Guest Editorial: Help Received, Help Given

“I’m an alcoholic.” 

I heard those words from my coworker Brian, and I was surprised. How had he been able to keep this under wraps for 20 years? How did I miss all the signs? So much for my being a superobservant paragod. 

Brian tasted his first beer when he was 15. He liked it a lot. At that time he was working in a marina at the big lake in New Hampshire. One of his duties was filling the store’s beer coolers. That was a way to get beer. Emptying 12-packs of soda, he would slide in 2 six-packs of beer. Leaving work, he would pay for the soda. 

Life was good. Brian grew up in Tuftonboro, New Hampshire, outdoors all the time. His father was police chief. Growing up he wanted to be a game warden; then he checked out an EMT program. Go to the ambulance garage, hang out, go on a call once in a while? He could do that. 

One day the ambulance responded to a neighboring town. The patient was more critical than the crew could care for. They requested a paramedic intercept. When the paramedics showed up, looking cool in their red jackets, it was all over—Brian was going to be a paramedic. 

He took an EMT-B course in his senior year, then passed his National Registry exam on his 18th birthday. The next year he was accepted to an accredited paramedic associate degree program at the local community college. He obtained his degree in emergency paramedicine. After graduation he was hired by the service with the cool red jackets. He worked with a young crew like himself, the 3–11 shift. After work they would close down the local bars. 

Life moved along. He met a nurse, and they married and bought a house. Two years later he was hired by the Laconia Fire Department as a firefighter/paramedic, his dream job. He and his wife started a family, but the stress of adulthood was wearing on him, and his drinking increased. He felt socially awkward not drinking. He’d get upset when it was his turn to be the designated driver. His marriage was straining, and he was having problems at work. 

One day his chief called Brian into his office. He suspended Brian from duty for an alcohol-related offense. The chief encouraged Brian to seek help. While on suspension he went to his first AA meeting. Brian proceeded through the 12-step program, 90 meetings in 90 days, with his chief’s support throughout. Those meetings continue today.

By 2015 the opioid crisis was devastating Brian’s community. The police and fire chiefs began discussions about an outreach program. They created a position for a recovery coordinator. Brian’s chief designated Brian as the fire department’s representative. He got a city cell phone, two hours of overtime each week, and a box of business cards. 

The team found itself fighting the stigma of addiction. Eight out of 10 substance abusers won’t reach out for help. The No. 1 reason Brian found for his patients feeling stigmatized? The police and fire departments, paramedics, nurses, and doctors. Too many think addicts are bad people. 

Brian and his partner put on training to teach both departments’ staffs to recognize substance use disorder. In the beginning there was pushback, but over time everyone came around. Now there is a recovery coach on every shift. If a patient declines transport, the crew leaves naloxone with the family. The program focuses on being proactive to head off trouble—one point of contact, helping with navigation to recovery programs, making sure no one slips through the cracks, all with full support from police and fire and hospital leadership. 

Since this program started local overdoses have dropped roughly 50% per year for several years now. The team has also helped increase knowledge about addiction through radio PSAs and increased PR. More than 500 patients have gone through the program. Some have become productive members of the community; some have relapsed. It can take multiple tries to be successful. 

It isn’t just the general community that has a substance abuse problem—it also runs among first responders. Three of 10 have alcohol/substance abuse issues and marriage problems. Two-fifths of EMTs engage in high-risk use of drugs and alcohol. The US Fire Administration estimates 10% of firefighters abuse drugs and 29% abuse alcohol, compared to 6.6% of the general population. An estimated 30% of first responders develop conditions like depression, PTSD, and suicidal thoughts, compared to 20% of the general population. Brian provides peer support to members of his department too.

Now 11 years sober, Brian feels gratitude for maintaining his sobriety and the support he has received. He has achieved the rank of lieutenant in his department. He spends as much time as possible with his wife and children at their camp in Pittsburg, New Hampshire, hunting and fishing. His wife, Dawn, is better at both.  

Mike Kennard, EMT-P, I/C, has been in EMS for more than 44 years. He is a retired paramedic from Frisbie Memorial Hospital in Rochester, New Hampshire and also served as assistant chief for Nottingham Fire and Rescue. He is still active in EMS education. Contact him at grumpy1medic@gmail.com.