Paramedic Peter Canning walks through Hartford’s Pope Park. He picks up empty heroin baggies as he passes by athletic fields, a public pool and a picnic pavilion where a few people appear to nod off.
"The pavilion place is really the place to go,” Canning says. “The people are down there using right now, so we’ll leave them in peace.”
Canning became a paramedic in Hartford in 1995, and he says he’s seen it all.
“I responded to opioid overdoses, but I didn't think anymore of them than I did the shootings or car accidents. It was part of the job,” Canning says.
He started to notice a disturbing trend about five years ago. He found overdose victims unresponsive in the bushes, port-o-potties and on the bench he sits down on. He started to feel like every call he responded to was an overdose. And it gave him an idea.
“I started just writing down the overdoses I did, how old the people were, their gender, how they got started, and then the heroin bags. I would write whether or not I saw heroin bags there,” Canning explains. “And I thought if I was keeping this information, which is really interesting, what if everybody was keeping this information?”
He was not sure how to put his idea into practice until he went to a conference about the opioid crisis in 2017. There, Canning ran into the interim director of the Connecticut Poison Control Center.
“He said, ‘You know poison control, we have operators there 24/7 and this is right up our alley!’”
So Canning and poison control at UCONN Medical Center launched a pilot program for a section of Hartford. Connecticut’s Department of Public Health took notice. It offered federal funding to expand the program statewide and issue monthly reports. Now, poison control will track all of the overdoses all in one place for the first time.
Before this, some hospitals only required Emergency Medical Services workers to report when they administered the overdose antidote naloxone. Now, every EMS worker must call a hotline after any suspected overdose under the Statewide Opioid Reporting Directive, or SWORD. The training consists of a simple 12-minute video.
A man’s voice explains the opioid crisis and the new protocol as a slideshow flashes by.
“How to place the call...THE EMS crew should call Connecticut Poison Control at 1-800-222-1222 and say ‘I have a call for Connecticut SWORD,” the training video says.
Then, a certified poison specialist like Lori Salinger picks up the phone. Normally, Salinger answers calls from worried parents whose kids swallowed something they shouldn’t have.
With this program, Salinger asks EMS 10 questions about the overdose and writes down what happened. EMS can move on to the next emergency call after that three-minute conversation, but Salinger continues to track the patient.
She calls a hospital to check up on an overdose victim and explains the new protocol to someone on the line: “So when they get transported to an emergency room we follow up for data regarding that to help trend it,” Salinger says. “So how’s he doing?”
Salinger enters patient data onto a spreadsheet as she chats on the phone. She says her office handles about eight overdose calls a day just for the Hartford area. Connecticut Poison Control has a grant from the state health department to hire more specialists to man the phones as the program goes statewide.
Out in the community, activists who work with heroin users say these rapid overdose reports save lives. Mark Jenkins leads Greater Hartford Harm Reduction Coalition.
He pulls up an old email from paramedic Peter Canning about a rash of 11 overdoses within two days this past May. The email even includes pictures of street drug baggies branded with logos for different types of heroin.
“These ODs were all separate incidents, one was fatal and the ID’d bags included ‘Pray for Death’, ‘I’ll Be Back’ and ‘Head Games’,” Jenkins reads, “Three ODs were on Park Street in the Frog Hollow section.”
Jenkins says the email came out fast enough for him to send street teams there to hand out naloxone kits and strips to test for fentanyl. That’s a synthetic opioid 50 times more powerful than heroin and it played a role in 75% of overdose deaths last year in Connecticut.
“When we get information like this it’s a heads up to say watch out for this particular bag, make sure you don't use alone,” Jenkins explains. “If you do use together, don’t use at the same time.”
Jenkins wants to use data from the Statewide Opioid Reporting Directive to make the case for more funds for naloxone and other life-saving resources. Advocates and state leaders want to help curb the opioid epidemic. To do that, they need a detailed picture of what’s going on.