In 2023, the Vancouver Fire Department responded to one to two overdoses a day on average, according to the department.
It’s not unusual for the second call of the day to be for the same person, who has overdosed on fentanyl or other opioids again after experiencing withdrawal from overdose reversal medication.
“Once we revive them, their first real thought is, ‘I don’t feel good right now, and I want to feel better, so I’m going to go find my next drug,’” said Robb Milano, emergency medical services division chief for the Vancouver Fire Department
Those second overdoses put a strain on emergency responders and have contributed to Clark County’s rising overdose rate. Fire departments in Clark County are implementing new programs to reduce overdoses.
The Vancouver Fire Department has seen a small drop in overdose calls since it received funding from the state in May to leave Narcan — a medication that reverses overdoses — with a patient in case they overdose a second time.
“Really the only thing that we’ve changed is these leave-at-home programs,” Milano said. “So presumably, and anecdotally, we would think that people are utilizing that leave-at-home Narcan and not needing to call 911 for us to come back out.”
Three decades ago, black tar heroin was the drug causing overdoses in Clark County, Milano said. After overdosing, people would go to the hospital almost every time.
But with the rise of synthetic opioids, including fentanyl, overdoses are becoming more common, and more people are refusing to go to the hospital. Although there were 890 emergency medical services calls related to drug overdoses in 2023 in Clark County, only 389 people went to a hospital, according to Clark County’s overdose dashboard.
“We revive them, and they refuse any further care, and they’re typically walking off before we can even finish getting any reporting (information) from them,” Milano said.
First responders are forced to leave the patient, despite the risk of a second overdose.
Narcan and Suboxone
According to the National Institute on Drug Abuse, Narcan blocks the effects of opiates on the brain, which can cause sudden withdrawal. With it comes dysphoria, vomiting, diarrhea and fever.
Leaving Narcan with someone, especially when they refuse further care, may prevent a second overdose if someone uses drugs to alleviate those withdrawal symptoms, Milano said.
Thanks to the Washington State Department of Health, which covers the cost and provides one-for-one replacement of Narcan kits, the department left behind 57 Narcan kits, each containing two doses, from May to June.
Vancouver firefighters hope the program will slow the growing number of deaths in the homeless community, which averages almost one a week.
Milano said first responders in Clark County want to take the program a step further.
Soon, Clark County may be one of the first counties in the nation to offer medication, such as Suboxone or buprenorphine, to treat withdrawal symptoms people experience after overdosing and Narcan treatment.
“What that does is it takes the edge off those withdrawal symptoms, that ‘dope sick’ that most opiate addicts feel, and helps start to change their brain chemistry,” Milano said.
Clark-Cowlitz Fire Rescue is starting a trial with the medication in north Clark County, Milano said, but the program may soon expand to the entire county, pending state approval.
“We wanted to do something different here in Clark County,” Milano said, “to allow all of our paramedics on every firetruck, every ambulance, to be able to administer that so we can get it hopefully in more people’s hands.”
