America in Crisis Breaking the Cycle of Addiction – Episode 38 Ted Lane and Lisa Maccario

Welcome to episode 38 of America and crisis breaking the cycle of addiction my name is David Hunt and I am your host please see your DVI to record the show could save your child’s life according to the Department of Health in Massachusetts we have had over 2,000 opioid related deaths in

2023 today we will be talking about the latest deadly subst found in opioids xylazine the street name is Tran it is an animal tranquilizer it was never intended for humans it is found in eight out of 10 opioids that contain fentanyl over the summer I attended a webinar put

On by Boston Medical Center about xylazine with what I learned I put on a presentation for the middle sex district attorney Marian Ryan’s opioid task force and last week a live presentation for the Beverly Emergency Management agency and the Beverly sir team if you think you are buying only

Heroin or an opioid you are so wrong our guests are experts in this field we will hear from the people that actually know what they are talking about today’s guest our offic at Ted Lane of the Beverly police department and Lisa Macario of Beth Israel Ley Behavioral

Health I met Ted on a training webinar he taught last week and I knew he just had to be here today officer Ted Lane is a certified paramedic for 29 years as a paramedic Ted worked for a private ambulance services and hospital-based services as well as a flight medic for

Boston medflight Ted has been full-time with the Beverly Police Department for 19 years Ted is trained in mental health first aid and Crisis Intervention team known as CIT Ted is trained as an instructor for CIT Ted also serves on nck critical incident stress management team Lisa marcario is

A clinician for Beth Israel Ley Behavioral Health Services she is currently embedded in the Beverly Police Department Community impact unit where she co-respondents with law enforcement to provide behavioral health support and follow-up care to residents of Beverly and ipswitch Lisa has 25 plus years experience in client directed trauma focused Crisis Intervention

Stabilization and treatment and the Balo that includes community-based program development and implementation she and Ted are both certified CIT instructors as well as cism with nck response liser also works for Riverside Community Care Incorporated with their trauma Response Center and with nine wise incorporated as a trainer consultant lastly she sits

On the advisory boards for Essex County Outreach and not the center for occupational health and safety Ted Lisa welcome to my show Ted let’s start with you you’ve got quite an impressive bio and introduction here thank you now you’ve been with the Beverly police for 19 years how is the drug crisis

Progressing year to year um I think probably about 10 years ago we saw a spike in some deaths and everything and a lot of that had to do with the mixture of fentanyl into the drug stream um right now heroin almost doesn’t exist at all fentanyl has pretty much taken over

All the Death so the drugs are much stronger so we’ve been needing to use more Naran to reverse the drugs so we’re seeing a lot of that um we’ve also started to take more of a proactive approach police officers have always been reactive yes and we’ve always you

Know treated them overdose at the scene and then we kind of separate ourselves from it we’re also not not arresting people for possession of needles we’re not arresting people who call 911 so it’s safe to call 911 if you have an emergency and you need something like

That and then we’re also starting to get a little bit more into the preventative part and also working post overdose with recovery coaches and harm reduction coaches so we’re kind of thinking a little bit more outside of the box as police officers which is a little bit of

A stretch for some of our our guys but we’re getting there and we’re making progress and I think that’s the only way to handle this problem because you can’t just treat an overdose and then expect it to go away cuz it’s just going to repeat itself and I noticed in your

Resume you also an instructor cpri n can all that have all your officers been taken that type of training correct yes so um as a paramedic for almost 30 years now uh prior to getting on the police department I had 10 years working as a paramedic so I’m one of the lead

Instructors along with Lieutenant panani who’s also another paramedic and we have a couple other instructors on our department but we do all the CPR first resp responder AED and Naran instruction for the Department I know how ambulances do get tied up especially after the tragedy and win up when the ambulance

Are out on a call and it’s nice to know your offices can startop get the ball rolling until the actual Transportation gets there absolutely yeah we’re often the first ones on scene so having the AED or Naran can make a big difference and you know when things are time

Sensitive especially with the N can I understand that’ll revive them actually on the scene rather than wait to get to the hospital yeah it’s a it’s a pretty amazing drug when used appropriately and it’s not it’s not an end all Beall um type thing but it certainly has saved

Many many people it’s nice to know what 10 20 30 cruises running around compared to one or two ambulances right the chance of getting help right away yes yeah definitely all of our Cruisers have Narcan in them uh along with AED so any officer not just myself or anything but

All of our officers are trained and it took a little bit of a curve to get used to it but I think right now now our officers are very quick to get out the Naran and assist I really don’t know one officer that would sit there and just

Watch and not do everything in his power absolutely help save that life correct now you’re part of the uh Community impact unit can you explain to our viewers what that is please so the community impact unit is a part of the police department that’s trying to take a different approach to dealing with

Police type issues and we’re also dealing with all Community issues so our goal is to you know be there for the community the community be able to reach out to us also deal with a little bit of the more vulnerable population in the community our unhoused our mental health

Our substance use and alcohol use disorders but in general we kind of cover everything we work with different units and or groups within the city we work with the public health department on things like hoarding if there’s someone who has a hoarding issue so I I have my particular Niche and that’s

Obviously working with Lisa and doing a lot of the mental health stuff the substance use alcohol use disorders but um we kind of we’re pretty kind of cover a lot of a lot of area and how’s that made a difference in the community I think people are much

More willing to approach us and be willing to reach out for help um working well with the unhoused population create a good rapport with them try and get them assistance and anything that they’re willing to help with I think in the mental health field we have a lot of

Patients or clients that we see kind of repetitively so they get used to seeing our faces and training our officers so I think it’s it just makes the police department a lot more approachable and not always like you know they’re here to arrest us or they’re here to you know so

Appro they can call the police it doesn’t have to be an emergency it it could be something that they just need assistance with mean I was growing up the police basically had one role if he did something wrong they would come in either teach you a quick lesson right

There in the spot read you the riot act absolutely take you away and that was their role basically and now you’re responding to emergencies you’re doing Medical how is this difference in the 10 20 years since I grew up made a difference in the community with everything that you are offering to the

Community I think one of our big goals like you said that was the same when I first started but our goal especially with mental health and substance use is jail diversion our goal is not to send people to jail not to arrest them and that’s difficult for some people to

Understand and even some of our officers to take that approach and everything but our goal is to get them the help that they need get the services in place of avoid transporting everyone to the hospital CU before especially with mental health police officers only option was an ambulance to the hospital

Now we can co-respondents um the our community behavioral health centers or different programs that the people might already have in place we can facilitate and kind of fill in some of those gaps and cracks and prevent someone from having to go to the hospital or having to get arrested

And go to you know Court Court in jail and have to go through that route what other the things in mental health is so important that the role you’re doing now compared to what you did 20 years ago I think there’s a lot more of it uh you

Know Co certainly we saw a spike in mental health issues with that I think it’s just um and we’ve seen other instances where in the United States where things people with mental health issues and it’s gone poorly um and our goal is to prevent that from happening

To be able to go in slow things down deescalate not go Hands-On not have a bad outcome try and get people the services and things that they need in place as opposed to the oldfashioned you know police come in we’re going to arrest you handcuff you and you know

Type situation so I think it’s important to have that attitude going in being able to deescalate and just slow everything down just be calm now we spoke about the first day that your offices have been trained in I know there are other courses throughout the years that are being offered to uh the

Police department can you tell us what some of those other courses are and what type of training that they actually have in addition to just the first aid um so me along with the mental health portion of it is um a course called um Crisis Intervention team and that’s something

That we’ve been working on and we’ve both gone to training and become instructors in Crisis Intervention team and the it’s a 40-hour course when we teach it and the whole purpose of that is to uh train officers in a very brief overview of all mental health disorders and that can include developmental

Disorders autism other other things just so that officers are kind of aware of the different spectrum of ways people might respond and a big portion of that is deescalation slowing things down talking to the person introducing yourself saying your first name coming in and saying in instead of wearing a

Big bulletproof vest and this is what I wear when I go out to a call I try and keep it as lowkey as possible I go in I say hey I’m Ted what’s your name and uh and people are like oh okay and it’s kind of like disarming and just kind of

Bringing everything down a little bit so um our goal is to train a good portion of our officers we’re not shooting for 100% but um we’re going to work within our department and we’re hopefully doing most of Essex County and to train them and create a team approach to mental

Health now a lot of times the police do arrive first to the medical services if I down on the ground not breathing no response what basically Walkers through with that officer can do it for me what’s he trained in so we’re trained in CPR so the first thing would be to

Determine whether the person is responsive breathing has a pulse if there’s no pulse they would go right into CPR we have the aeds they’re very our officers are great with that that took a little bit of a learning curve but they’ve been on the in the vehicles

For well over 10 years now so aeds are like and if the person is breathing we’re trained to recognize signs of an overdose the pinpoint pupils the decreased respiratory rate the cyanosis of the lips or blue fingers and immediately administer Naran and the other big thing that I push with all my

Officers is ventilations Absolut so we have a everyone’s trained in how to use a bag valve mask Naran and we’ll talk a little bit more about it there’s some other Naran is a great drug and it helps reverse narcotic overdoses but there’s other things mixed in sometimes alcohol

Um benzo xylazine so it’s not always going to be the end all be all so I always emphasize Airway Airway Airway ventilation we carry oxygen we carry bag valve masks um we’re you guys are prepared now you’re also with nck what do you do with the critical stress with

Nck um so the critical incident stress management team is through the uh New England or Northeast law enforcement Council I’m trained and Lisa’s also trained in uh group and individual um therap not therapy but um what’s the best word group individual treatment and so our goal is to we do different things

We do a diffusing or a debriefing and that’s we basically come in after a critical incident so a police department within our catchman area has a really bad accident maybe a child is a pedestrian child is killed and it really affects the officers having that seeing

That stuff over and over and over again we’ve learned that it does affect us we are people we uh we feel we grieve um so in order to prevent that we have these de briefings where officers can say in a safe environment how they feel what bothered them we talk about them it’s

Not a Critic it’s not we don’t say oh you did this wrong or this right or anything it’s just a time for officers to be able to get that off their chest and feel a little bit better about it afterwards and if necessary there are resources for further treatment and um

We work with clinicians officers and we also involve clergy with that too right now when I first was talking to you I’d asked you to send me in a bio introduction for about 30 seconds and Ted sent me in a 7 and a half minute

Bio so there’s a lot of stuff on there that obviously I did not come with the introduction I think that’s important that you just like to share with our viewers what your level of terific are some training you’ve done you graduate if you could take about another 30

Seconds 30s I know I owe you 7 Minutes uh real quick my U BS is in biology I kind of was thinking the Premed route but after college went to paramedic school at nor Eastern graduated from nor Eastern in 1995 January 95 as a paramedic worked for as a paramedic for

10 years then got on the I used to work for Boston medf flight which I I that was an amazing job very educational above and beyond um even like as a paramedic the stuff that we learned and then I joined the police department and got my master’s degree in criminal

Justice with the certificate in forensic psychology and from there just have continued to go on to take more continu education classes the grin classes the CIT classes I it’s just that’s my Niche I kind of the mix of police and paramedic kind of make me fit into that

Category I think a little bit well said Thank you short and sweet short and sweet I had the them from Jeopardy going through my mind just 30 seconds I’m cutting right there okay now T Beverly seems to have a lot lower number of incidents overdoses of fatalities than a lot of the

Surrounding communities what can you basically attribute that fraud I think honestly part of it is we are fortunate in that our numbers are lower we tend we have less overdoses um we we’re smooshed in between Gloucester and Lynn and Salem some bigger cities that have a much

Higher problem so part of it I think is just our population so we’re fortunate in that I think the other thing is you know we’ve been trained in Naran so preventing deaths that way and I think our new approach of just doing followup prevention working with harm reduction and Recovery Services so we

Work with one stop out of Lynn there are our harm reduction group that we go out with and we work with Essex County Outreach and there our Recovery Group so we have people with lived experience that I go out with and Lisa joins us sometimes and we can go in and talk to

Somebody who’s had an overdose and see if they’re ready to take that next step so I think as a police officer we’ve always just kind of responded to the immediate emergency but now we’re trying to Branch out and event and followup okay well you’re not off the hook yet

But I will be coming back to you okay Lisa well hello David so so you’re with Beth Israel uh Le Behavioral Health I am what do you do there other than the six and a half minutes you sent me in on the bio another 6 and a half minute bio I’ve

Worked for Beth Israel Ley behavioral health for 10 years in fact it’ll be 10 years on Saturday congrats um thank you um it’s been a great run but in 2018 I’ve done several different rol R but in 2018 the city of Beverly contracted with um Ley to provide a jail diversion

Clinici and with my previous training and experience um that was the role I applied for and this is the role I got and so I’ve been doing it for 5 years um and it’s a we actually have seven clinicians that do what I do now wow um which cover 16 police departments

Collectively we have a manager Danielle SOI who has been doing this role 10 years prior to me in Salem and danverse okay so it’s expanding uh Le’s committed to community work they’ve always been committed to community work and this is just another arm of that and what is the jail version that

You did at the beginning you mentioned the jail diversion yeah what is that I know what is lot our viewers know what that is yeah yeah so jail diversion you know unfortunately I feel like it is um a title that is a little bit misleading because we’re not it’s not just about

Diverting from the criminal justice system it’s also about meeting people where they’re at helping them receive Services they need so that their problems don’t repeat okay um and that they’re able you know that they feel like they’re being helped instead of penalized we do divert from the criminal

Justice system that is our primary goal our other goal and that means if someone’s committed a crime that’s up to the police department to decide if this crime is something that they need to move forward but if it’s a mental health or substance use driven crime there’s better interventions for prevention

Right and it’s hard to measure prevention but as you can see we are reducing our numbers of overdoses because we’re doing preventive work Outreach and that stuff so now obviously Ted brought you along for a reason this was going to be a show on xylazine I was

Trying to find someone that could talk to me in view was on xylazine it took me forever to find somebody and that was Ted and as soon as I asked him to come in he said I work with all these programs and you’ve got to bring Lisa in

Do work together and it was a package deal he wouldn’t come in without us we are a package deal that’s funny so I’m going to ask you how do you interact with the Beverly Police Department what is your role in Daily interactions with them so I am embedded into the Beverly

Police department so I am part of the community impact unit okay um I also cover five other police departments in the North Shore would you like to elaborate on those well um so chief leasha for Beverly uh was sort of spare headed in in drove this with the

Gloucester Police Department um and so we collectively addressed concerns in Gloucester Essex Manchester Rockport IP switch and Beverly so there’s six of them okay um I am embedded into the Beverly Police Department I provide followup to the other departments while we’re waiting to hire a second clinician and how do you interact with

The public is your role with on The Beverly pleas um so a call will come in if I’m so if I’m on shift so what’s difficult is there’s you know three shifts 24/7 in policing so events happen frequently when I’m not there they haven’t cloned

You yet no I always say we need 10 of her how many officers do we have we probably need that many um but in any event we if there’s a call that comes in dispatch will um send us out to correspond with the patrol officer okay

Who who gets who arrives first and so and when we get there I let the police officers Take the Lead they assess the situation at safety saf is primary yes of course so for everyone for the person that we’re treating or we’re meeting the police officers myself the community at

Large it’s all about safety so when we get there it’s it’s safe for me to assess the psychological need right so I will do in the field while Ted stands by and make sure things remain calm and safe um along with the patrol officer sometimes they leave if it’s taken too

Long but for the most part it’s about safety so I will assess the person’s need um ically and I will create a disposition so do they go to the hospital is this a section 12 where I have to send them against their will because they are just so unstable and I

Can’t stabilize them in the community um or people go voluntarily then if they don’t go to the hospital we send them to the community- based Health Center which now are across the state um it’s a great organization um I think it’s big step forward in mental health and or I

Connect with their already in place providers so I work with dmh and their contract is with Elliot um Behavioral Health oh yeah so um those clinicians work with a lot of people that have mental health so we will I will call them and say this is what’s going on

What do you recommend and they’ll either say we can come out and help stabilize this or please you need to send them to the hospital whatever so we work with providers to stabilize in the community as best as possible what other trainings have you had uh that you do for this intervention

Let’s you had a very impressive bio here’s your chance to get it out I wasn’t going to read 12 minutes so I’ve been doing trauma response from the bulk of my career uh 25 plus years I hate to say but yes um she started when she was

Very young I was 12 no I’m just kidding so anyway um I’ve been working with trauma response so this was a natural um transition for me to take my experience into policing um I have to say though you asked me a question earlier about policing what do I do and how do I

Interact with the police you know they had to adjust to a civilian a person coming in and working with them to say I think we should do it this way so it took some it was a challenge um there were two officers I worked with initially that really um onboarded me

Across the region with police to introduce me um have them build rapport have them get to know me so it was a little bit of a challenge but it’s been widely well received um so back to your the question question you just asked me um I work with Riverside Trauma Center

So I’ve been trained by them in psychological first aid which is a stabilizing method um I also do grief counseling for them so if we have to do a death notice or something I could actually do that help the person through the policing um I have been trained in

Deescalation a 100 different ways to Sunday um I work for I actually am on The Advisory board for Essex County Outreach okay and my role is the behavioral health role but their substance use knowledge has also helped me can you help us out and let the audience know what Essex County Outreach

Actually is I know what it is he knows what it is don’t know what it is what it is okay so Essex County Outreach is actually um a 35 a a 34 uh police so 34 police departments police agencies the sheriff’s department and community-based um providers all work together to

Respond to substance use overdoses to help bring treatment to the person they have recovery coaches we they have a system that is called Sims and it um police officers police departments across the region can put in a person’s name who is high-risk okay um say they had an overdose in Beverly but they’re

From Lynn Lynn Police Department could see that this person had an overdose so their team can go out to treat that person so there’s there’s linkages so Essex County Outreach has been instrumental in linking everybody together nice it’s a good way of putting it now Riverside I’m very familiar with

Them I took a couple of courses I came to them also with the psych first aid yeah very good classes yep yep so they also have mindwise as a company part of Riverside that’s coming up going to just ask you about that in a couple of minutes okay then I’ll wait that’s okay

You can talk well mind wise now well so the the trauma center let me just say the trauma center is a team of about 100 people who have been specially trained by Riverside to respond to critical incidents in the community so it can be um for uh something really dire like the

Marathon bombing yes it can be where a company like a beloved um employee has passed away suddenly and people are grieving um you know um communities that have like a tornado or some kind of critical incident so we go out as a team and we help stabilize people much like

The debriefing and diffusing we do with the sism team it’s very similar and we’ve learned in Behavioral Health that if people can actually speak their words what what they’ve actually experienced it helps take some of the power of the internal struggle that goes on away and

It gives people a voice and it gives them the ability to sort of compartmentalize and also the psychological first state is about selfcare so we teach a lot about how do you take care of yourself when you’re struggling with grief or trauma and so that’s what we

Do what would you like to see to make the greatest impact on mental illness ah so I think that Massachusetts you know we were out west in one of our trainings and so we were among PE among people from Canada and the rest of the country

And there’s a lot of great things going on across the country but and you know maybe I’m biased but I’m very proud of the work that Massachusetts is doing we are really we’ve come a long way we still have far to go so we have the community based Health Centers where

They can treat people for their behavioral health needs to divert from the from the emergency room um we have jail diversion clinicians that are embedded across the state we have um lots of agencies doing wonderful work I think the biggest there’s also the Department of Mental Health has their behavioral health line

It’s a 988 number that you guys will put on okay um but what I find happens is people don’t know where to turn when they’re in crisis they will turn to police yes but a lot of times they don’t right so they’re trying to find a mental health counselor they’re trying to find

The right kind of program or the right kind of treatment for whatever their need is and so Navigators are not case managers but they’re people that work for cities and towns that people can call and say this is what I’m looking for this is what I need do you have any

Recommendations so they have a resource list and those are becoming more and more popular and I encourage that I encourage more and more Navigators across the state so that people know where to call very well put I’m going to come back to you T sitting there thinking

He’s off the hook that I as I told you before when I first talked to you I’ve been waiting months to find someone that can come on the show that can talk to our viewers about xylazine I cannot interview myself I’m not that talented [Laughter]

Yet what can you tell us about XY Zine what is it well first I appreciate your comments and I did that training online um with you in one of the Eminem rounds and I actually enjoyed it very much thank you and I literally ended the call

Online and my phone rang and it was David saying Hey I want I want you to come wow that was quick but uh so xylazine is a new problem that we’ve uh started to see in this area xylazine is an animal tranquilizer is what vets use

To sedate large animals it is not for human use was never meant or made to be used by humans so it’s got a street name called Tran and basically because it’s a very heavy sedation tranquilizer and it got mixed into the drug stream a little

Bit and what it does is it kind of makes it it’s not a narcotic it does not respond to Naran so that’s one major problem causes heavy heavy sedation to the point that they’ Ed the term walking zombies the people that that take it and use it um become very dependent on it

Very very severe withdrawals to the point that they’re using it more frequently and more frequently and they um sometimes pass out and wake up two miles from where they were because they use the term like walking zombies they’re just tranquilized they’re just sedated and um yeah it’s a it’s it’s a

Scary scary thing now you mentioned this is a vet drug yes how on Earth is this up getting onto the street where’s it coming from originally where are we finding it how’s it getting to the US so it was uh initially mixed in with fentanyl probably to try and create a

More a longer High a more euphoric high and this started in Puerto Rico okay and and then it came into the us through Philadelphia very high Puerto Rican population the drugs were coming in from Puerto Rico with this U fent with the xylazine added to the Fentanyl people

Didn’t know that they were taking this they didn’t want this they didn’t ask for this they weren’t looking for it but it became part of it and then once they’ve had it they become so dependent on it so it started Philadelphia I kind of call Ground Zero um they have a

Similar area like Kensington Street where there’s people who are just they just have to keep taking it over and over again the withdrawals are so severe and then it spread a little bit to New Jersey and now we’ve seen positive um cases of it in Beverly it started in

Gloucester and Salem so we know that we’re right in between there and our drugs are tested occasionally through a program through brandise University and drugs that we confiscate and they will test and has tested positive in Beverly I’m totally confused I’m a businessman I don’t understand why are you putting

Xylazine in an opioid when you’re going to kill your customers what is the point why is this even going in there in the first place does anybody know I mean what’s it supposed to be doing for the person on the street well it’s probably one maybe cheaper to add it in so from

The business side of view and also it creates that dependency and it extends the the effects of the fentanyl a little bit more fentanyl’s relatively short acting you know they they take it and it’s in the system it’s out in probably an hour or two the xylazine just extends

That period a little bit so that they’re more sedated um more euphoric kind of almost trying to make it more like a heroin no there’s no heroin anymore no one’s growing and and and it’s much cheaper to in a lab make some Fentanyl and so I

Think this was an attempt to try and make it seem a little bit more like the heroin of a stronger version of the heroin of days past now when you take this obviously it’s affecting parts of your body what’s it doing directly to your respiratory system it’s uh again

Very heavy sedation doesn’t respond to Naran so we train our officers to you know treat every overdose the same you know check the pupils it’s always mixed in with something else no one’s taking xylazine straight so we still give Naran we still have to make sure so the

Problem is they’re not waking up so we would give four 8 milligrams of Narcan and they’re still not waking up maybe their respiratory rate has come up a little bit their pupils have dilated it a little bit because we’ve canceled out the narcotic Portion by giving the Nar

But there’s still the xylazine on board so we’re still worried about heavy sedation Airway management so they may need to be put in a position where you have to open up their Airway maintain their way possibly ventilate for them or sometimes they could be breathing well

On their own but you just have to protect their Airway it could be something like just putting them in a recovery position but you obviously can’t leave this person you know so now they need to be monitored and watched for several hours to make sure that they

Don’t aspirate or anything like that I just wanted to dis spel a rumor a lot of people and you are correct when you say uh not can doesn’t work on xylazine but you also said it affects the opioid porush and what I want to clarify is you’ve got three portions you’ve got the

Uh opioid originally you’ve got the N you’ve got the uh fentol and you’ve got the xylazine at least you’re knocking out the opioid Portion by giving the knockan so it’s not going to do anything for the xylazine correct correct but it is going to help me at least with some

Of the respiratory by taking the receptor off and getting rid of the opioid so one out of three you’re lowering the effect but still with the xylazine depressing your respiratory system you’re not doing good I’m sorry no and the Naran will reverse the effects of

The fenel too cuz fenel is an opioid but yeah like you said it goes in and it blocks the receptor so that the Naran oh sorry so that the opioid can’t hit that receptor and the only with that is not to argue with you but you know Mom and

Dad have a box of KN can it’s two uh bottles unfortunately with the fentanyl you might need four or five bottles six bottles of knockan so giving the two bottles it makes it hot on the lay person I’ve got my knock can my kid had an overdose three times I saved them

Suddenly fentel is introduced and Mom doesn’t even know fentanyl exists on never mind xylos so it’s like why isn’t this working today I agree with you 100% we do um leave Naran at the scene we go with our recovery coaches and our harm reduction coaches and leave Naran and my

Big thing that I stress is you need to still call 911 absolutely you can’t get in trouble you can’t be like if you call 911 to get someone help you’re not going to get charged the need are haven’t been you couldn’t charge for a long time um

But you’re not even if there’s a little bit of fentanyl or something present it’s not no one’s going to be in trouble please please please still call because they need to be monitored in a safe professional like at the hospital now the public doesn’t no not cancer is not

A cure all it lasts for about 90 minutes give or take unfortunately the opioid you talk is going to last longer it’s like an aspirin you got a headache it works for four to six hours you still get the cause of the headache it’s not going to go away you need another dose

Why is it so important with that in mind that your friend doesn’t give you a dose of knockan you’re up and R oh thank you very much I’m going to go home I’ll get behind the wheel of a car I live two hours away right do you see something

With wrong with this picture happening absolutely so um like you said the Narcan can wear off before the opio so the Naran doesn’t destroy the opioid it just blocks that receptor so the opioid fentanyl whatever it might be is still in their bloodstream the Narcan wears off that fentanyl or morphine ored or

Whatever they took is still in their system and can rebind to that receptor and CA the problem again to the point that now they they redone the um protective custody laws protective custody laws used to just be for alcohol they’ve changed it to include all sorts

Of drugs now so we anyone that gets Naran from the police department or fire or anything like that goes to the hospital to monitored for a couple hours and even to the point that if they refuse to go we can place them in protective custody use whatever is necessary usually my Verbal

Judo is uh is enough to to get them to get on the ambulance and and no one I’ll be honest most people don’t fight it anymore they’re just okay I I’ll go to the hospital I’ll I’ll uh sit there for a couple hours they want to be safe um

Yeah so you’re in the room with your friend playing cards you took an opioid you overdosed your friend gives you a shot so what we’re saying is so important that somebody calls 911 for that person just because he’s up and breathing really isn’t doing anything that’s good for the moment but an hour

From now when that knock can wears off and that kid’s driving home we can lead the problem so what I’m trying to say viewers is if you don’t need an ambulance because the guy woke up please do not let him get in a vehicle and drive drive him to the hospital yourself

Of course the best route obviously is to call 911 if you feel you don’t want to do that yourself get somebody safe to get him into a hospital CU you don’t want him out there 90 minutes from now and the op takes over again because the not can War off

Absolutely so injection a lot of people still shoot heroin and which has the Fentanyl and has your sosine so that if I’m going to get a wound or there always going to be in the ejection side I take the shot in my arm put you know you put

The rub a hose around put the band around it’s in my arm there were side effects there were wounds is it always going to be in my arm no not at all so with xylazine and they’re still studying the reasons behind this and everything but can cause very serious very serious

Wounds throughout the body and it’s not necessarily at the injection site you may inject in your right arm and get a wound on your left leg and these wounds if they’re not treated and cared for become very necrotic and to the point of like in Philly they’re dealing with a

Lot of people on Kensington Street with multiple amputations and Below leg amputations and everything from these wounds CU they’re uh not getting treated properly chopping the legs off unfortunately it gets to that that bad but I shot myself in the arm yeah they’re trying to it’s systemic yeah

Okay we’re working with a doctor out of uh Thomas Jefferson University Megan Reed and we’ve worked with her through Pari and there’s trying to study like why is it happening elsewhere in the body starts as a little blue necrotic area and can quickly quickly spread if

If not treated okay I have a slide from a xylazine class which I teach this slightest courtesy of the national uh Medical Library used with their permission warning what you’re about to see is graphic may be disturbing to some viewers so I hope they don’t put this

Show on at 5:00 on Sunday night when the family’s having dinner you may now show the slide Ted Lisa what are we seeing here that’s not good no that’s a very Advanced wound from xylazine that’s very actic you can see the black areas that’s all dead dead tissue um that’s never

Going to be able to get back they could attempt some sort of you know obviously antibiotics grafting but a lot of wounds that severe will end up in amputation so bsy I can stick my finger through the leg that’s wide open germs bacteria yes I wouldn’t recommend it yes but

Yeah so basically that wound is almost the least of his problems where he’s got a wide open area for every bacteria and these people line in a hospital setting this person was under an area living homeless not the cleanest conditions so every disease on the street either from

E coli or anything else on the street that they can pick up is going to be inside your body which goes through every other SP of your body and this by the way this was a 25-year-old female which was picked up brought to the hospital let us use her slides by

Permission to the national uh Medical Library to show people that’s way the there’s no face here what it can come through now if you on the street was to see this what’s the first thing you would do before putting them say all the ambulances were tied up never happens

And you need to get them to the hospital they just want to ride in you don’t need lights and siren what would you do they they took their n they took their uh fenel hours ago so they’re not really overdosing you came across I’m homeless they’re having

A conversation oh yeah my last hit was 5 hours ago okay so it’s not an emergency it’s what would you say to this person and what would you do before putting them in your Cruiser sh of putting plastic everywhere yeah the most important thing is keeping it they say

Moist and sterile so so wrapped yeah we we actually have wound care kits usually for the much less severe cases to try and prevent them from getting to this point the problem that we’re seeing is that um people is the stigma okay people are letting their wounds get to this

Point because they’re afraid to go into the hospital hospital because they’re afraid of being treated poorly when they walk into the hospital the stigma of being a substance use abuser and IV drug user is it’s they would prefer to sit and let these wounds Fester than go seek

Treatment absolutely so our what we need to do is get is change that attitude within our hospitals within our medical community within our police departments I train when I teach people in Naran and xylazine now I spend a good couple minutes on stigma using the proper words

We’re not saying the negative words that we used to use before we’re saying someone with a substance use disorder someone who is um in active recovery we’re using positive terms we’re not using the negative terms that I don’t need to say that we’ve used in the past

So I think that’s the biggest thing is getting over that hurdle of stigma so that people are willing to go to the hospital to get treatment prior and then if we the other thing that we’re doing is we have a wound we’re we’re starting with our Public Health Department in one

Stop a van that comes into to the city once a week and they’ll do testing whether it’s STI testing um but they’ll also do wound care training we have wound care kits that Pari has supplied for us that we’re trying to get out there we haven’t seen it in Beverly yet

But better to be prepared than to be like it’s around us so it’s going to end up there I am not advocating in any shape of form they say this make this crystal clear that you do self treatment a treatment to your friend something like this needs Hospital needs

Intervention and it needs it right away but if there’s that person that is not going to go to the hospital come hella high water there’s nothing you’re going to say that’s going to get them there and they’re screaming bloody murder if you tell them I’m going to call an

Ambulance for the parents that want to do something which is better than nothing while you’re working on how you’re going to convince the kid to go to the hospital Ted you’re an instructor how would you teach mom and dad to do something while they’re convincing their

Kid to go mother never saw that before kid runs downstairs she sees that late for the first time what would you tell Mom and Dad to do take take a deep breath while Dad secretly calling the calm down try and uh Not freak out because I know that if

I saw that on my child I would be freaking out so just try and uh and then the other big thing is moist sterile dressings wrapping it up not tight keeping it loose but um trying to prevent further infection and also trying to prevent that drying out of it

That um we’ve worked with some people at Pari who that that’s recommendation is moist you know sterile water sterile gauze if possible you know to keep it as clean as possible and keep it covered okay now would probably be a good time to flip over to another logo I’m sure

Half my viewers have now passed out and 911 is ringing off the hook with about 30 people that have passed out on the living room floor that’s a lot better Lisa you thought you were off the hook I thought so no I’m just kidding why is the work you guys are doing as

Ley behavioral so important to the community well we are a community B we we’re community- based hospitals right so the Beth Israel Ley system is all over the North Shore so there’s Anna Jake there’s Beverly Hospital there’s Addison Gilbert so there’s many and like I said earlier we’ve been dedicated to

Doing community work for a long time so I feel like the collaboration between the medical side the behavioral health side and the other providers in the community and policing and you know things like recovery coaches everybody work working together towards the same goal and and and Beth Israel Ley is a

Collaborator in that way so I mean I’ll go off the subject for a quick second 20 25 years ago I got a very severe issue wasn’t drugs I swallowed something that wasn’t supposed to be where I ate it it was something in a food and basically I went into Winchester Hospital more dead

Than alive literally projectile you know wanting absolutely very bad it was a corrosive substance and could have killed me if I didn’t hit the hospital thank God I Live 5 minutes from the hospital and the whole idea was I got in I got treated and they basically saved

My life I mean you have to thank the hospitals the training that these people have had and just what they do right away what to do right away what happened they didn’t know exactly what I swallowed all they knew was was a corrosive substance and how to treat it

So these hospitals are so embedded in the community and just the level of care I can’t thank them enough which is one of the reason I’ve been trying to get either uh lehe or Winchester when it was Winchester then it went over to Le then over to Beth Israel I’ve been trying to

Get someone on for three years on the show oh but in an area they really didn’t do much with the drug program the way you have so I’m so happy oh there’s a lot of people doing a lot of work that you now it’s really changed in the last

20 years yes so Lisa do you have any final words for our viewers um couple you wanted to bring up earlier um I just final words um I feel like I hope that people understand that we in in many the state in many capacities provider networks you know the hospital Network Beth Israel

Ley um we are all the state you know dph and dmh we’re all working towards addressing the problems right we’re we’re trying not to be reactive we’re trying to be preventative and we’ve grown and I want people to know that we want to hear your voices but we also

Want to know that there is help out there oh yes and um don’t get discouraged look for it you’ll find it you know call the hospital call the police department call agencies around you um call the helpline the dmh helpline um to you know go to the community- based Health Center um if

It’s not an immediate crisis but you know you need help they can help guide you so there’s there’s things out there and I want people to know that they’re out there to help I get a lot of calls people say I don’t know where to turn

Exactly l so so Ted do you have any final thoughts I can’t say final thoughts is Jerry’s thing I’ll get sued do you have any last thoughts sure I think the big thing that I I’m would say is decreasing the stigma um if we can decrease the stigma around mental health

Substance use disorders they are truly medical issues and just like diabetes or other medical issues we tend to treat mental health and substance use disorders differently and I think if people can decrease the stigma there’s medications to treat a lot of these problems people need to be able to go

Into a hospital or talk to a police department and just feel comfortable that they’re not going to be judged that they’re going to be treated kindly with sympathy and empathy and just um always you know reach out if you’re having trouble it’s important to reach out and there there Services

Whether it’s us from the police department point of view from recovery coaches to everything else just uh we’re here to help the help is there that’s where our goal is to help now before I closeing I’d like to present each of you with one show on the bottom of your

Screen Lisa this is for you oh thank you this is for f I appreciate you coming in oh thank you so much the work that and the work that you have done and continue to do through both Beverly pleas and Lees programs David thank you for much

You a great guest thank you I four years ago I’d never do a Tome was difficult but you guys separate yeah know you guys just tied in so well I had I had to do it thank okay thank you very much okay I would like to thank

Our guests Ted Lane and Lisa marcario for appearing today as always thank you for watching please share this program with your social media friends if you were someone you know was suffering from a substance abuse disorder and now we even a gambling problem you can contact the Massachusetts substance use heline

The number is 1 1800 327 75050 also the contact information for Beth Israel Ley will be on the bottom of your screen and at the end of the show so give Ley a call the the work that they’re doing is absolutely amazing give them a chance to help you out uh loved

One out this show can be seen on a rotating basis on wuin public media stations and On Demand at their website and on YouTube as always thank you to the staff of wuin public media center for making this possible please enjoy our closing theme rise above the Noise by fireart who is a

Former guest on our show through the credits for important contact information for America in crisis breaking the cycle of addiction my name is David Hunt thank you for watching we have more shows lined up we are back is what We The Whispers that I hear behind my back Those who never lost a child a friend so they La sense of loss a peace that’s gone with no return above the noises how we cope above the noises how we learn the most important things in life I found comes deep within the heart the pure s

Of those who won the fight now they found a l is true a l are rich above the ground we are people who care people who l again sound not hurt is what we bear we Areound not H is what we been The sound not Hurt