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Let them die. Three strikes and you're out. This was the suggestion by Middletown, OH, Councilman Dan Picard recently for opioid overdose victims who've already been saved twice before by the city's overworked paramedics. A third overdose? Just refuse to send the ambulance and paramedics.…

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Let them die. Three strikes and you’re out.

This was the suggestion by Middletown, OH, Councilman Dan Picard recently for opioid overdose victims who’ve already been saved twice before by the city’s overworked paramedics.

A third overdose? Just refuse to send the ambulance and paramedics. Period.

Picard’s shocking idea was picked up by the news and went viral across America. It drew all kinds of fiery protests on social media from outraged people around the country.

But Picard says he’s desperate. He says the city just can’t afford to keep racing ambulances and teams of paramedics to the scenes of overdoses, and injecting expensive doses of Narcan into overdose victims who they’ve already saved multiple times before.

High cost with no apparent return

The cost to the small city of 50,000 souls for the first half of this year is already on track to exceed $100,000 – just on Narcan alone. The city’s costs treating overdoses and deaths are way over last year. By mid-June, the city had already responded to 100 more overdoses than it did in all of 2016. And there’s already been 51 overdose deaths this year in the city while there were only 74 all last year.

Not only that, only one of the hundreds of overdose victims treated repeatedly over the past year or two has agreed to seek drug treatment. Over and over again, victims wake up from the shot or two of Narcan that snaps them out of the opioid embrace of death, get up and just walk away.

From the news clips, it looks like the cops and paramedics know all the repeat heroin abusers in the city by now. And it’s not a friendly scene. It’s dark, it’s serious and it’s depressing as hell.

City Manager Doug Adkins says, “We can’t arrest our way out of this. I can’t keep it out of the city. It’s a Middletown problem. It’s a southwest Ohio problem. It’s an Ohio problem. It’s a national epidemic.”

Once, twice, goodbye? Not quite.

When Picard asked Adkins if there was a law that the city must respond to all calls for EMT, Adkins replied: “If we want to get out of the business, we have the right to get out of the business,” the suggestion being that the city could privatize emergency medical services and not be liable for the hundreds of rescues.

But Picard wasn’t proposing an “instant death sentence” for three-time losers. In fact, he suggested a program that would allow overdose victims a chance to extend the city’s expensive life-saving services.

Paramedics would respond only twice to the same overdose victim – a database would have to be built to ID and track victims. But now, victims would receive a summons to appear in court, and would be required to do community service after being treated.

And if they don’t show up in court, or don’t complete the service, and then they overdose a third time? The hammer drops. Paramedics would not be dispatched.

Will it ever happen?

The fact is, even though Middletown may not be legally bound to respond to calls for emergency overdose treatments, it’s unlikely that such a rule will ever be adopted.

According to a report in the Cincinnati Enquirer, city manager Adkins has ruled out the idea, partly because of all the negative attention it’s received. “This isn’t going to go anywhere,” he said. “Even if it was, I’m not sure I would want to face the lawsuits that could come from it.”

As for Picard, his council term expires at the end of the year, so he’s not currying public favor for a re-election. After nearly eight years, and all the attacks he’s received in the social media, he’s had enough.

“During the last four or five days, life has not been good,” he told the Enquirer.

His Facebook page contains tons of comments “lambasting” him:

  • You are a disgrace to humanity! said one.
  • “Have fun in hell!” read another.
  • “It costs $0.00 to be a decent human being,” another post said.

“My goal was not to stop treating overdoses, it was to solve a financial problem – not to stop the drug problem,” Picard told the Enquirer. “If we dispatch, then we have to treat. I have no problem with that.”

Deserve every chance

Fortunately, the city of Middletown, OH, has abandoned the 3-strikes idea. Perhaps the court intervention might be a workable idea, especially along with specific attention on helping victims coax their need to get clean into action for treatment and recovery.

It’s been our experience here at Novus that people with addiction problems do possess the desire to recapture sobriety and get their lives back. It can be deeply buried, but with the right help, it finds its way from darkness into light.

The secret, of course, is “the right help.”


Just how dangerous is fentanyl? The synthetic opioid painkiller that’s usually mixed into heroin is turning up almost everywhere. Fentanyl is so dangerous that the Drug Enforcement Agency has issued a formal warning to law enforcement and paramedic first responders to be super-careful when…

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The DEA warning guide

The DEA Warning Guide is a comprehensive and highly-technical 19-page report that also includes the history and development of fentanyl and its derivatives such as carfentanil – often called “elephant tranquilizer” in the media and its role in today’s opioid epidemic.

The guide cautions first responders to get educated about fentanyl and its many derivatives, and trained to recognize the drug when they see it. The DEA says that to be properly protected from any contact with the drug, first responders should at least use the basics – gloves, dust masks, safety glasses and disposable paper suits and shoe covers.

Entering a lab or “pill-milling” location is another story altogether, and requires full HAZMAT protective gear – and immediate notifications to the building’s owners and occupants.

The agency also says that first responders should always have a supply of the opioid overdose antidote naloxone with them. Fentanyl can bring on an overdose so quickly and unexpectedly that naloxone – and several doses of it – should be close at hand.

The DEA has also released Fentanyl Roll Call, a video for all law enforcement and first responders nationwide, about the deadly consequences of improperly handling fentanyl.

Not news to the feds

The fentanyl problem is not so new to the DEA. Following a surge in its use in 2013, the DEA formed a Heroin-Fentanyl Task Force (HFTF) in 2014 to address what was becoming a serious national health problem.

The HFTF involves at least six government agencies, all working together to facilitate what is called “a whole of government approach” to the fentanyl and synthetic opioid epidemic in the United States.

The HFTF currently includes people from the DEA, Homeland Security (HIS), Customs and Border Protection (CBP), the FBI, the IRS and even the Post Office Inspection Service – this last agency because most synthetic opioids have been arriving in North America from China by mail.

China agrees to crack down on fentanyl

During the 1st quarter of 2017, the DEA ID’d 230 fentanyl and fentanyl-related substances in seized drugs. Fentanyl was found in combination with heroin in 61 percent of the samples, as well as with U-47700, alprazolam, ketamine and cocaine in other samples.

Most of this fentanyl comes from China or Mexico – highly refined from China, not so refined from Mexico. As we reported in April, China has agreed to crack down on fentanyl and other synthetic drugs.

Brand-name look-alikes

Although it’s usually a chunky or powdered substance, Fentanyl and other synthetic opioids are turning up as pills or capsules that look like OxyContin (oxycodone), Xanax (alprazolam) and other diverted pharmaceuticals. The dangers are the same as when mixed into heroin.

The DEA says criminals love fentanyl-type drugs because they’re so cheap and they boost the effect of other drugs when mixed into them.

“Due to the elevated potency of fentanyl over traditional opioid drugs (i.e., heroin), criminal organizations can use one kilogram of fentanyl to produce approximately 1 million 1-milligram counterfeit pills, resulting in potentially 10-to-20 million dollars in revenue,” the DEA says. “There are also reports that consumers in some areas are seeking fentanyl over heroin, as the ‘rush’ is greater.”

DEA Guidelines will save lives

The rush may be greater, but overdose deaths involving fentanyl are soaring and the drug is definitely threatening our first responders.

We recently read about a policemen who returned to the station after a drug bust, noticed a speck of white on his shirt, brushed it off and fell immediately into an overdose. The speck turned out to be fentanyl. Fortunately, fellow officers saved his life with naloxone. There have been numerous similar reports recently.

The new DEA fentanyl safety guidelines will help protect our first responders in the field. And we hope our report will help protect you. If you or anyone you care about needs help with opioid use or misuse, call Novus Detox today.

Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

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Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

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Novus is the best way to get your life back as painlessly as possible.

Call to speak to one of our experienced & caring detox advisors today!

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