Lebanon
But as powerful opioids such as fentanyl and carfentanil — just a few grains of which can cause an overdose, even through inadvertent contact with the skin or by being inhaled — have come to the Twin States, police have had to change the way they approach testing drugs.
“(We’re) telling law enforcement not to touch the stuff anymore,” Jon DeLena, the assistant special agent in charge of Manchester’s Drug Enforcement Administration office, said during a training session at Dartmouth-Hitchcock Medical Center last week.
The event Thursday morning, organized by the Center for Rural Emergency Services and Trauma — a DHMC-based effort to improve emergency care at hospitals in rural Vermont and New Hampshire — offered a chance for first responders, health care workers and social service providers to learn about current drug trends and ways to protect themselves from harm.
The training took place as the country is in the midst of an opioid epidemic, which claimed the lives of 112 Vermonters and about 420 Granite Staters in 2016.
Due to its potency, fentanyl results in many more overdose deaths than heroin now, DeLena said.
Because such a small amount can result in an overdose, the risk of exposure is borne by everyone, not just drug users. Pointing to an incident earlier in the week in which emergency responders had to revive a 6-year-old boy in Manchester using naloxone — the opioid reversal drug — DeLena said, “That’s what worries us the most … accidental overdoses.”
DeLena and another DEA agent held the attention of the approximately 150 people gathered in the DHMC auditorium on Thursday.
Organizers need not have worried that they would have trouble attracting a crowd in the middle of the summer, said Sarah Blum, project coordinator for the Center for Rural Emergency Services and Trauma.
“(We were) really amazed at the outpouring of response,” she said.
Though Matt Herbert, a veteran of the Norwich Fire Department, hasn’t yet been on a call where fentanyl was present, he said a callout for a drug overdose now is more likely than a house fire.
“Fifteen years ago, I wouldn’t have dreamed of this being an issue,” Herbert said during a break in the training.
After listening to DeLena’s description of the way that drug dealers mix fentanyl in a blender with substances such as caffeine or lactose, resulting in some bags with much more of the drug than others, Herbert said drug users are “really spinning the wheel of chance.”
Herbert, who is the safety officer for the Norwich department, said firefighters can’t casually stroll onto a scene without protecting themselves from exposure to opioids. Even if a patient looks like he or she only has a simple sprained ankle, he said, “maybe it’s from drugs.”
Concern from first responders is prevalent these days, DeLena said. The DEA gets calls all the time from law enforcement officials wondering how they should approach a given situation, he said.
Brave men and women in law enforcement “never thought they’d be running from overdoses,” DeLena said.
Upper Valley police and fire departments have adjusted to this new normal by avoiding field testing illicit substances and equipping officers with protective gear.
In Hartford, Deputy Police Chief Brad Vail said officers stopped field testing drugs last year, according to DEA protocol. Instead, officers — wearing gloves — ship bagged samples to a laboratory, Vail said.
Fortunately, Vail said, Hartford officers have so far escaped exposure to fentanyl.
In Lebanon, police and fire officials purchased gloves, respirators, coveralls, boot covers and protective sleeves this spring in response to new guidelines from the Centers for Disease Control and Prevention, said Fire Chief Chris Christopoulos.
In addition, Lebanon firefighters also increased the number of doses of naloxone they carry on ambulances. And Lebanon police have now provided officers with naloxone for managing a possible overdose while working with evidence and even for treating police dogs should they be exposed to fentanyl.
“There have been a number of documented exposures with police K-9s while performing searches,” Christopoulos said.
No Lebanon emergency responders have been exposed on the job, Christopoulos said.
Several employees of New Hampshire’s Division of Children, Youth and Families were also present at the event. Though the attendees declined to be interviewed, Christine Tappan, the division’s acting director, said in a telephone interview that human service providers, like first responders, are on the front lines of crises such as the opioid epidemic.
“Sometimes the public doesn’t understand the types of dangers that our staff faces,” Tappan said. “Sometimes (we) can be in the role of a first responder.”
Because of that, Tappan said, DCYF workers try to follow current trends in safety preparedness.
“(We) make sure that we’re learning what our partners are learning,” she said.
The division’s employees are now equipped with gloves and face masks, said Michael O’Connor, DCYF’s interim bureau chief. Officials have directed staff to put the masks on and leave if they suspect fentanyl is present, he said.
O’Connor said he wasn’t aware of any members of the staff being exposed to fentanyl through their work.
For Jacqui Baker, a substance misuse prevention coordinator for All Together — an Upper Valley-based effort to address substance misuse — the event highlighted the way in which addiction affects everyone.
She pointed to comments DeLena made about how real estate agents now have to ask clients to lock up their medicine cabinets for open houses.
“(Drugs) do touch every part of our society,” she said.
The second half of the training session, which focused on the intersection between the opioid epidemic and sex trafficking in New Hampshire, was led by Michael Posanka, the Manchester-based resident agent in charge for the Department of Homeland Security and Immigration and Customs Enforcement.
He told participants that his agency sees people who are addicted to opioids who are coerced into sex work in order to feed their habit.
These cases can be difficult to prosecute, Posanka said.
Victims may be frightened of ICE and the police, he said. Because they are often addicted to opioids, interacting with police would mean interrupting their routine, another disincentive for them to cooperate, Posanka said.
“If police intervene (they’re) not getting high that day,” he said.
In the past two years, Posanka said, his office has connected 25 victims with treatment, and 12 people have been prosecuted for sex or labor trafficking.
But, he said, the numbers are not all-inclusive.
“It’s such an underreported crime,” he said. “(There are) so many victims out there who don’t realize that they’re victims.”
The Hartford Police Department sent two detectives to the DHMC training and they were particularly focused on the sex trafficking component, Vail said.
“It’s out there,” he said. “We need to be wary of it.”
Valley News Staff Writer Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
