By Linda F. Willing
Safe Stations, a program begun in Manchester, New Hampshire, in 2016, is an initiative that allows fire stations to be the first point of entry for someone with addiction issues to access help. In jurisdictions that have adopted the program, addicts can come to any fire station at any hour of the day or night and get immediate assistance. According to the program founder, Manchester Firefighter Christopher Hickey, “The idea was to capitalize on the moment when people really want help and are ready to accept it.”
Since the first Safe Station was created in 2016, the program has spread across the United States and saved countless lives. But the program also raises the issue of safety for those firefighters who make that initial contact with people in need.
There may be a significant risk for first responders who encounter synthetic opioids as part of emergency response. This risk can be diminished when equipment and safety protocols are strictly followed.
Equipment and safety protocols for encountering opioids
The Virginia Department of Health recommends, at a minimum, that all first responders wear nitrile gloves for every contact where opioids are suspected to be involved. Where a substance is confirmed to be present, those state guidelines call for gloves, P100 filtering facepiece respirator and safety glasses. The Huntington, West Virginia, Fire Department currently issues goggles, an N95 mask and needle-resistant gloves to every firefighter.
Different safety issues come into play when patients come to the fire station versus when they might be encountered in the field. If anything, the Safe Stations program can improve safety for first responders. As Chief Brian Rhodes, of the Nashua, New Hampshire, Fire Department commented, “I would rather have people come voluntarily to a clean, well-lit fire station” instead of encountering someone under unknown conditions in the field. He pointed out that Safe Stations provide a more controlled environment for all involved, allowing people to get the help they need as quickly as possible.
Still, there are safety considerations even under these more controlled circumstances. Chief Rhodes reported that training protocols dictate that every person who comes to a fire station as a Safe Station be met at the door by a firefighter who initially asks, “Do you have anything on you that could hurt you or me?” Every fire station is equipped with a lock box where any drugs, paraphernalia or weapons can be safely stored.
Colerain Township, Ohio, Fire Department, which instituted Safe Stations this year (they have had Quick Response Teams in place since 2016) has a designated secure room in every fire station for those seeking recovery services. A medical assessment is performed and the decision made whether to direct the person to either a medical facility or a recovery facility. Every Safe Station walk-in is also given a Narcan kit they can take with them in case they choose to terminate the encounter before full assessment and treatment take place.
A network of support for safe stations
In Nashua, law enforcement is not normally part of the Safe Station encounter, but officers are on close standby in case they are needed. However, Chief Rhodes reported that in two years, police officers have only been called once for backup. “People with opioid addiction are down, they want no trouble, they just want help,” he commented. The Safe Station program may be “their moment of clarity, their last hope.” The police department supports an approach where they respond only if needed. “The police department does not want to be a barrier to recovery.”
Even as firefighters handle Safe Station contacts, a larger network is in place behind the scenes. As firefighters notify the recovery agency (Harbor Homes in New Hampshire) to initiate the intake process, an informational page goes out to many others, including the fire chief, the mayor’s office, and other officials. “It’s kind of a backup,” said Chief Rhodes, “so that everyone is in the loop.”
Finally, long-term care for caregivers is an important part of the response to the opioid crisis. The Huntington Fire Department has secured grants to create wellness and self-care programs for firefighters. Nashua FD provides resiliency training for its members.
Keeping Safe Stations safe involves effort and vigilance on multiple levels: making sure first responders have the equipment and training they require, and further, providing support systems for all involved that honor that moment when someone in need may finally make the move to a better life.