musician, whether it's a fan or just members of the band or members of the crew or whatever. So I don't think musicians by definition are druggies, you know. I think it's um, and I'm air quoting around that, I think it's just because you're just in the environment. And so it's it's a little easier to access. And I just said, tell me what you're trying to do. And so that led to a conversation with Music Cares, who's one of our partners, it's uh part of the Grammys uh Music Cares provides uh uh emergency assistance to musicians, and Music Cares already had a program and it just never had gotten legs. And I just said, Look, I I totally believe that the rising tide will lift all boats. What if we just collaborate? And so we created Tempo, which proudly my kids actually came up with the acronym, and TEMPO is training and empowering musicians to prevent overdose. And you can find more about it at TempoMission.org. And while it's a program of Gibson Gives, it's almost like a standalone uh entity. So we gave it its own website, and basically we educate musicians on what overdose is, what overdose looks like, and then we provide naloxone uh and naloxone training, and so we we started out at first putting these uh you know this this in practice at festivals like uh Honoru or the Pilgrimage Festival, um Coachella, and we now what's happened is uh tempo has become 16 like-minded nonprofits that are all working together. So what's happened now is it's becoming a movement. It got the attention of Hickma. Hickma makes naloxone in an eight milligram dose, and they made a million-dollar grant of product to help us facilitate growing this program. Naloxone is not always easy to find. One of the first things we do when we go on site at a place like Monterey is we reach out to the security, and nine out of ten times they don't have naloxone on their person. And so the first thing we do is we give all the security people uh naloxone. You know, the the strange thing about uh naloxone, naloxone training is a lot of people are kind of fearful of uh what it is, you know, if I give it, is it gonna hurt somebody? Naloxone is benign, it will not hurt you. You can give it to an infant as young as one year old and it will have no net negative effect. I'm not saying that there's not somebody out there that might be allergic to it, but by and large, it is a harmless product. If you suspect somebody's overdosing, give it to them. As tempo grew, we we um started partnering with more and more uh of these nonprofits, and we're now putting these uh the product on tour buses at rehearsal facilities, and then this past January we partnered with uh the Metro Nashville Police Department. They recognized in a sort of a heat map fashion, if you will, that there was a large spike in overdoses in Lower Broadway and Printers Alley and around some of the bigger areas where live music is prevalent. So we we introduced the live music uh venue program with Tempo. We partnered with a company called One Box. This is a uh a one box, I know your radio audience can't see, but um this is a one box, it's it's a box that contains uh naloxone. And what's really brilliant about it is that when you open it up, it's got a CPR kit, we stock it with two doses of naloxone, but then when you open it, it will autoplay. So it it runs a video that walks you through saving somebody's life in real time, and then it also has a Spanish button, so you can uh press that for Spanish. It also has a training mode so that if you put one of these in a venue, they can they can train their staff just from the video that's it's in here, and it's a rechargeable system. So I actually open each one of these and I load it with two doses of uh cloxado, the eight milligram dose, and then I hand apply the decal that says powered by tempo with our tempo mission.org uh website. I re put it in the box, I seal the box back up, and then I mail them out. I do every single one of these by hand by myself because we are a team of of uh a few, just very few. And so I during meetings like we're having now, I can't applying these labels to the boxes. So you know, it's uh I I'm rewarded by it because we're saving lives.
SPEAKER_00It reminds me of some of the prior conversations I've had. This problem seems so big, and how are we gonna fix all this? And you know, you just say just one at a time, just one at a time.
SPEAKER_01It it it is the proverbial eating the elephant, one bite at a time, and that's how we're gonna that's how we're gonna we have to attack this. And so we we placed 70 of these in downtown Nashville, and it became really successful. We put them in right before 4th of July, and and we got a call the week after that we had saved a life with one of these units. Fast forward, that program that we did in in Nashville kind of got the attention of some folks in in Knoxville. And so they reached out and said, Hey, uh we kind of like what we saw here. Do you do you think we could replicate that program? And so we sent our first 10, I think it was 10 or 15 of the one boxes uh over to the smart folks there at uh UT. And you guys placed um, I think 10 of them, and within a week you'd already saved a life.
SPEAKER_00Yes, that's exactly right. Yeah.
SPEAKER_01I mean, like just really prove positive of why this is needed. Saving one life makes the entire effort worthwhile. And what you should know is that you know, now that we've we're putting these in Knoxville, that's got the attention of Athens, Georgia. Athens being a really strong music town with indigo girls and REM and Fred Schneider B52s all coming out of that area. So now we're placing these in uh in Athens, and that got the attention of a counterpart in Atlanta, and so now we're reaching out into Atlanta. We've been contacted by Waukeshaw County and uh where Les Paul, who's famous for the Gibson Les Paul, sure, uh, he's from, and they want to do the program there in his honor. And so it's just really kind of it's not a full-time focus for for Gibson Gibbs. It is something that we do as we can uh as we're growing it, but it's it's mushrooming rapidly.
SPEAKER_00Now that you've heard about Tempo and the one bucks with Clixado, here's the venue manager in Knoxville talking to me about what it was like using one, as well as what it's like to be a venue manager and employee in the age of Fentanyl. He has asked to remain anonymous.
SPEAKER_02I was gonna say we've had two in the last probably five months. I hired an employee that's had to actually deal with it uh on her first day of work, and then again this weekend and happened again, so that's about a five-month span. She started back in May, so there's been two during that time period. The first one we didn't have anything in the building. Uh we called the paramedics, they came and used an arcane. Right. Um second time, you guys have brought the box in, we used that uh this past weekend. Um also hired a new employee that started on that day, so we are now two for two for new employees that have been overdoses on the first day they started with a five-month period. So, you know, I was out of this business. I've been in this business for almost 24 years with about a four-year break in it. But I got out uh between 2017 and 2021, 22, around that time, started to get back into it, and it was just amazing, or not amazing, but just I don't how much it's changed that you know, we went from an industry to where alcohol was the main focus that we were worried about, people getting too drunk at bars, you know, and providing rides home. Right. And that was our main issue is that ABC classes, and now we're dealing with that you can have somebody walk in your door and sit there and die, you know, for nothing that we have done really um bones to us. Um so it's a bit just it it it's it's just crazy how much that's changed the responsibility of what we're asking our staff to do now. From um, you know, they've been certified with ABC for years, and that's always regulated by the state, you know, and it's such a big deal that that's taken care of. Well, now, you know, we've got this much, much, much more immense responsibility that's just going unnoticed that I would say a majority of bars are probably having to deal with and just don't say much about it publicly. Um that's I I don't know if they don't want to give a stigma that people are using drugs in their place or what it is. Um they don't want to be known for that, I would guess, but it's becoming to where it's not necessarily that you're known for it, everything's known for it, and I feel like just people aren't missing these days.
SPEAKER_00Yeah. Already in our experience with this program, that's that's what we've encountered, is that uh many places are already carrying it and have already dealt with it. And the same hesitancy if they don't want to advertise like it. It's a strange situation to have saved a life but not want to advertise it.
SPEAKER_02Uh well and well, and it's also I I guess uh there's cocaine that's kind of always gone along with bars that that uses has. So that's a problem. But now it's that, you know, somebody that's doing that can have fentanyl mixed with it, and they're unbeknownst to them, and it's not even a choice that they've made necessarily. You know, they've chosen something to do something illegal, but it's not a conscious decision of uh something that they they're known or familiar with, you know. Right. I want cocaine, I don't want okay. And it's getting mixed up, and it's and it's so sometimes I think that we're dealing with issues where people just aren't aware of what's out there and what's what's going on. Um and it became to where it's just such more thing, you know, from chasing people out of the bathrooms or drinking cocaine to picking people up off the floor, you know, it's a totally different issue. Um so it's just a it's I I and I'm not sure what we do about it to change that environment or to change, you know, or to even bring attention to it. Like you will think with WBR or like our local news, somebody would do a a news article on it or a story on it, but if they can't get people to interview or talk about it or point out, you know, it's hard to even try to bring that up or to or how many bars want to say, yeah, it happened at our place this year.
SPEAKER_00Um it's interesting to hear that there's already such a conversation behind the scenes. It does make sense, uh, being that um, like I said, from from our perspective, we've certainly been seeing that people saying they have seen it. Um and that lack of data is an issue. Uh that's something we focus on a lot. But uh something that when you told me about the incident uh really stuck out to me was that uh uh you said what seven minutes from identifying the situation to administering the naloxone.
SPEAKER_02Yeah, so what happened? I mean, just kind of details and in why I'm kind of confident that it was an opioid-based something or another. You know, because you're always uh were they just too drunk? Yeah, or were they too drunk of the overdose? But in this situation, somebody we're familiar with that comes in here often, um, she drank one drink, was in this building within five minutes, and had gone from having that drink to passed out on the bar within five minutes when the bathroom came back out, it was passed out in the bar in five minutes. And one of our bartenders was missing, you know, now I know the difference between somebody that's just passed out of the bar and someone that stopped breathing. You know, she collapsed the bar, they brought her over into a booth, and like her lips were going purple, her fingernails were turning purple, like she had stopped breathing. Um, eyes had rolled back in her head. Uh so they I've got a video of it. You can see within it probably a seven minute span, she goes in the back, gets the box, starts calling 911. I think they give her that first dose of Narcan after they realize that she has completely stopped breathing. Um one of our bar patrons, actually sitting around here, gets up and goes and gives her, starts giving her CPR while they're on the phone at 911. They gave her the second dose of Narcan, and within minutes of that, she sat straight up in the floor. And within probably a minute of that, the EMTs walked in the building afterwards. So it was it was she was awake before they got here.
SPEAKER_00Do you think this should be standard in bars? That that's such such like a first aid kit for opioid response.
SPEAKER_02Yes, but I almost believe that it should be something that is dealt with with the health department almost. You know, it's like if they can regulate an ABC and require us to have a license to serve people, if we're gonna have to deal with this responsibility, then you know there should be some government backing in that, not just I mean, I have a shot of Narcan other than the box because one of my employees, the same girl actually that got this box, and it's the one that's dealt with it twice now, um, ordered it for herself. She used the hotline and called and ordered it a free dose for to bring into here. We're relying on that, our employees to do that. It's you know, so for us it was like trying to deal with also do we now not allow that person to come back in because of the choices they make, and that's a whole other thing that we you know, we've got a whole list of people that we have banned because of different drug use, you know, and that kind of thing, and it's now that's also in that topic. And we've ended up uh we're gonna ban her from the place uh because you know to us there wasn't there was nothing else it could have been.
SPEAKER_00Well, even just the risk of risk of dealing with it.
SPEAKER_02You know, to us it's not necessarily so much it's not about them or the person in the incident, it's that why would you put that responsibility on us? Because that's what this is in a lot of situations, I feel like, is that and that's I think that some people might be reticent to the Narcan, and I don't know if that's ever been brought to you, that it in a way there's a sense of enablement to it. That you know people that are using those drugs feel like, well, it's safe I can go in public and use this because if I OD, I've got people around me that will take care of me and Narcan's available, you know. So it that conversation has always kind of been in the back of my head of carrying it, of like, you know, are we enabling people to do that and making it feel like, well, it's no big deal, I go out in a bar in a public atmosphere where it's safe, and if I OD, somebody will take care of me. Um but I don't now after this situation, I don't think that I think the answer is you still carry it regardless. Right, right.
SPEAKER_00Kind of like having a fire extinguisher, you hope you never have to use it. Same yeah, yeah, same kind of situation. Gotcha. No, that's interesting. It's interesting that this this uh maybe changed the conversation a bit.
SPEAKER_02Yeah, I think so. Well, the the employee bought it and I don't let them carry it. It was one of those things that was like, I don't think that you know we advertise that we've got an RQ and stuff, but they asked, can we buy some? It said, yeah, we can buy some. So we yeah, we had it four or five months ago that we had, you know, decided we'd had it should have it in there. But that was actually an incident that we had somebody else overdosing, that we didn't have anything. We had to call the paramedics and essentially wait had to wait until they got here and used it.
SPEAKER_00Well, considering what happened then and that the box has a training function, are you considering using that on your staff?
SPEAKER_02Um yeah, I have a very small staff, and honestly, at this point after that incident, there were five of the eight employees I have here were here. So crash course. They've all pretty much seen it at this point. Um and the remaining two, I'm almost positive that the people involved are going to explain to them how, you know. Um I work different shows than a couple of them, but it will be conveyed to them to try to show them how to use that. Um but essentially minors, you know, opening it is the biggest step. They just open the box and it's got the video started.
SPEAKER_00I really appreciate you speaking with me about this. I think your insight is extremely valuable. And like you said, not enough people are being opened because they can't. Yeah. Um is there anything in particular you think you would like legislature, community leaders, health department? And you you've said some good things I think that are worth listening to. Is there anything else on your mind that you might like heard?
SPEAKER_02Um I don't think so necessarily. You know, just that we're trying to do the best, you know, and a lot of people, because that and when it does start to come out, or say people find out where things like that happen, that it's, you know, we're not doing anything different than anybody else's. You know, it's not our fault that it happened. We're not we're not providing an environment where those things can happen. It's it's rampant throughout the population and all different things. You know, I'm to the point now where I feel like you're gonna start seeing this in everyday just jobs, you know, somebody just come back and sit down at their desk and pass out, that it's not even being an insulated bar situation. So it's you know, I I think the stigma's got to get away from that, you know, we're causing it or somehow providing an atmosphere that allows that to happen. Um and then once I feel like that that thought changes a little bit that people will start addressing with solving the issue. Um ultimately, you know, the stuff just needs to be quit being produced, but that's a that's a whole nother topic. That's an international topic. Yeah, yeah, that's a much, much, much more uh bigger problem.
SPEAKER_00But thank you so much for your time. I really appreciate it. Yeah, you're welcome.
SPEAKER_01I I again I think there's also uh a lot of concerns around liability, and the Good Samaritan law really covers anybody. If you're making an effort to save somebody's life, that's what you need to do. And you know, the Good Samaritan laws kind of blanket you uh from any potential harm from that. I mean, we ran into issues in Nashville with some of the bigger venues because of the, you know, they all have legal departments and understandably there's concern about liability and whatnot. And we actually ended up having the the um security firm for these uh advocate on our behalf. Uh the head of the security firm is actually a former uh Nashville Metro Police Officer. And a paramedic. So he he understood the importance of this. And so he actually went to uh the legal team at these larger venues and advocated on our behalf and was able to break the barriers down. And you know, I think once people understand uh what we're trying to do, uh, we're not we're not trying to mark you as a place where overdose happens. Overdose is happening everywhere. It's not because of where you are or what you're doing now. You know, granted, uh Lower Broadway in Nashville uh sees a higher level of overdose, but it's because there's a higher level of concentration of people. Right. It's not because of you know that people are going down there just to do drugs. It's it's just because there are more people there. So more people, more opportunity for overdose. And that's what's happening. And, you know, quite frankly, people go out to have fun at a live music venue. That's the weather tending to do a little bit more drinking and a little more experimenting, you know, and so that that uh that it can also be a contributing factor.
SPEAKER_00Well, that's why we think of it as uh you put life preservers where there's water.
SPEAKER_01Exactly.
SPEAKER_00Exactly. Right. There are some other laws worth keeping in mind that we've been telling people about, like a pending law, this one hasn't passed but may, that uh would require any any place that serves alcohol, which does include a lot of music venues, um, of making a certain amount of sales to carry naloxone on board. And in fact, we did encounter that several places did already carry naloxone, but the location wasn't great. It was like in a box somewhere that wasn't easily accessible, uh, or in a drawer or something. And that there wasn't such a clear first aid type approach. And uh that was a big game changer, especially uh especially factoring in that this box uh also offers a training component. That was very appealing because a lot of a lot of people are unsure of how to even use the stuff.
SPEAKER_01Well, I think, you know, to your point, the the one box with the autoplay video takes away a lot of the the fear factor uh for for a venue owner because they're like, I don't know anything about it, but hey, guess what? This video will tell everything that we need to know about it. And so it it does, it it takes away that that fear barrier that might uh provide somebody to push back. And I think you know, a large part of this is just awareness, um, Jeremy. I think that uh and to your your point also, um I believe that you probably face the possibility of more liability by not having it than by having it. And you know, think of a place catching on fire, not having a fire extinguisher or a fire suppression system. I mean, that you know, I think that's why these laws are on the book, and I feel pretty confident they're gonna pass, saying that you really have to have this product on display. What we try to do is that uh I will tell you that the guy who created uh the one box is a musician. He's also a great Gibson fan. And um he created it because he was attending a university, came upon a fellow student who was overdosing in a rehearsal room and knew there was an eloxone in the building, but it was locked in the dean's office and they lost the student. And he was like, We need something that goes next to the first aid kit or next to the DFib that you know people will know. So they developed this thing and they they call it the purple box, and you know, look for the purple box when you're trying to save a life. And so they've partnered with us along with Hickma, and they're they provide these one boxes. That's you know, that's not an inexpensive unit, it's about loaded with products, about$400 a piece. And then we just make them available to you guys. And of course, we do take donations at uh tempo mission.org to help us fund the cost of distributing the the boxes and that sort of thing. But um we're happy to do it. We feel like that whether you're a musician or a fan of a musician, this is a crisis that just I mean, we lost our minds when the pandemic hit, and this thing is killing more people than the pandemic ever thought about killing. And nobody's sounding the alarms. You're seeing more of it on the like your nightly news and whatnot, but we should be shouting from the rooftops. This is it's really prevalent, and then you know, now we're seeing a lot of unfortunately residual deaths happening. Uh parents checking into uh an Airbnb, and the previous uh person who stayed there used and left a residual, it gets on their kids' hands, the kids touch their mouth, they ingest it, and it doesn't take very much. It sends them into an overdose, and the parents don't know what's happening to their child, and unfortunately, the child dies. And I'm not making that story up. This is it's commonplace. And so I think just educating people that this is a crisis. Um, and so we feel like that with uh Gibson Gibbs with the tempo program resonating through our artists, that we can make an impact and draw attention to what needs to be done.
SPEAKER_00So something that struck me, you you you mentioned how no one's raising the alarms uh in this space. And and and I certainly sympathize to that fact. Even the places we went to, there was where there was uh enthusiasm for what we were seeking to do, and they you know took the box and and and so on and so forth. There has been repeatedly a hesitancy to be too loud to to openly identify as carrying it, or uh or or or to even announce a success story because there is a fear that they'll put out the uh call it the illusion or the myth that this is where people do drugs. And the thing is in in my conversations with these with these managers uh in multiple venues, multiple, multiple venues, is it's happening everywhere. It's it's happening in every location. You know, there's there's not a place that isn't touched by it.
SPEAKER_01It it is, and I mean look, you think about um, you know, I'm much older than you, Jeremy, but I've played a lot of clubs in my life, and I can remember being in clubs where you couldn't see you know the lead singer in front of you because there was so much smoke in the place. And we didn't know at the time that that was not healthy for you. I mean, we kind of had an idea, but uh you know, society accepted that as a norm. We have to look at this like uh this makes cigarette smoke pale in comparison with the net negative effect and how fast and how rapidly this is growing uh at an epidemic rate in this country. And so tempo, uh, there are a lot of times with uh with our tempo mission that I feel like we're just not doing enough, but we're doing as much as we can. And I think, you know, partnering with people like you guys and you taking it to live music venues, educating the owners there, and then saving a life. The first time they save a life, they're wanting more, and they're starting to tell their other club owners uh about the this thing that happened, and they really need to reach out to you to have this product available. So we we fix this problem by raising awareness. And um, you know, you can't fix a problem until you admit that you have one. It's unfortunate that I and I will say this, Jeremy, and you probably can attest to this for the longest time. I mean, this isn't really a new problem. I think that because of the level of fentanyl that we're seeing in product now, it's becoming uh more talked about. But this has been a it's been associated with shame for a lot of people for many, many years. This is the thing that the family didn't want to talk about. And when you don't talk about it, you lose lives. And so I think it's so important now that we as a society are opening up and acknowledging that we have this situation and we need to talk about it. Families need to talk about it. Kids need to be talked to about. Don't take candy, don't take any kind of, you know, what you think is an over-the-counter drug from a friend, you just don't do it. It's you just can't do it.
SPEAKER_00All right, well, Daddy, it was awesome talking to you, man. Same here, bro. I appreciate you. For 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.tennessee.edu. I'm Jeremy Corvellis. Thank you for listening and see you next month.