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For the past 24 years, I have been a firefighter
in Huntington, West Virginia.
As firefighters, my team and I are tasked with saving lives
and property
from such disasters as car wrecks, house fires
and also life-threatening medical emergencies.
I am a woman leading a department in a male-dominated profession.
And 10 years ago,
I decided to increase my medical knowledge and I received a nursing degree.
That was because it became clear
that the next big threat facing not only my city,
but other cities around the country,
was not the one-and-done disaster,
where you can ride in like the cavalry, as a firefighter,
put out the fire and leave, feeling like you have made a difference
and everything is OK.
The next big disaster in my city was and is the long, debilitating
and lethal disaster known as opioid addiction.
We now call this a health epidemic,
and we have replaced the name "addiction" with "substance use disorder."
To give you some perspective
of how significant this epidemic has become,
in 2017, in my county of 95,000 people,
we saw 1,831 overdoses
[and] 183 deaths from overdose.
This is the job of my firefighters, as well as other agencies,
to respond to that.
(Coughs)
Excuse me.
So, watching this epidemic unfold for several years,
I developed some insight.
For this disaster, we need to redefine our job as a first responder.
We need to be more than just the cavalry.
We need to do more than just save a life.
We need to find ways to rebuild that life.
And it's going to take a lot of people to do that.
And that is exactly what we are trying to do
in Huntington, West Virginia.
Now, let me give you some insight as to what we do.
First, this is what happens when somebody overdoses.
Imagine you are somebody who is suffering from the brain disorder of addiction.
You are fragile.
You're embarrassed, you're ashamed.
And you overdose.
Maybe a friend or a family member calls 911.
And then all of a sudden,
you are awakened by five or six total strangers in uniform.
And they're rubbing your sternum,
and they're saying, "Wake up, wake up!
You overdosed, you could've died."
Now, would you not be defensive and angry?
Because I know I would be.
And on top of that,
those strangers gave you a dose of naloxone,
which has sent you into withdrawals,
or what is better known as "dope sickness."
Dope sickness makes you feel absolutely horrible.
Some say it's like the flu, times ten.
Nausea, vomiting, diarrhea, body aches.
So not only did we, as strangers, wake you up,
but we also made you feel really sick.
So in turn, you, the patient, are not going to be very kind to us.
And you're going to refuse further medical treatment.
OK, well, then that's going to frustrate the heck out of us,
and we're going to be mad,
because you're ungrateful that we just saved your life.
This is not a good dynamic here.
What we are dealing with is a brain disorder
that changes your thinking.
It convinces you that you don't have a problem.
So, this might have been not only the first time you've overdosed,
it might have been the third, fourth or fifth time
that we, personally, have revived you.
This is not a good situation.
Second,
first responders do not receive much education
on what substance use disorder is.
Neither does the medical community.
We're not trained how to deal with those suffering from substance use disorder.
I am trained to put out many different types of fires.
I am trained to save a life in the moment.
But I am not trained to deal with the intricate interaction
between first responders, the health care community,
social services
and the wider community that is necessary to save a life long-term.
Thirdly,
and this hits home.
As a first responder, I consider myself the cavalry.
We're knights in shining armor.
We want to swoop in, do our job and leave feeling satisfied
that we've made a difference in somebody's life.
But that just doesn't happen
when we're dealing with somebody with substance use disorder.
We leave feeling frustrated and useless.
We deal with the same people over and over again,
with no positive outcome.
And you know what?
At some point, I realized that it is up to us as first responders
and as a community
to solve this problem,
to find better ways to deal with those that are suffering.
So what I did is I started observing more on overdoses.
I started talking and listening to my patients.
I wanted to know what led them to where they are.
What exactly are they experiencing?
What makes their situation worse?
What makes their situation better?
I began experimenting with my words
and paying attention to my own actions
and how it affected those of my patients.
The education that I have received
and continue to receive on a street level in Huntington
has been both eye-opening and life-changing for me.
So, in Huntington, West Virginia, we have come together as a community,
and we are changing the way that we treat
those that suffer from this horrible disease.
We have started many programs, and it's making a difference.
I'll tell you about just a few of those.
Last year, we started a Quick Response Team,
QRT for short.
The team consists of a paramedic,
a police officer,
somebody in the recovery community and somebody in the faith community.
As a team, they go out and visit people who have overdosed
within 72 hours of that resuscitation.
They talk.
They listen.
They build a rapport with that patient,
and they offer them treatment options.
Right now, about 30 percent or up to 30 percent
of those that the Quick Response Team have reached out to
have accepted some form of help.
And the wonderful thing about this
is the first responders who are involved in this team,
they actually feel like they can make a difference.
Positive change where there wasn't any.
This year --
(Applause)
This year, we opened a free-standing specialty clinic, called PROACT,
for those suffering from substance use disorder.
It's a one-stop shop, if you will.
A patient comes in,
they're immediately assessed by somebody who's an addiction specialist.
They work with them to provide treatment options
based on their own needs, individual needs.
This does several things for us.
It gives first responders a place to either take or refer our patients
who are no longer in a life-threatening situation,
that have refused to go to the hospital.
And it also clears up
the overwhelmed emergency rooms in hospitals that we have.
The third thing that I want to tell you about
is very dear to me and very important to my team.
We recently started a first responders self-care program.
More and more ...
first responders are experiencing compassion fatigue and PTSD.
It is not uncommon for the average firefighter in Huntington
to deal with or see up to five young deaths per month.
These are their friends, these are their classmates.
So this much-needed program will not only recognize their hard work,
it's going to give them a voice.
It's going to provide them with training
that will help deal with the stress that they are under.
And it will give them more mental-health options
that they desperately need.
We now have yoga classes in fire stations.
(Laughter)
(Applause)
We've also provided on-duty massages, which is fabulous.
(Laughter)
And we have some off-duty programs that we've started,
like cooking classes for first responders and their significant other
and pottery classes.
So a couple of months ago,
I walked out on the apparatus floor, where I had some firefighters.
And half of them had had a massage,
and the other half were getting ready to have a massage.
And I saw 10 firefighters who were bantering
in a very positive, relaxed manner.
And I hadn't seen that in years.
And that relaxed state is trickling down to the community, to the citizens.
So a couple of weeks ago, I had a neighbor overdose.
Twenty-two years old.
So of course, I hurried down to help my firefighters and my neighbor.
And what I witnessed was my firefighters being supportive.
Talking in a non-judgmental way.
I watched as one of my firefighters
showed the father and another family member
how to provide rescue breaths, should this happen again.
And left him with a bag valve mask.
Positive change.
Positive change.
Did I happen to mention
the two things that firefighters dislike the most?
The way things are and change.
(Laughter)
You know, I recognize that there have been drug epidemics before.
And I've seen what crack can do to a community.
A lot of our critics think
that this new compassionate response that we're doing in Huntington
is because of race.
That because the overdoses are happening so much to the white community.
And I understand that criticism,
because we as a country messed up.
And we treated black people poorly during the crack epidemic.
We can't forget that.
And we must do better.
But right now, what I know is people are dying.
And we in Huntington deal with people suffering from substance use disorder
of every color and every background, on the streets, every day.
The job of a first responder: prevent unnecessary deaths.
Period.
So ...
Obviously, I'm a stubborn firefighter and nurse.
And I refuse to believe that there isn't a way around every barrier.
One of the barriers that we have
dealing with the opioid epidemic is stigma.
So ...
We in Huntington, West Virginia, are showing the rest of the country
that change can happen.
That there is hope dealing with this epidemic.
Our current overdoses are down 40 percent.
(Applause)
Currently, our overdose deaths are down 50 percent.
(Applause)
This epidemic is far from over.
But each and every one of us has a part to play in this epidemic.
Just by listening and being kind to somebody,
you have the ability to make a difference in their lives.
Thank you and God bless.
(Applause)
コツ：単語をクリックしてすぐ意味を調べられます！

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【TED】ジャン・レーダー: オピオイド危機で 命を救うために必要なこと (In the opioid crisis, here's what it takes to save a life | Jan Rader)

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林宜悉 2019 年 1 月 23 日 に公開

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