THE OPIOID CRISIS: What it’s like for paramedics


By Laurie Hamame - lhamame@aimmediamidwest.com



LifeCare Ambulance paramedics Andrew Harmon and Zack Tomasic administer a pain reliever to a patient while we ride along and discuss Lorain County’s drug epidemic.

LifeCare Ambulance paramedics Andrew Harmon and Zack Tomasic administer a pain reliever to a patient while we ride along and discuss Lorain County’s drug epidemic.


Laurie Hamame | AIM Media Midwest

Reviving most overdose victims require six boxes, or 12 milligrams, of naloxone. Pictured here is a two-milligram dosage.


Laurie Hamame | AIM Media Midwest

The ambulance company, which serves Lorain County’s largest cities, gave us an inside look at what it’s like to respond to emergency calls in the city.


Laurie Hamame | AIM Media Midwest

I bit the inside of my cheek — a nervous habit — as I followed two paramedics into what looked like an abandoned, dilapidated Lorain home.

In the narrow stairway, ragged shower curtains flapped over windows. Layers of adhesive tape clung loosely to the edges.

My camera bag bounced against my leg as we ascended to the second floor. My hands wrapped tightly around my reporter’s notebook and pen.

My day didn’t begin at the office as usual. Instead, I was buckled into the third seat of a LifeCare ambulance, speeding down busy city streets with sirens blaring.

We arrived at the house just after noon for a possible overdose. My hosts, paramedics Zach Tomasic and Andrew Harmon, expected the usual culprit — heroin.

We stepped into an apartment, empty except for dozens of bursting cardboard boxes stacked along the walls. A white kitten with a red bow trailed between my feet.

Two police officers stood in the bedroom talking to someone I couldn’t see. Tomasic and Harmon joined them to exchange info, and I stayed in the living room, moving so I could see the scene play out in the reflection of a mirror.

I watched as a young woman’s body began to shake. Once the first tear broke free, the rest followed in an unbroken stream.

“I’m sorry. I’m so sorry. I’m sorry. So, so, so sorry. I’m so sorry,” she sniffled.

“For what?” Tomasic asked.

“For everything,” she sighed, clutching a bottle of anxiety medication. Luckily, heroin wasn’t in play here, but that didn’t mean everything was all right.

“Do you have any friends or family?” the paramedic asked.

“No,” the woman said, crushing a joint in a nearby ashtray. “I have no one.”

I closed my eyes and took a slow, focused breath, heart aching for this stranger. She was 23 — my age — still so young. I wanted to know who hurt her, and what I could do to fix it.

On our way to Mercy Health Lorain Hospital, we drove over cracked roadways, past windows with gunshot holes, and near deserted shopping strips. I couldn’t help but think about how easy it would be to fall in with the wrong crowd in a place like this.

Heading back to home base at the corner of West 23rd Street and Broadway, I asked Harmon and Tomasic how they can handle the human suffering they see every day. Do they get emotional? Does their blood run cold when they see a body on the floor, lips and fingernails blue from oxygen deprivation — heroin’s telltale sign?

My question was met with a scoff. “No, no, no, no. That’s long gone,” Harmon said. “You do it enough and it gets normal. It’s just a job.”

Tomasic chimed in from the passenger seat. “It used to be a big call. You’d hear it and be like, ‘Oh my god, it’s an overdose.’ But now, it’s not different than going on a general illness call. It’s kind of weird.”

When paramedics hear the patient is “unresponsive,” they immediately suspect drugs. A large number of calls — up to 15 a day — are overdose-related, but the days of zero calls are rare now.

“I don’t know if people really know how many there are,” Tomasic said. “Even if the news tells them, I don’t think they grasp how big of a problem it really is.”

If an overdose is in play, patients typically are barely breathing, on the verge of respiratory arrest. They’ve often turned blue from cyanosis and their pupils are the size of pin-pricks.

“The border between overdosing and just high is not very wide,” Tomasic said. “They pretty much want to be unconscious, but it doesn’t take long after that for them to stop breathing, so they are teetering. The perfect high is just almost dead.”

Syringes, spoons, needles, and cotton balls are normally nowhere to be found. It’s pretty standard for other drug users to pack all the evidence and leave before calling paramedics.

Harmon recalled a time when a woman was thrown out of a car on the highway because she overdosed. Her friends drove away before calling 911 and pretended to be bystanders.

This is the first of many stories I heard during my ride-along. The LifeCare workers’ willingness to talk about their experiences revealed, in stunningly work-a-day tones, just how commonplace these overdoses are.

The two remembered finding a patient with frozen kielbasi falling out of his pants. The trousers were stuffed with frozen food by well-meaning but misguided friends or family who believed the myth that the cold would end an overdose.

“We’re tired of seeing people soaking wet,” Harmon said — water cannot bring someone out of an overdose, either, as some believe. But it can cause them to drown, and will definitely create a slip hazard for emergency responders. Water will also make it harder to start an IV or make tape or electrodes stick.

“Just leave them where they are at and call us. There isn’t Narcan in Lorain’s water,” he said.

Maybe there should be. LifeCare crews in Lorain stock their kits with naloxone — Narcan is the brand name — but as endless varieties of opioids such as fentanyl and carfentanil hit the market, the supply is getting slimmer.

When Harmon first started working for the Elyria-based ambulance company, paramedics used to carry only one box, or two miligrams of naloxone. Now there are six boxes per truck. Most overdose victims need a full 12 milligrams to wake up.

Without the drug, Harmon said the body count would be even higher.

Paramedics said they spend their days and nights experiencing deja vu, reviving the same addicts over and over again. The conversation almost always starts the same — “Do you know what you took?”

Rarely do people wake up and acknowledge their brush with death. From “I’m just drunk” to “I was napping,” Tomasic said he’s heard all the excuses.

Sometimes he’ll hear someone say, “I tried to buy heroin but I’m guessing they sold me fentanyl.”

Heroin’s more lethal chemical cousin thrusts drug users into a daily gamble with their lives and many are in too deep to fight back.

Lorain County coroner Stephen Evans lives with the death toll every day. He said the overdose volume has boomed 10 times over in the past decade. Fentanyl is largely to blame, but users can’t stop what they can’t detect.

There are so many variations, like carfentanil and 3-methylfentanyl, that authorities are struggling to track them and police and coroners are struggling to identify them. As the variants spread, the number of dealers multiplies.

“We asked a guy that overdosed, ‘If we let you out right here, how hard would it be for you to find heroin?’ and he said, ‘Within 20 minutes, I’d have a fix,” Tomasic said.

As deaths continue to mount, some EMS providers think a tough love approach is a much-needed reality check to scare addicts into recovery.

“If you’re ever actually going to kick this, you need to pretty much restart your life,” said paramedic Mike Abner. “You can’t live in Lorain anymore, you can’t even live in Lorain County. You have to get rid of all of your friends. All your friends that you hang out with, even when you’re clean, they’re doing heroin. Why would you stay around that?”

I talked with a group of paramedics between dispatcher calls and cups of coffee. Soon the overriding opinion in the room was clear: After years on the front lines, the professionals are fatigued by the endless overdose calls.

“Sometimes we go to the same place multiple times a day, multiple times a week. And I’m like, ‘You know what this will do for your body, you’ve been to rehab and you decided to put yourself back in a terrible situation.’ I used to have so much sympathy but now I’m just like, ‘You know how to make the change, but you just don’t want to do it,” said Kati Kinder.

As a parent, she feels bad for the young kids who have no other support system than the friends who enable them.

“I’m sorry but it’s hard to find sympathy,” said Daniel Fern. “We still try to be humane and try to have empathy for that person, but it’s difficult. It really is.”

Paramedics that get emotional don’t last long, Don Crocker said. He’s seen people walk out after just one day on the job.

In 10 years of being an inner-city paramedic, he said he’s seen so many awful things that he can’t remember which is which. Someone could die horrifically and it won’t sit long in his memory.

“Doing the job doesn’t affect most of us. It’s another day in the office,” he said.

There are addicts and recovering addicts in our midst — not just in Lorain but in rural Pittsfield and Brighton, in middle class Amherst and Avon, and in white picket fence Wellington and Oberlin. But for many folks, continued news of the opioid epidemic has grown numbing.

So it was clear, after eight hours talking to paramedics about heroin, why their reactions to it were almost lighthearted. I can almost understand how those calls have become routine. I can’t dismiss the paramedics’ dark humor.

But Lorain County has a problem, and by all accounts by experts, it’s not getting any better.

Readers, you cannot turn away from this. Heroin and its opioid cousins are killing people. We have all made some mistakes in our lives, and perhaps addicts can recover from a nearly fatal one.

Laurie Hamame can be reached at 440-775-1611 or @HamameNews on Twitter.

LifeCare Ambulance paramedics Andrew Harmon and Zack Tomasic administer a pain reliever to a patient while we ride along and discuss Lorain County’s drug epidemic.
https://www.theamherstnewstimes.com/wp-content/uploads/sites/43/2018/01/web1_LC3.jpgLifeCare Ambulance paramedics Andrew Harmon and Zack Tomasic administer a pain reliever to a patient while we ride along and discuss Lorain County’s drug epidemic.

Laurie Hamame | AIM Media Midwest

Reviving most overdose victims require six boxes, or 12 milligrams, of naloxone. Pictured here is a two-milligram dosage.
https://www.theamherstnewstimes.com/wp-content/uploads/sites/43/2018/01/web1_LC1.jpgReviving most overdose victims require six boxes, or 12 milligrams, of naloxone. Pictured here is a two-milligram dosage.

Laurie Hamame | AIM Media Midwest

The ambulance company, which serves Lorain County’s largest cities, gave us an inside look at what it’s like to respond to emergency calls in the city.
https://www.theamherstnewstimes.com/wp-content/uploads/sites/43/2018/01/web1_LC2.jpgThe ambulance company, which serves Lorain County’s largest cities, gave us an inside look at what it’s like to respond to emergency calls in the city.

Laurie Hamame | AIM Media Midwest

By Laurie Hamame

lhamame@aimmediamidwest.com