Q&A: What's it like to be first on the scene when someone has overdosed

Middlesex-London EMS operations superintendent Adam Bennett sat down with London Morning host Rebecca Zandbergen Monday to talk about what paramedics are seeing in the city.  

Here's part of that conversation: 

It's Monday. What have your colleagues been telling you about the number of calls for overdoses this past weekend?

The increase over the weekend has continued from what we've seen throughout the week. There's been approximately four and five times the number of overdoses that we would normally see throughout the year. [That's] just this past week. 

So, how many calls would that be over a 12 hour shift?

That would be between four and five calls per shift.

Is this comparable to what you saw last summer? 

I would say it's on track to be at least comparable to what we saw last summer. It just seems as if it's been ramping up this past week. Hopefully it's an isolated incident and the number will start to slow down. 

What is it like when you arrive on scene and someone is having an opioid overdose? 

When we show up, either the person is still unconscious, and they're having very shallow respiratory rates, or there might be people who are already performing CPR. Now, with the prevalence of naloxone kits in the public as well as police carrying them, a lot of the times the patient has been administered naloxone before we get there. It seems as if maybe the strength of some of the drugs that are on the streets right now are a little bit more intense than what they had been in the past, because they're taking a significant amount of naloxone in order to reverse some of those effects or to increase their respiratory rate. 

• Five men have died from overdoses in the last six days in London, Ont.
• London police officers used naloxone to save 57 people last year

When someone is given naloxone, what happens to them? 

Opioids depress the respiratory rate along with the heart rate. So, as the patient slowly becomes unconscious, their breathing slows down as does their heartbeat. The naloxone will actually remove the drug from that patient's central nervous system, so that it allows the person to wake up, their body to start breathing, their heart to beat a little quicker on its own. We want to use that in order to help increase their breathing rate. That's what you'll see when you give people naloxone. When you give them large doses [of naloxone], similar to what's available in those kits, the patient tends to wake up. So, you're giving them enough to actually undo the high, for a short period of time. 

And then, how long does it take for that person to recover from that experience? 

Well, unfortunately, the naloxone doesn't last as long as the actual drug in their system. So, our concerns are when someone is woken up with a naloxone kit, the potential exists that as the naloxone wears off, depending on how much of the drug they took and when they took it, the drug can still have effects on that patient and that patient can end up unconscious again. That's our concern when we're interacting with patients that somebody else has administered naloxone to: the person thinks that they're fine, but really they do need more medical intervention. They need a follow-up and they need to be watched to make sure they're in a safe environment before that drug is fully out of their system. 

So, if someone is with someone who has overdosed, they've given them naloxone and now they seem okay, they should still call you? 

Absolutely. 

Lastly, you're someone who goes to some of these scene, what is it like for you knowing that there is this spike happening right now? Do you wonder what each night will bring? 

Absolutely. All paramedics are concerned with their patients. Paramedics are very much wanting to help people and help the community. There's an emotional investment into every call that a paramedic attends to. As we see more danger happening within the city, if we see an increase in potential overdoses, we're concerned there will be more deaths.