EXCHANGE: On the front lines of the opioid crisis

KANKAKEE, Ill. (AP) - Dispatch gives him an address and a quick brief.

A person is unresponsive and not breathing. They are in a home. A restaurant bathroom. The side of a street.

That scenario is how Cory Chase begins his job. The 39-year-old Riverside Healthcare paramedic gets in an ambulance and heads to the scene, ready to save a life.

When he hears "unresponsive" and "not breathing," the scenarios run through his head. The past few years in Kankakee County have him thinking this could be an overdose.

He arrives on the scene. The quick details turn into reactions. The training kicks in. Then comes the realization. He just saved the life of an overdosed former high-school classmate.

"Through dispatch, we only know there is a possible overdose. You don't know who it is," Chase said. "Then, you pull up. You look down, and you see somebody you recognize. You see a friend, someone you went to school with, someone you trained; and it hits you. It's tough."

These calls have become more frequent for Chase the past few years as heroin, fentanyl, carfentanil and other opioids have swept through the area.

"This is a problem that has gone from the shadows of America into everyday USA," Chase said. "If you are a human, it's a problem you face. It can impact anybody's family. The people overdosing are not the typical 'junkie' you see in a movie. They are people who will sell you a car; people who will clean your house; people who will watch your kids, teach them or drive them to school. There are no boundaries with opiate addiction."

In 2017, a record 56 people died from overdoses in Kankakee County. That overdose death rate per 100,000 people was more than three times greater than Will County's.

Kankakee County Coroner Bob Gessner responded by bringing in anti-addiction speakers Tim Ryan and Nick Morgan, who were former heroin addicts. Gessner visited schools, churches and businesses to speak about the opioids crisis. He and other county leaders held several public forums to discuss the issue.

Along with some key drug busts, those efforts nearly cut the overdose death rate in half in 2018, when 29 people died. That decline was the first time the yearly overdose death total dropped since 24 people died in 2014.

While the decrease provided a morale boost, first responders still see the threat opioids pose to the area, especially with fentanyl and carfentanil. Of the 29 people who died from overdoses in 2018, 20 had fentanyl in their system.

The presence of fentanyl, a painkiller often prescribed to people with terminal cancer, and carfentanil, a substance used in elephant tranquilizers, has caused first responders to administer more Narcan to reverse overdoses.

Paramedics with the Kankakee Fire Department once had to administer six doses (12 milligrams) of Narcan to revive someone from an overdose.

"These people are as close to dead as you can get when we arrive," said Jed Beaupre, the Kankakee Fire Department's EMS coordinator. "They are only breathing a couple times a minute.

"I have noticed that since 2015, we have had to give more Narcan to someone who overdoses. The only true way to assess it is, you give them a dose. You wait 10 to 20 seconds. If that doesn't work, you give them another one. If that doesn't work, you give them another dose."

While overdose deaths are a concrete statistic, it is more difficult to assess how many people are saved by emergency responders with Narcan, for several reasons.

First, Narcan does not have an effect on someone who is not overdosing. So, first responders can administer it to an unconscious person having a heart attack without harming them. As a result, Narcan has been used more frequently on people who are unconscious for unknown reasons.

Also, Narcan is sold over the counter. It is not prescribed. Anyone can buy it at a local pharmacy. That enables people to administer it inside their homes rather than taking a trip to the hospital.

Last year, Gessner's office found Narcan strapped to a deceased man's leg with instructions on how to administer it.

"Addicts want to go to the place that is close to death," Gessner previously told the Daily Journal. "They want that euphoria, and fentanyl gets them there. They set themselves around people with Narcan and designate someone to administer it while others shoot up."

When he trained at the Illinois State Police Academy, Bourbonnais Patrolman Davis Domagalski heard his instructors talking about the drug epidemic in Kankakee County.

In his two years as a police officer, Domagalski has saved three people from overdoses by administering Narcan.

"It's not what I expected 10 years ago when I told my mom I wanted to be a police officer," Domagalski said. "I thought I would be off chasing bank robbers. Now, we are doing that along with some medical duties."

The opioid situation has caused police and paramedic duties to overlap. In 2015, the Kankakee County Coroner's Office received a grant to equip almost every officer in the county with Narcan.

That practice has saved several lives. In 2017, police were credited with 27 saves by administering Narcan. Last year, they saved 18 more. Those numbers include a man who Bradley police revived three times in the same day at three different locations.

"It's not police being police, firefighters being firefighters, or paramedics being paramedics anymore," said Al Ponton, Riverside's EMS director. "Our jobs are overlapping. We are all working together."

That evolution is one local police have welcomed, especially in rural areas. Officers tend to arrive on scenes before ambulances since they already are out on the road. That timing helps save lives.

"When I began my law enforcement career 18 years ago, we had pump-action shotguns in the car," said Bourbonnais police Detective Andy Cox, who also is a paramedic with Riverside. "As crime changed, so did we. After the LA Hollywood shootout, we were carrying weapons to deal with active shooters who wore body armor.

"On the medical side, we were fighting marijuana, cocaine and opium. Then, all of the sudden, we had this opiate epidemic upon us. From that, we have become more like medical first responders. That is empowering. We are no longer standing around, waiting for paramedics to arrive. We are intervening sooner to help someone stay alive."

Manteno Patrolman Chris Reynolds felt that empowerment last December when he not only administered Narcan to a woman who overdosed but also performed CPR.

"It was exhilarating," Reynolds said. "I saw her on the ground. She was turning colors and not breathing. My adrenaline was going crazy. I was just trying to slow down and remember the training. In that moment, everyone is around you, screaming, wondering if that person is going to be OK. You're just doing your best while someone's life is in your hands."

And it can be a rewarding feeling. A woman Domagalski saved from an overdose earlier in his short career wrote him and another officer a thank-you letter.

"That was uplifting," Domagalski said. "Not every situation is like that. But after a save, some of the guys in the department will come up and say, 'Nice save.' That gives you a boost."

It's a common question many people ask on social media when news outlets report on overdoses: Why save them?

For first responders, the answer almost is second-nature: Because they are human.

"Everyone has a job to do," Chase said. "A utility worker doesn't get to choose when to go out there and fix a line. There could be a tornado. People need power. It's your job to bring it back.

"As a paramedic, it's my job to save lives. It's not my job to judge who I am taking care of. I'm not a judge or jury. I handle emergency situations. I have to make sure they stay alive. Whether it's a heart attack, broken leg or drug overdose, I need to keep them alive so they have a chance to change."

When asked that question, Domagalski thought about a man he saved from an overdose. The man broke his back several years before he overdosed. He went from taking pain pills to scoring street drugs.

"If that guy never broke his back, he could be working at the Bourbonnais Police Department or Daily Journal," Domagalski said. "People go through certain life circumstances that affect their outcome. They are human beings. All humans make mistakes. So, I think everyone is worth saving."

And for the critics, Cox has a message:

"Everyone needs to realize this is a glass house we are living in," he said. "Did you make the right choice every day of your life? Nobody who walks on this planet can say they have. Everyone is doing the best they can with what they have in front of them. Some people struggle and fall. But as a society, we need to put a hand forward, help people get up on their feet and make each other productive citizens."

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Source: The (Kankakee) Daily Journal, https://bit.ly/2T4wpJk

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Information from: The Daily Journal, http://www.daily-journal.com