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Jessica Hulsey [00:00:01] One of the physicians during that training said we didn’t learn this in medical school and it wasn’t in my residency and this needs to be made available to all physicians that are currently practicing or in training. And that was really helpful and such a heartfelt testimony from a physician that we trained.

Narration [00:00:23] This is Countermeasures brought to you by Emergent. Join us as we explore the shifting complex world of the opioid crisis. In each episode, we’ll hear from makers of positive change as they recount personal narratives of loss and perseverance and offer a way forward to a better future. As the opioid epidemic has changed and evolved, our understanding and responses have had to change as well, but have our systems kept up? Barriers to care, stigma and other factors all impact people struggling with opioid dependency when it comes to accessing the help they need. In this episode, we explore how the health care and social systems in the United States and Canada have responded to the epidemic. And what is being done to ensure that professionals on the front line are equipped with the knowledge and skills they need to best support people and have a meaningful impact.

Jessica Hulsey [00:01:26] My name is Jessica Hulsey and I’m the founder and executive director of the Addiction Policy Forum. APF is a national nonprofit organization and I’ve been in the field for a long time. We really wanted to address a lot of the major gaps that still existed in the field of addiction, including bringing patients and families to the table.

Narration [00:01:47] Founded in 2015, the Addiction Policy Forum or APF, is a nationwide nonprofit organization dedicated to eliminating addiction as a major health problem. This work includes helping patients and families in crisis, expanding prevention and early intervention programs, and increasing education among policymakers, medical professionals and the wider public.

Jessica Hulsey [00:02:12] I got involved in the addiction field because of the impacts that addiction has on my own family. My my younger years when I was a child was a lot of disruption and difficulty really caused by my parents struggling with the substance use disorder. So I was homeless and and in and out of the foster care system and then finally raised by my maternal grandparents when my mom went to prison for addiction related issues. And so at 15, I got involved in our prevention organization wanting to sort of use that, you know, lessons learned and lived experience and the knowledge of how destructive addiction can be in a family and a community, really try to make a change and and sort of help improve how we respond to this. Since then, I’ve worked in prevention, treatment and drug policy, came to DC when I was 17 and have been doing this this work. This is really my my life’s work. I call Addiction Policy Forum, a love letter I write to my mom every day. I lost my mom when she was only 50 to addiction related health consequences, though she’d had a number of years in recovery, and I lost my dad, who struggled with opioid use disorder and crack cocaine and stimulant use disorder when he was like 48 years old. So I tried to turn that tragedy and that difficulty into maybe improving and helping. What happens when addiction hits a family, when it hits a community, how can we respond and mobilize in a different way? And all of that sort of passion and and experience that my family has gone through, it really fuels my work.

Narration [00:03:55] Social worker Shannon McLaughlin has worked with marginalized populations for most of her career. She works in Hamilton, Ontario, a Canadian city that has been heavily impacted by the opioid epidemic. Shannon has seen how difficult it can be for those with opioid dependency to access the social and medical systems we take for granted.

Shannon McLoughlin [00:04:16] There are a lot of barriers to service. For instance, lots of marginalized people have had a bad experience historically with the medical health profession, either being having people be rude to them, having them being dismissed because they’re maybe they’re they’re dirty, maybe they’ve showed up with a garbage bag that has their stuff in it. People who are in the throes of an addiction, their lives are often very often disorganized and being able to get to an appointment on time consistently or even to have the ability to get to that place, to have the money or the transportation is often a real barrier. So there’s areas of fear, there’s barriers of access, there is barriers of historical interaction with the health profession previously. A lot of people who are on the street, they don’t have a fixed address. So there are at least in the city that I live in, there are outreach workers who will connect with people where they’re at and help them get to the appointments. People are really trying to bring those barriers down. But still, there are people who fall through the cracks and aren’t seen. Also, mental health often gets complicated. You’ll often see a mental health issue with the addiction or with the opioid use or whatever people are using. And so together, that makes it very difficult. There could be paranoia. There could be a little distrust, which is often based in real reality for these people.

Narration [00:06:02] Jessica and the Addiction Policy Forum have conducted research on this issue and have found that barriers still exist for many people. They have also seen the importance of holistic approaches to recovery and access to a wide variety of resources to help overcome barriers.

Jessica Hulsey [00:06:19] We did find some very consistent themes. These pinpoints are barriers to sort of finding treatment and recovery. They included the stigma or back to that thing of why people face stigma coming from health care providers, family members, friends and others, and other really tangible barriers, such as really long wait times to finding treatments, to finding services, not understanding where to get an assessment or how to navigate this very complicated process, insurance barriers and the high costs of programs and lots of policies that were really difficult to navigate like fail first and prior authorization. We also found barriers on sort of the tangible resources that people need to have accessible to them to be successful and healthy and well, such as transportation, access to food and housing and employment and resources. All of these these sort of pieces that can be really big hurdles to getting the care that you need. Other barriers included not knowing what level of care was appropriate for them at for yourself and not knowing where to go to sort of start that that process. And it’s really, I think, important that we take the lead from our patients, whether those who have an active use disorder or in recovery or currently seeking treatment so we can make improvements to this process and have low barrier access points to improve how we bring people into care. And no other space in our health care system, when we look at chronic health conditions, do we make it so difficult to start care when a diagnosis is made. And so that’s that’s where we should be heading in our goal. How long does it take a diabetes patient or a cancer patient or heart disease patient to start linking up with the tests with the doctors, the services and the treatments that they need?

Narration [00:08:13] There is progress being made to lower barriers to care in both the United States and Canada, however, there is still stigma present that affects people’s ability to get care.

Shannon McLoughlin [00:08:25] So say someone tries to access the ER. I would say, yes, that there is stigma baked into that system. I think now those systems are at least some of them are trying to look at themselves and perhaps crumble that cookie and maybe make a new one. But the language, you know, oh, we got a frequent flier. You know, you can sit there for a while. He’s here all the time. Well, that’s pretty disrespectful. But I know I’ve heard that language. They have legitimate reasons for being there. And but often I think people, you know, ERs are busy, fast paced, they’re crowded. I don’t know anywhere where you don’t sit for a really long time. And I think in those in those situations, people’s hidden bias may come out a little easier because you’re stressed and worn down.

Narration [00:09:21] Jessica is happy to see programs emerge that are designed to break down some of these issues.

Jessica Hulsey [00:09:26] There are some innovations that are out there that are doing such a great job with this. I’m a huge fan of the bridge clinics, so these low barrier access points to start treatment. Boston Medical Center has really developed an amazing program there. So we’re really talking about the availability of treatment on demand and starting care immediately, bringing in different clinicians and different services, but also inducting and initiating medications for opioid use disorder very quickly and then continuing that person and that patient with the care that they need. So I think we can look towards these sort of spotlights and and beacons of hope and programs that are popping up all over the country and figure out how we can expand and replicate them. So we start to change these barrier points.

Narration [00:10:15] Jessica and the team at the Addiction Policy Forum advocate for evidence based programs to help bridge some of the gaps and help lower barriers. And both she and Shannon believe multidisciplinary teams are a step in the right direction.

Jessica Hulsey [00:10:29] We have amazing programs in the criminal justice settings. In Cincinnati, Ohio, they have this amazing program where they’re providing evidence based treatment services to individuals who are incarcerated in their county jail, who have any type of substance use disorder and have a combination of medications that are available, pure recovery coaches that are available during incarceration, and also really focus on that transition to the community, which is a high risk time. And they’re starting to build recovery pods. So you have a residential unit that provides an extra level of care while people are incarcerated, and then we have harm reduction, recovery support services, recovery community organizations and supports that provide people with that long term care support that they need to manage their chronic health condition. So there are so many innovations that are available. I think it keeps it should keep us very hopeful, but also focused on how do we replicate these innovations and take them to scale. Also love the QRT models that we’re seeing pop up in the addiction space and that sense for quick response teams. And it’s kind of a growing model and it’s not just about that initial 911 response, but also when you see someone, let’s say in your emergency department for a non-fatal overdose, when we are able to reverse an overdose. And then places like Kentucky and Ohio, when you have teams that go out to provide services to that individual, because we know that those who’ve had a non-fatal overdose are at risk for another one. And we want to follow up that naloxone administration with connection to services. And you have these multidisciplinary teams all over the country that are doing active outreach to make sure that we make that we build that bridge to care after we reverse an overdose. And I love that work that they’re doing. We should be expanding and taking to scale quick response teams as well.

Shannon McLoughlin [00:12:29] I think multi-disciplinary teams work very well. So you have a psychiatrist, you have nurses, you have peer workers. I think peer workers, people have lived experience who can who can speak to people from a place that I can’t are really important at normalizing the the individual’s feelings and truly understanding what it’s like. Social workers, we do practical things like make referrals and depending on your role. You might pick up someone and take them to an appointment. You might do in-house visits to make sure that you know their groceries and stuff, they’re being fed. But I think multidisciplinary teams work very well because you pull the person, it treats people holistically. They need a social worker perhaps to for some therapy to talk about how they’re feeling.

Narration [00:13:27] The language and images we use impact stigma and how individuals with opioid or substance use disorder are treated by the medical system.

Jessica Hulsey [00:13:37] We’ve started in the field doing a lot around language and changing our language sort of really matters. How we talk about people who are struggling with addiction or in recovery. It sort of signals how we value individuals in a certain space. So changing words like addict and junkie to a person or individual with a substance use disorder or a person in recovery from a substance use disorder, changing language like a positive or negative urine screen. It’s not a clean or dirty screen because that dirty piece ain’t saying that to someone who has a positive urinalysis test and is really weighted down with blame and shame and judgment. And that language piece can really signal that we see this through that health lens.

Narration [00:14:25] Shannon also emphasizes the importance of language.

Shannon McLoughlin [00:14:29] I think that language is appropriate to all different situations, but everybody wants to be treated with respect and everybody deserves to be treated with respect. A lot of people aren’t treated with respect for for whatever reason, whatever reason it is, but that is going to alienate people and not feel that make them feel welcome, make them feel very wary and also not inclined to engage. They very may well be judged by whoever is seeing them, whoever is triaging them.

Narration [00:15:02] When Jessica began her work, there was still a lack of understanding that addiction was a disease and not a choice. There have been steps in the right direction, but the stigma that exists today is still rooted in these beliefs. Understanding how stigma continues to impact responses to the opioid epidemic continues to be important. While stigma may not be as overt as it once was, myths and misinformation are still prevalent.

Jessica Hulsey [00:15:30] What I’ve learned, what I’ve learned doing this work for so long is the pieces that are underneath stigma, right? So the the items and the areas that we need to correct to eradicate stigma are really about misinformation, lack of knowledge and myths that really exist when it comes to SUD. Myths like this is a moral failing, that this is a character issue that sort of devalues the entire population of individuals, not just who have are in recovery from a substance use disorder or seeking treatment, but devalues and sort of alienates individuals who use substances and are struggling or have this this chronic health condition. We also have these myths and misinformation that sort of feed into that or feed into sort of our our need to distance herself from this entire population. Right. And that’s what we really need to to correct. We want people to be reaching out to offering support to being helpers and that connection to care and not pushing our entire population away. As my mom and dad struggled with SUD, so I started with alcohol use disorder and cannabis and some pills and escalated into heroin and crack cocaine. There’s lots of between family systems and educators and jail systems and prison systems and child welfare and employers that they lost jobs from. There’s also people that came in contact with. But we don’t understand addiction in terms of how we can all be supportive and have a role in responding. And that misinformation sort of means that we miss these opportunities to engage. So when we start to correct misinformation that this is a health condition, it does start by behaviors. But humans participate in a lot of risky behaviors from eating things we shouldn’t eat, smoking risky sex, driving too fast. All these different different things that can lead to injury or harm. But understanding addiction through a similar lens, understanding that some of the behaviors that we define addiction as are actually symptoms of a brain disorder and really reinforcing that people do recover. Treatment works. We have medications with like a 75 percent rate of reductions of fatality. Could you imagine if we had a medication for cancer or heart disease that reduced your chances of death by 75, like 60 to 75 percent? There would be lines around the pharmacy in the hospital for those meds, and yet they’re underutilized. So when we deconstruct misinformation and we replace it with science-backed real information from a health lens, we really start to deconstruct and take away that stigma and replace it with a more compassionate health, health care based response.

Narration [00:18:20] Shannon is also hopeful that things are moving in the right direction. She works with students at McMaster Medical School to understand the biases they may not know they even have so that they do not carry them forward with them when they begin to practice.

Shannon McLoughlin [00:18:34] I think it’s about helping people who perhaps have not had exposure to some of the folks that they will be treating depending on where they choose to go in their career. But to look at the assumptions that you have, person who has feelings and maybe had a family and doesn’t have them anymore, maybe they had their kids taken away, or maybe they’re really struggling, maybe they’re in a intimate partner violence, and so you don’t know. And so I think it’s teaching students, you know, the medical profession of the future to approach with curiosity and no judgment, which is which is admittedly difficult to do, but that’s part of what school is, is, you know, you learn how to do brain surgery, but you also learn how to see people as people, not as addict. And also, this is not to say that this is widespread, that every medical professional, every social worker, every outreach worker. No, it’s like it’s like anything. There’s different people are different. People have different attitudes. They have different thoughts. They have different ways of approaching. But sometimes I think it can be kind of overwhelming. And if you see the same person in ER time and time and time again, and you think, well, why are they here? Some people, it’s a safe place for them, to be perfectly honest. They come in because somebody says hi to them. Not to say that they’re not there for some medical reason, but also they might be there for emotional and social reasons.

Narration [00:20:20] Jessica and the Addiction Policy Forum have also been providing training to health care professionals. And the programs are effective.

Jessica Hulsey [00:20:27] You know, we’ve been surprised about the reception of some of our education and, you know, stigma reduction efforts among health care providers. We were we were just on the ground at a hospital doing a training with physicians and nurses and even researchers in the room and providing more, you know, science-backed health care related information about SUD. One of the physicians during that training said we didn’t learn this in medical school and it wasn’t in my residency and this needs to be made available to all physicians that are currently practicing or in training. And that was really helpful and such a heartfelt testimony from a physician that we trained. So I think there is an openness. Sometimes when we’re out doing trainings, we do encounter certain rooms or certain practitioners who might be attached or very connected to some of their old misinformation or way of doing business. But when you sit with folks and convey the science, right, and there’s a huge gap in how we’ve relayed this information to so many practitioners in our field. When you take the time to sit with people and go through what we’ve learned and where we’re going and what innovations are available? I have yet to find a group of physicians, nurses, educators, those working on child welfare who aren’t ready for that information so they can do a better job of helping people.

Narration [00:21:55] Jessica is hopeful for the future and is optimistic about what she sees.

Jessica Hulsey [00:22:00] We have sort of a changing constellation of barriers such as fentanyl and its prevalence in our communities, which is creating more overdoses, more overdose fatalities we have. But for every barrier or hurdle that we encounter in this field, we have ten innovations, new treatments, new programs or innovations that can help patients and help families. So I think the good news here is that when we follow the science, when we replicate what we know what works, when we really focus on a health care response to addiction, we really can see significant improvements and reduce fatalities. So it’s kind of a one-two punch with lots of difficulty, lots of tragedy. Most of us have someone we’ve lost or someone who’s struggled with addiction in our lives. But if we really look to the programs and jurisdictions who are doing it right and implementing new ways to address addiction that have proven results, I think we can start to turn the tide.

Narration [00:23:12] Jessica and Shannon have both worked on the front line of this crisis. They have seen firsthand that it can be too easy for people to slip between the cracks or become alienated by our health care and social systems. But the future is promising. Employing evidence based approaches to treatment like bridge clinics and multidisciplinary teams, continuing to educate to help break the stigma and investing in prevention, intervention and harm reduction are all moving us toward a future without accidental overdose. To learn more about the Addiction Policy Forum or about the opioid epidemic in Hamilton, Ontario, please visit the links in the description. Thank you for listening to this episode of Countermeasures. To learn more about what Emergent is doing to address public health threats like the opioid crisis, visit EmergentBiosolutions.com. If this episode resonated with you, consider rating and reviewing Countermeasures on your preferred podcast platform.

Amanda Scott [00:00:01] You walk down the street from where you live and where you lived your whole life, and you all of a sudden see that there’s been this whole world of recovery this whole time. It’s been right here where you live. And I think that that gives a reality that I think a lot of people, while using, don’t know that recovery is possible or how common it is. It really gives you that like, “oh dang, again, this has been here like this, you have doing this all the time. I didn’t even know it.”

Narration [00:00:33] This is Countermeasures brought to you by Emergent, maker of NARCAN Nasal Spray. Join us as we explore the shifting complex world of the opioid crisis. In each episode, we’ll hear from makers of Positive Change as they recount personal narratives of loss and perseverance and offer a way forward to a better future. For those struggling with opioid dependency, feelings of loneliness, guilt and isolation can be overwhelming. Bringing awareness to the reality of opioid use disorder is an important part of building empathy and driving education. Resources like community groups, peer mentorship programs and other safe spaces are important tools in addressing the opioid crisis. In this episode, we explore the importance of community connection as a fundamental building block of the path to prevention, treatment and recovery.

Amanda Scott [00:01:35] My name is Amanda Scott. I am the prevention program director at Detroit Recovery Project. I’m also an individual that identifies as being in recovery, so I have been in recovery for 15 years and so it becomes a part of your life to a certain degree.

Narration [00:01:55] The Detroit Recovery Project is a private nonprofit corporation dedicated to supporting recovery, which strengthens, rebuilds and empowers individuals, families and communities who are experiencing co-occurring mental illness and substance use disorders. At Detroit Recovery Project, Amanda and her team work to provide access to integrated networks of effectively and culturally competent holistic health services. Amanda says that one of the biggest initial findings of the initial Detroit Recovery Project team was that this holistic approach was a necessity. People in recovery need support in various ways, from mentorship to writing their resume to finding a ride to their 12 step program.

Amanda Scott [00:02:39] So Detroit Recovery Project started in 2005 as a peer organization. So the idea was that a lot of individuals accessing substance use disorder treatment most often find that they go back to using pretty quickly after returning home from being in treatment or sometimes being incarcerated. There were peers that were using mental health services and that seemed to really help like navigate some of those bonds, like where do I get support? Who do I call at 3 a.m. when I feel like I’m going to crawl out of my skin? So they started that way. It was written by people who had lived experience. It was employed by people who had lived experience to serve, people who wanted to access recovery. But it became really clear pretty quickly that you couldn’t just address the substance use without like acknowledging all the other components of an individual’s life that have that outcome, right? Like if I just stop using drugs, but I still am on house without a phone and that was no support, like, how long am I going to stay off of those substances? And it can be pretty daunting.

Narration [00:03:49] Many people who have been impacted by substance use want to use their lived experience to help others in a similar way. Amanda Lick, director of Community Health Solutions at Emergent, is one such person. While she has never struggled with substance use disorder herself, she grew up watching her mother battle an addiction to prescription opioids.

Amanda Lick [00:04:11] So like my life story with the opioid epidemic or the way that opioids impact the lives of people happens not with my control, not really with my consent and happens in utero. So my parents hit a deer on the backroads of northern Michigan. My mom broke her pelvis in two places and my dad sort of struggled and suffered from brain damage because they were on their way to the hospital due to my dad withdrawing. So or at least that’s the story they’ve been told. So it’s really fascinating because as I have grown, I and learned and unlearned and just, you know, weaved through life, trying to make sense of who I am and how trauma has impacted me and how it’s created beautiful parts of who I am and how it’s created parts of me that I have to, like, dive deeper to understand. I’ve realized that the opioid epidemic was impact me long before I even knew. My mom died in 2007 from an overdose too, with prescription drugs. She died the first year that the CDC had died, like had said, more people in this country was dying from overdose due to prescription drugs than automobile accidents. So prior to that, I was a part of the whole generation of folks who saw their parents maybe take substance use and then become dependent and then become addicted to the substances. And I witnessed just like how damaging that was. And there were just a number of different factors that played into it. What I can do is tell our story, communicate how there are so many people that are just like me that have their own stories that are complicated and beautiful, that likely have been touched by the death or loss of someone that they loved that was also complicated and beautiful and also tell our story, but then also get to do the work that I do every day that makes a difference in so many lives.

Narration [00:06:20] Like many Americans, Amanda Scott and Amanda Lick both have personal experiences and stories that tie them to the opioid crisis. They have both witnessed firsthand the importance of community and the ability to openly share experiences with others. They have also both channeled their experiences into becoming positive forces, engaging with communities to create a network of support and resources to help. Amanda Scott and the team at Detroit Recovery Project follow the Healing Force Model of Recovery, a concept of the Wellbriety Movement, adapted from Native American teachings. The Healing Forest is a metaphor for the clinical treatment of addiction and follows that if you plant a tree in a sick forest, it will stay sick. But if you plant a tree in a healthy forest, it will heal and eventually thrive. Championing community resources and peer mentors to help those on the path to recovery is one of the first steps to curating a healthy and healing forest.

Amanda Scott [00:07:22] When you go to the bus stop and like wait for the bus in the morning and everyone’s smoking weed and that’s where everyone’s always smoking weed, like that’s like an issue for you. But like down the street, they have live music every day or they’re out on their porch playing music and like it’s not centered around substance use or drinking and it’s in the same neighborhood. But you don’t know because like your area of focus was always like, where can I use, who’s using? How can I use more? So the peer can help, like navigate that. Like, hey, right down the street there’s live music. It’s not centered around using, right? Like, so here’s this other thing you could do that is fun and healing and healthy and community and you just didn’t know. You just didn’t know was there. So that’s one thing a peer can offer. The other thing is, is I think it’s kind of a part of that full circle, which is if you get sober and you have like a criminal background as a result of your using, you are limited in what you can do. There’s only so much employment you can obtain. You’re that you kind of are forever held accountable for those behaviors. Recovery support is an opportunity to do something different where you can really access a level of employment that is maybe levels of employment or like a level of professionalism that you wouldn’t be able to access otherwise because so many, like white collar jobs, require clean criminal backgrounds. So like, it gives you a chance to also grow and to be a part of that healing forest by like being a part of like the community as like a gainful employee, which sounds strange, but it is like so it’s another part of like completing the circle to like giving space for people who are recovering to grow and like kind of level up in their lives.

Narration [00:09:19] The Detroit Recovery Project runs the Recovery Training Institute, where individuals can train to become a certified peer recovery mentor. Peers are paid for their services, and the program provides a new path for people in recovery to help others and also gain important skills that can transfer to other parts of their lives.

Amanda Scott [00:09:37] In the state of Michigan, they have made it so that peer recovery support services are billable services, which is great because that means we have a way to sustain funding for individuals to provide that service. But in order to do that, you have to have certifications. And those certifications have like a whole list of stuff, like you have to have 40 hours of SUD education, 16 hours of SUD ethics, 150 hours of continued education, the other 500 hours of shadowing. It’s kind of a lot. And then there’s an exam and then there’s like certain professionalism, things that some people in recovery might not have acquired the education on throughout their life based on maybe where they grew up or how long they’ve been using. You know, some people start using when they’re 13, 14, so they may have never truly written a professional email like that might not be something they ever did because they were doing other things. So the Recovery Training Institute provides all of that. It’s I think it’s like a month, maybe it’s six weeks and it’s like half day of classes where they kind of go through all those trainings and you do roleplaying and try to really make sure the individual has all the information to access the exam and pass the exam. And then we’re not the sort of fire, but we try to set the individual up to succeed with certification through the state. So we like try to help them set up the account that they’ll need and get everything uploaded, all that good stuff. And then if they want to apprentice with DRP, they can do that. We are recognized. So if you want to go on and do your 500 hours of apprenticeship as as you can and it is paid.

Narration [00:11:28] Amanda Lick’s Mother didn’t access community programing, peer mentorship or have a healing forced around her, but Amanda wishes she had.

Amanda Lick [00:11:36] The program that I wish my mom had had. So one, I guess there’s two programs I wish she would have had. It was she would have had more support as a young mom. So there are certain programs that support women who are pregnant, like early in their pregnancy and do home visits with those families. So I wish my mom had that because, you know, my mom was in the motorcycle accident and she was pregnant with me, broke her pelvis when we went, when she went to deliver me, it was a very stressful delivery. In fact, we almost both didn’t make it. So not only did we survive the motorcycle accident, which we probably shouldn’t have, then we survived the birth in which they actually asked my grandma, like, Which one do you want me to save? Because we don’t know that we can save both of them. And my grandma, of course, said her daughter, because my mom at the time was only 17 and luckily we both made it. But, you know, I look back, I have the birth records of when my mom gave birth to me and she actually was a very dedicated like mom and wanted to attach. And that was like a really beautiful thing to read that and to know that she was committed to being a really good mom in those moments. I just think she could have used some additional support. So now there’s lots of programs like that available for moms and dads and babies and toddlers that offer home visiting. And it’s really wonderful. The second thing I wish that my mom would have had was naloxone. Two things that probably would have made a huge difference in her life, the one having that program, and then the second, having her life saved when she was overdosing.

Narration [00:13:11] In her position at Emergent, Amanda Lick works with communities to get naloxone into the hands of people who may need it. Building awareness around naloxone and educating the public on how to use it is part of creating a holistic, community based approach to supporting those with opioid dependency.

Amanda Lick [00:13:30] I think the reason my job and other jobs like mine are important is that we are sort of the conduit of, you know, helping share best practices, like how how are others creating innovative ideas that are reaching people when they need it most in areas where they’re seeing high numbers of overdoses. So we kind of like have this really great view of the landscape and then can sort of maybe help accelerate some of the some of the program building by sharing something that’s already been done so that people across the country aren’t just having to start from scratch. And of course, they can find that other ways. But I think our team does a really good job of saying like, Oh, you’re thinking about finding a distribution solution in a high need area. Oh, have you thought about like vending machines or distribution boxes or. I know of this great program in Chicago that’s using libraries. Let me connect you to the person. We’re constantly learning, engaging. I think our team really is focused on, like so many of us, have our own personal story and how we’ve been impacted by the overdose epidemic over the last 20, 30 years that I think that we take that and carry it with us. And so it’s never about the product. It’s about how the product can help others and how can we help build better relationships, help strengthen communication, help improve programs and help people get what they need when they need it.

Narration [00:15:09] Making sure naloxone is widely available to those who may need it is one element of harm reduction, a spectrum of strategies that focus on keeping people who use opioids and other drugs alive and as healthy as possible. Amanda Scott says pushback against harm reduction tactics like syringe services every day and has even struggled with it herself.

Amanda Scott [00:15:30] So harm reduction is really about meeting people where they are. So it’s kind of like that gap of service like this applies as you do. But I think this probably applies to everything, right? Like there is a population of humans that are not currently able or willing to access further services for whatever reasons. So you have this group of people that aren’t ready to do something different. They are actively using. So going to them and providing that service and providing safe using equipment. I know that that’s one that like personally I haven’t struggled with was a little bit at first was like, is this perpetuating using, and I really just like to talk a minute and I thought about it. Like, I like I said, I’m a person on long term using. I personally know that like the last syringe I was using before I got sober, it was so faded, it didn’t have any of the numbers on the side anymore. The needle itself was bent and had rust on it. And I still used like it didn’t matter what the syringe looks like, you know. And I kind of like thought about that and was like, yeah, that never made a difference for me or anyone I knew. Is having syringe services going to make me high today? No, and not at all. And would having syringe services have like, perpetuated me using? No, not at all. The only thing is, is I probably wouldn’t have gotten cellulitis or cotton fever as often as I did.

Narration [00:16:59] Amanda Lick comes up against similar barriers when it comes to ensuring everyone has access to naloxone if and when they need it for an opioid overdose emergency.

Amanda Lick [00:17:09] So we can take a data driven approach. And that is incredibly important, like where we make naloxone available at the upon discharge and the ED, or we make it available upon release for those incarcerated folks for coming back out into the community. Absolutely, important programs need to be done, but other types of programs that make it available to people who are using other forms of drugs that may not realize that opioids are in it or programs that make it available to parents whose children have been given an opioid for surgery or grandparents who’ve been prescribed. I mean, really, at the end of the day, like if you have an opioid in the home or if you are a loved one, or even if you’re someone who doesn’t ever use an opioid, you could be at risk not knowing where these potential drugs are coming from. You know, 16 years ago, my mom died of an overdose. I knew she was using and naloxone wasn’t available the way that it is out in the community now. I wish it was because I would have given her some every time I saw her. She wasn’t injecting drugs. She wasn’t using drugs outside of well, she was using them illicitly in the sense that she was taking them, not how they were prescribed. But she would have said that she wasn’t using drugs, but she still should have had it. And she became a statistic and she became a statistic in the year that more people died of overdose than car accidents. To me, that life, my mom’s life is just as important and should have naloxone available to it as someone else who might be using four to five times a day. And that person should have naloxone available to them every single time that they use. And until that person dies, I don’t think we’re at that point of saturation yet. I don’t want to live in a space of fear where I’m like, Oh my gosh, anybody can be exposed and die at any moment. Like, that’s not I don’t feel like that’s a healthy place but I also we’re seeing record numbers of people who are using cocaine die because opioids are in their cocaine and they had no idea that they were at risk for a death from an opioid. And that’s super scary. Someone could try cocaine once and have no idea that they are at risk of dying and no one has naloxone available because they don’t consider themselves at risk. Just this idea that to a certain extent many people are at risk and we need to have access for those many people, regardless of whether they’re high risk or low risk.

Narration [00:19:52] While progress is being made, stigma and silence are still barriers to ensuring robust programing and support for prevention, treatment and recovery. Support from the community and peers can help fill this void and create a safe place for people affected by the opioid crisis in all its many forms.

Amanda Lick [00:20:12] I guess the first time I realized I had a problem or that my family had a problem, my family’s different was when I was in elementary school. My mom overdosed in front of me. It was where I knew my family was different. I knew that my mom was different. I knew that things just weren’t quite right necessarily, but I didn’t realize just like, how different. One of the things that people don’t understand about stigma is that it creates an environment of silence. So like me as a child, I was silent and didn’t feel like I could talk to anybody. I didn’t feel like I could talk about my own family. We didn’t talk about it in my own family. My mom would pass out. My other family members would, you know, pass out or do things and nod off or whatever. And it was like, no one talks about it. It just became our norm. I’ve always said this. I truly believe that, like, silence kills and it kills within ourselves. If we’re silent within ourselves, it kills within our families, it kills within our communities. We have to not be silent. But I think the reason we are silent is because the stigma and the shame that is placed on people who have a disease. And it’s just so unfortunate. Even our silence communicates something. And if you take a situation like those who struggle with substance use disorder and in families, for instance, it’s like it by not communicating about it, it becomes the norm. Or by not communicating about it, it it’s saying that we don’t care. By not communicating about it, it says that it doesn’t exist. And if you do see it exist while you don’t know what you’re talking about. It’s dishonoring our reality. It’s dishonoring the lives that matter to all of us, the lives that matter most to us. It’s truly silence kills and it perpetuates this idea that these human lives don’t matter.

Narration [00:22:22] Amanda Scott emphasizes the little things that we don’t talk about also matter.

Amanda Scott [00:22:28] Accessing food. We see a lot of dehydration in the winter. So like preventing deaths or other issues by people just like getting water, gloves and coats in the winter. I can tell you I have multiple like videos of participants being like nobody is talk to me like a human in years. If you’ve ever attempted to go to treatment, it’s not easy. It’s at least a minimum of a two-hour phone call to identify your level of care. And then it could be longer from there and oftentimes there’s waits. So having someone to help navigate that with you is really important, too. Even today, we have one young person who has over three years in recovery, but I was told that she might not be able to work in this space, this this particular grant anymore because she has a larceny from 2019. Mind you, she’s I completed her probation and stayed sober, really done all the things she needs to do. But because she has this, she’s not allowed to bill for services. Even though she’s done all the training and they specifically want a youth who’s in recovery under the age of 25 with lived experience. However, it has to been five years since that criminal charge, which is an insane amount of hoops to jump through. So just like I don’t know, there’s just a lot of like poor decision making. I think poor policy hasn’t really like looked at the truth of an issue and then a lot of like racism, stigma, bias that’s happening that I think in the last few years people have become more willing to look at. But I think that those are the things that hinder us. And as soon as things are an issue anymore there, unless those things get dealt with, they are going to be the things that continue to hinder us.

Narration [00:24:15] Amanda Lick and Amanda Scott are just two voices of the many in the U.S. and around the world who have been impacted by the opioid epidemic. We want to thank them for their willingness to share their stories and help break the silence and their important work cultivating healing forests in their communities. Having conversations about opioid dependency and overdose, supporting harm reduction strategies and championing those with lived experience are all key steps to combating the opioid crisis. We aren’t there yet. We need to have open discussions about community support in order to make an impact. To learn more about the Detroit Recovery Project, please visit the link in the description. Thank you for listening to this episode of Countermeasures. To learn more about what Emergent is doing to address public health threats like the opioid crisis, visit EmergentBioSolutions.com. If this episode resonated with you, consider rating and reviewing Countermeasures on your preferred podcast platform.

Narration [00:00:02] This is Countermeasures, brought to you by Emergent, maker of NARCAN® Nasal Spray. 

Join us as we explore the shifting, complex world of the opioid crisis. In each episode, we’ll hear from makers of positive change as they recount personal narratives of loss and perseverance, and offer a way forward to a better future. 

Across the country, Americans from all walks of life have been impacted by the opioid epidemic. For Crystal, a mom from Missouri, the epidemic hit home the night her teenage son overdosed on her front lawn. The incident was recorded by the family’s Ring camera, and Crystal uploaded the video to social media to help raise awareness about accidental overdose. She has since become an advocate in her community for education about the dangers of accidental overdose, and the importance of carrying Naloxone, an opioid antagonist that can rapidly reverse an opioid overdose.   

Crystal [00:01:12]: The night that the video was taken, I had let my 16-year-old go out with a friend who I typically hadn’t let him be around. he had gotten in some trouble with him, but they had recently had a friend overdose and die, on Fentanyl. I had seen that child at the funeral and I, I thought these boys seeing their friend in a box, that they would learn. I really trusted him after that because he did. I mean, he looked me in the eyes and he said, never again. And I believed that, and I allowed him to hang out with that friend. 

The next thing I knew was I heard the dog bark, and our dog never barks at night, rarely barks at all. Um, and so I kind of woke up a little bit, but enough to see my phone flashing because it was giving an alert, I thought that that was odd. And so, I grabbed my phone, and it was the ring doorbell and I brought the live feed up and all I saw was our front yard, but I knew that the dog had barked, so I thought, I’ll watch for another couple seconds. And the next thing I knew, I saw my son being carried by a friend to my front door.  

Narration [00:02:55]: EMS arrived, and Crystal’s son’s life was saved by Naloxone and the provision of emergency medical care. Afterwards, he went to rehab in order to start his journey to recovery. A journey he is still on today.  

Crystal [00:03:10]: So it was, it was hard for both of us, obviously. We had never been apart like that. He came home, and he seemed to have his head on a little bit straighter, and we decided that we were gonna work on his mental health and we would think about school when we needed to. And, um just really focus on getting him healthy. 

Well, after eight months, he relapsed and I came home to him slipping in and out of, you know, consciousness. And thank God for the education I had gotten because I was able to administer the Naloxone myself, and get him to the hospital myself this time. As a mother that breaks your heart. I was mad, and I was sad, and I still am…disappointed. There was a lot. It’s, there’s a lot of guilt too, a lot of emotions that go with all this. And there’s no rule book for how to, you know, get your kid healthy from something that’s so addictive. He did go back to rehab. This time on the other, on the other side of the state. So there, my kid is gone again. He was gone for another 60 days. He came home, and it wasn’t even a week, and I found some things and he’s currently in rehab again. 

Narration [00:05:13]: In this episode, we explore accidental overdose – the signs and symptoms, and how Naloxone works to reverse an overdose. We’ll speak to some of the advocates and professionals working to ensure the public knows the importance of carrying Naloxone, and how and when to use it.  

Overdose deaths – the majority of which involve opioids – continues to be one of the leading causes of injury-related death in the United States. 

Last year, approximately every seven minutes one life was lost due to an opioid overdose…that equates to more than 200 fatal overdoses every day, each with its own emotional toll.  

The opioid crisis does not discriminate, and can affect anyone, no matter their age, sex, race, or socioeconomic background.  

Dr. Bonnie Milas [00:06:05]: So, what happens during a drug overdose? And it’s important to recognize that nearly all of these overdoses involve an opioid. What’s happening is first the individual becomes unconscious, they fall asleep. If they’re discovered, you cannot wake them up. But then the other effect of the opioid on the brain, besides causing them to be overly sedated is that their breathing slows. 

Eventually their breathing will stop, and at that point, the brain is no longer getting oxygen, and the brain is critically dependent on oxygen for survival. And once you get over five minutes of not having oxygen to the brain, then brain injury can occur. But in that process, the heart is no longer getting oxygen either. 

So, the heart will eventually slow and stop as well. And that’s what happens. That’s the sequence of events when someone suffers a drug overdose. So, the sooner that we intervene the individual is just falling unconscious, and their breathing is just starting to slow…that’s the point at which it’s critical that we intervene. 

Of course, you can intervene at any point, but if we can intervene at that point, at its earliest, then that’s how we can prevent either permanent brain injury and or death. But it’s most important to understand that this is not a cardiac, a primary cardiac event. This is not a primary cardiac arrest.  

Instead, this is a primary respiratory arrest. It’s the breathing that stops first, and then eventually, if no one intervenes, then that’s how the heart eventually stops. So, it’s important for the public to recognize that it’s not the same, and you do have the opportunity to save them from dying. 

Narration [00:08:01]: The voice you just heard belongs to Dr. Bonnie Milas, a Penn Medicine physician, and Professor of Clinical Anesthesiology and Critical Care. Dr. Milas has both professional and personal ties to the Opioid Epidemic. As an anesthesiologist, she handles opioids every day as part of her work. She has also tragically lost two sons to accidental overdose.  

A large part of the work Dr. Milas does is to educate the public on the importance of carrying Naloxone, whether someone you know is at risk of accidental overdose, or if you think you’d never have to use it.   

Dr. Bonnie Milas [00:08:39]: Things that the public can do to intervene in an overdose situation would be to educate themselves first and foremost. So, there are many sites that you can turn to to seek out that information. Namely, I have, through my professional society, I have spearheaded the REVIVEme.com campaign. 

That is a website that is rich with content, and in fact, if you’re someone who needs to be convinced as to why you need to be ready in the home or in a public space with Naloxone, there is a, It’s kind of like a, uh, TED style talk where I try to convince people of the urgency that I have felt in the home because I have had on occasion in the home to have to rescue one of my sons. On a number of occasions. I have the skillset, but not everyone has that skillset. So, if you go to the REVIVEme.com website, it teaches you and implores you to be ready. And it also has links to where you can find Naloxone. It also talks about the importance of rescue breathing and maybe even the need for full on chest compressions or CPR, so that’s just one site that you can go to.  

The American Heart Association has a very nice opioid educational component as well, and in fact, the ASA and the American Heart Association we have a very close relationship. We have a joint statement essentially saying how important it is for the public to be educated and to intervene. And if you need CPR basic life support training, you can go to the American Red Cross and get that type of training as well. So those are just three websites that can be used for the public to become educated, to really know what to look for. 

So, things that I’m doing out in the public space is, first of all, I certainly do go out and talk to other physicians. I try to stimulate interest in my, not only my own professional society, but I’ve also spoken to family practitioners, pediatricians, about what we can do to really stem the tide of loss of life due to drug overdose.  

In addition, I also go out and talk to community groups. I work locally with my county health department and we teach people the very basics of what do you look for, calling 911, having a Naloxone product immediately on hand. And then basically, how do you rescue, what is the importance of that? And then where do you put your hands to intervene, If you really don’t want to rescue, breathe, if you don’t know the individual and you’re only willing to do hands only CPR. 

Narration [00:11:55]: Gay Owens, Senior Director, Global Medical Affairs at Emergent, has spent her career studying opioid antidotes – she knows the importance and impact of Naloxone becoming available over-the-counter for expanded community use. 

Gay Owens [00:12:11]: So, what I think is the biggest benefit to now having community-based Naloxone available in a retail setting is really for everyone to understand where there’s a risk of having an opioid…someone experiencing an opioid overdose. And that really has, unfortunately, in this opioid epidemic, really broadened, um, one from initially when the epidemic started from a prescription problem to now an illicit fentanyl, or adulterated drug problem. 

And so that now the epidemic numbers have continued to rise, and so having something available to the broader consumer and community use will allow someone to understand and recognize signs and symptoms of an opioid overdose, and now be able to actually have something to take action.  

So, a couple of things I think are needed in this environment in order for folks to understand where and when are the signs and symptoms of an opioid overdose, how to recognize them if you come upon someone who may have experienced an opioid overdose. 

And now, how to understand that there is a product available that could be utilized to potentially save a life. And as I mentioned, utilizing our human factor studies, understanding that a consumer could go in and be able to pick up this product, potentially have it in their home, have it on them available in order to save a life. 

It’s now really more critical than ever that people have something at the time, or when they witness a potential opioid overdose. Timing is critical, hence why we now have something available to a broader consumer group to make it more accessible.  

Dr. Bonnie Milas [00:13:53]: The significance of having Naloxone over the counter…I had already mentioned it’s easy access, but the other thing in terms of stimulating conversation, I think most people think of, first of all, of having a substance use disorder as being something that, well, they made a conscious choice to take that drug. 

Even at an initial stage, early on, early age, and that you willingly made that choice and therefore you can willingly stop anytime you want. Well, if you are knowledgeable about addiction and how that occurs, you would clearly understand that, we all make decisions and we may try something or do something, but very few of those decisions, especially at an early age, are something that ultimately you cannot undo. 

With the understanding of addiction, and with the way the brain receptors get reset, that they reset, in a manner in which the brain is constantly chemically imploring the individual to use. So, they’re constantly getting that messaging, and if they stop that, they are going to have a sickness, they’re gonna have withdrawal symptoms. 

So, you know, having the drug over the counter should stimulate discussions about addiction and about that mechanism. And I think too, that if we see people picking up Naloxone, and people are talking about it, that the image that we have of what a drug dependent individual, what they look like will also change. 

Because what is often portrayed in the media are pictures of, you know, I live in the Philadelphia area, so they’re pictures of Kensington…there are pictures of individuals who live in the Tenderloin area in California, and it’s an image of someone who is dipping out, falling asleep. Their pants are halfway down, or their dresses halfway up around their neck, and they’re urinating and defecating in public and they have a needle in their arm, and that’s the image that many people in the public have of this is a picture of what a drug addict looks like.  

Well, I can tell you that most individuals don’t look like that. And I know that my children, you would’ve looked at them, you would’ve met them, and you would have never guessed what they were struggling with.  

Highly educated, successful, and in fact, you may be working with somebody in your office space that is using on a daily basis, but you don’t know that. 

Narration [00:17:08]: Gay further emphasizes the importance of carrying Naloxone 

Gay Owens [00:17:12]: When you look at this from your own personal perspective, there are many variables that could potentially predispose someone to an opioid overdose, and those, some of those factors you may not know. So risk of having opioids, taking them either illicit or illicitly, but now as I mentioned, exposure to adulterated drug substances has really been what’s driving the opioid epidemic.  

So, you may not even know that someone’s at risk for an overdose. You may be in a situation where you’re not sure of what someone’s taken, and now as I mentioned, timing is critical. So now you have access to a product that you can utilize, but essentially an opioid overdose can occur at, you know, to no fault of one’s own doing. 

Where they may not even be aware, they’re exposed to this and yet their breathing has slowed, and now you have access to a product that could restore their breathing. Regardless of whether it’s in your home at an event, riding transportation. There are many scenarios where you may not know, and most likely you won’t know what someone’s taken, but now you have an ability to take some action that could potentially save their life. 

Narration [00:18:31]: But what can you do if you see someone you suspect is having an overdose, and how can you identify the signs?  

Dr. Bonnie Milas [00:18:40]: So, some of the signs that you would look for, say for instance, you are on public transportation…someone appears to be sleeping, but you notice that maybe their position is a little bit off, they’ve fallen forward where, um, anyone who’s not impaired, they might catch themselves. So, you see their positioning’s not quite right. Something about that doesn’t look right.  

Or maybe you see paraphernalia around that individual, but you might go over and see if you can wake them up. And you try to rouse them or shake them gently and say, “Hey sir, miss, are you okay?” And if it seems as though you cannot get them to respond to you, and if there’s also maybe nobody else around them that you can ask their circumstance, you know, did this person recently use, do they, do they use substances? 

From that point on, if you cannot wake them up, you would certainly want to call 911 at that point. Now, after that, you can also look at signs on the individual or about the individual. So if their pupils are pinpoint, see if they are breathing to see if their chest is rising and falling. 

Well, certainly if they are not breathing or if they’re breathing less than eight times per minute, then you know that something is clearly wrong. Their pupils are pinpoint, we’ve already mentioned their fingertips are blue or their lips are blue. And then you could say, well, even in the absence of, I don’t know, there’s no paraphernalia around the individual. I don’t know much, but that’s enough to get you to think that this is probably a drug overdose.  

Since I carry Naloxone, I would administer that nasal spray and if they are still breathing, I would potentially turn them on their side and I would stay with them until trained help arrives. If they are not breathing, if this is someone I know and somebody that I feel comfortable rescue breathing, then I would give two breaths and then a breath every five seconds. 

And if I didn’t know this individual and it was a situation where they were on the train and I didn’t have any protective mechanism, like a face mask where I could protect myself against the individual, then I might only do hands-only CPR. But those are kind of the basics.I have enough information there to tell me this is probably a drug overdose. 

Narration [00:21:21]: When it comes to reducing the number of deaths from accidental overdose, stigma remains a major barrier. Conversations about accidental overdose and opioid use are still considered taboo in many circles. Breaking the silence and stigma is critical as we continue to fight against the opioid crisis.   

Gay Owens [00:21:40]: So, stigma I feel, has played a big role with where we are with Naloxone education awareness, and now, distribution, or having folks have access to the product. So, stigma, again is this crisis initially started was around prescription opioids and those using prescription opioids as unintended potentially, or misuse and abuse of prescription opioids. 

That market then shifted to more one of heroin. And then now if you look at the waves of the epidemic, it’s illicit manufactured  fentanyl, as well as adulterated drug substances. And so I think stigma along the way… the data lags behind, we’ve always been looking at this product, or naloxone, as a potential for those with substance use disorders or opioid use disorders. We haven’t, again, normalized this to anyone in any situation could actually come across someone experiencing an opioid overdose. 

Again, unintentional, these are not intended opioid overdoses. And so now unfortunately, folks are being exposed to products that may not even be aware of because of the adulterated drug supply. And so, I think stigma really needs to be addressed. And now with potentially having, or now that we’ll have an OTC product, we can actually educate a broader consumer group on who could be, um, who has the potential to save a life, but who could potentially suffer an opioid overdose and what those signs and symptoms look like. 

And again, now with a broader distribution of Naloxone, we hope to have enough to avert, start to avert opioid overdose deaths from occurring. 

Narration [00:23:15]: After posting her video on TikTok, Crystal saw firsthand the power of speaking up and breaking the silence on how the opioid epidemic envelops families and communities like hers.  

Crystal [00:23:27]: Because awareness is the only way we are going to even get a handle on this. My son didn’t have time. His friend didn’t have time. You know, if, if we do not get a handle on this, I’m gonna have more friends lose children. The more that it gets out there, the more chance a mother knows what to do if that were to happen to her kid.  

I can’t urge enough. You, you have to have it on you ,and you have to know how to use it. It is very important. It’s just as important as you know, talking about other things that you talk to your teenagers about. Your kids need to know about this. I even know some of my teenage family members, who are carryingNaloxone because better safe than sorry.  

You know, and I want to bring awareness. I can’t get sober for my son, but I can share the video that literally makes you feel something inside when you are watching what happened to my kid and put that on a mom’s heart.  

You know, one thing is, is that when you, when you are big on social media, which I am not, that is the only video that has gotten that many video or views, um, I feel like you can get negative comments on anything that you could say, you could say “this cat is cute”, and somebody will have the nerve to say “No, it’s not.”  I’ve had nothing but great. Comments, of people are sharing their sobriety number of years. Moms who said, “I’m going to show this to my kid when they get home from school.”  

Just wonderful comments. Andt hat shows me that the reason for me putting it out is working because that’s all I want. I feel like if it’s kept quiet, it’s gonna hurt more people. So I say, say it loud and, and be truthful. 

Narration [00:25:36]: Dr Milas, Gay and Crystal are all outspoken about the importance of openness, awareness and education when it comes to accidental overdose.  

Dr. Bonnie Milas [00:25:48]: Reasons why people might think that, well, I don’t really need this drug. I, I hear a lot of times because someone might say to me, well, “I don’t have that problem in my family,” or “not my kid.” But what they are failing to recognize is that many people experiment, and they try a substance for many different reasons. 

And if they are inexperienced, and they’re not tolerant, then it could be a first time that someone tries a substance that they would indeed overdose. So, you might think that I don’t need this in my home, but in fact, you very well may and it’s too late. Once you discover your adolescent, or your family member down to say, oh, I guess I really did need that.  

It’s emergency protection that every home should have. So, if you either have someone in your home that has a substance use disorder, you have opioids in your home, or if you have anyone who may try a substance, then it is probably in your best interest and theirs, particularly in their best interest, for you to have that immediately available. 

I think if anyone is listening to me and you’ve heard what I have to say, that that in and of itself should be enough to stimulate you to go out and pick up the medication. It’s too late when you’ve already discovered the actual circumstance right in front of you.  

Now, why would you want to necessarily carry it in public? 

I would tell anyone that having Naloxone on you is essentially a sign that I care about members of my community, I care about my neighbors. I care enough that I went out and I obtained this medication. I have it on me. I have it with me, and I am willing and ready to respond.  

I consider this to be a sign of good citizenship, to have this available and to be willing and able to respond. 

Narration [00:28:21]: The Opioid Epidemic does not discriminate, and an accidental overdose can happen anywhere, anytime, to anyone.   

Carrying Naloxone puts the power to help reverse an opioid emergency in your hands, and has saved lives, including the life of Crystal’s son.  

Naloxone is just one tool in the fight against the opioid crisis. In this series we’ll explore the stories of people working to change the trajectory of the crisis.  

For more information about opioid overdose and the important resources available to you, please go to the links in the description of this episode.   

Thank you, Crystal, Dr Milas and Gay for sharing your stories and expertise.   

Thank you for listening to this episode of Countermeasures. 

To learn more about what Emergent is doing to address public health threats like the opioid crisis, visit emergentbiosolutions.com

If this episode resonated with you, consider rating and reviewing Countermeasures on your preferred podcast platform.