The Stories Behind the Stats-Addiction Talk Featuring Peter Canning

Paramedic and author Peter Canning has witnessed the opioid epidemic from the frontlines, responding to over a thousand overdoses. In this episode of Addiction Talk, Canning—author of Killing Season: A Paramedic's Dispatches from the Front Lines of the Opioid Epidemic—returns with insights from his new book written for families and loved ones impacted by addiction. He shares his powerful perspective on the overdose crisis, why addiction is not a character flaw, and what every parent, friend, and family member should know to help save a life.

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Transcript

Thank you, Peter, for joining us for another edition of Addiction Talk, where we're sharing some powerful stories. And we wanted to have you on, Peter, because you have such a unique perspective, being on the front lines of the overdose crisis. Few people can see how you've seen it from your perspective. So we're excited to dive into that. But before that, we always like to get a chance to know our guests. We always start with a few icebreaker questions because we want people to know a little bit more about you. I know you've been a paramedic for years on the front lines. Let me start with the first question. What do you think most people are surprised to know about paramedics? We have our ideas. We picture them in the truck driving and making sure you're staying alive, but what is it really like? First of all, thanks so much for having me on. I really appreciate the opportunity to talk with you. What's it like being a paramedic? A lot of people think what they see on TV is what being a paramedic is like. Now, it's true there are lots of life-threatening calls where, you know, it's really every second matters. But in the longer term, it's more about just being a social worker, working with people, trying to help them through their day, through, you know, crises that they're having. Sure, you know, we drive lights and sirens a lot, mostly to a call and not so much to the hospital. Because once we get there, we like to think that the emergency is over. But the one thing I think that people may not recognize, one of the benefits of being a paramedic, is the food that we get to eat. Because we're on the road all the time and we're posted from street corner to street corner, we have access to all these wonderful restaurants. And our city has Jamaican restaurants, we have, you know, Puerto Rican restaurants. Vietnamese, Brazilian, all types of food. So when we come in in the morning, my partners and I usually say, well, what are we going to eat today? And if we get lucky, we get a break, we're able to stop and, you know, pick up a beef patty or, you know, some, a pho sandwich, I mean, a banh mi sandwich or something like that. Some days we just end up, you know, eating crackers, but it is a, It is great, the food. At one point in time, I wrote a blog called The Paramedic's Guide to Takeout in Hartford. And to get in it, it had to be a place that you could be in and out of in five minutes with your food. So that was a lot of fun. It sounds like a really good reality show instead of man versus food, paramedics versus food. That's actually clever. So I have a question. You said something really important and I don't think people understand that. You said that you become like a social worker. Yeah. Why did you, what was your purpose in becoming a paramedic? Did you deal with, you know, problems and then realize people needed help? What was the first reason to take that career? So, I have two answers to that. One is a very common answer to that a lot of paramedics will tell you. When I was a kid, there was a show on TV called Emergency, where these guys, they were the first paramedics working in Los Angeles, and they would go out and rescue people. And there was a beautiful nurse named Dixie McCall, played by Julie London at the hospital. And these guys were just good guys. And I thought, you know, that would be something great to be. The second part, which is more unique to me, is for many years I worked in Washington, D.C., for Lowell Weicker, who was a senator, and later he became governor of Connecticut. And I was his speechwriter. And I really liked that he was a man who stood up and fought for those without voices. He used to say that the mark of a country is not how we treat our best citizens, but how we treat our most vulnerable. So when he was done being governor, I was trying to decide, well, what do I want to do? Do I want to get a job being a lobbyist, you know, which a lot of my coworkers were doing? Or do I want to try to go out for myself? And I had, you know, I had worked as an EMT for some period of time at night, which I really enjoyed. And I thought, you know, I'm going to go out. I've worked with my brain and with writing and stuff before, but now I'm going to see what I can do with my hands. So the day after he became governor, the day after his term ended as governor, I started working as a paramedic in Hartford. And I've been doing so ever since. So I really enjoyed that aspect of it. And, you know, one of the things I wonder when I think about your journey, Peter, one, you know, you just being able to pivot and be of service. You know what I mean? I think about you talk about the governor being of service, but you being of service to your community. But one of the things that I think people don't realize is just how bad the overdose crisis is. So I'm curious, just from your perspective, what was it like and what is it like being on the front lines and seeing people who have been impacted? by this in real time? So the overdose crisis, I've really witnessed it over the last thirty years. And when I started, we went on some overdoses, mainly people who overdosed on heroin or whatever. But then gradually in about two thousand fourteen, two thousand fifteen, I started noticing a whole lot more overdoses. And then I wanted to try to find out what what was causing it. So I read as much as I could. I talked to doctors. I talked to substance abuse experts. I talked to law enforcement. And it wasn't really until I started talking to my patients that I really figured out what was going on. But it is, you know, the overdoses can be very sad. And too often we get there when it's too late. Ninety-one percent of the people who die of fatal overdoses die using a loan. Because the stigma drives them into the shadows. And if you use, particularly with fentanyl out there right now, you use by yourself, and there's no one there to see you, no one to give you naloxone, and you get a bad bag, it's really tough. So that's a difficult aspect of it. I've been working as an interventionist for fifteen years, and I'm serving like twenty years, and when I was going through it, there was never fentanyl. There was heroin, there was coke, you know, and crack and stuff. So I have a question, because you're a paramedic, so you know it. There's always this thing with fentanyl, and they say, oh yeah, it's a thousand times stronger than this, it's this and this. Really, really speaking, because there's some people, police officers, that have overdosed getting in contact. I've been around addicts, and I can smell it on them. It's deadly. Can you explain for the viewer, because you are a paramedic, how deadly this really is? It's not just a mock thing. It really is that deadly. So there's two things. First off, yes, it is, by weight, fifty to a hundred times stronger than heroin. But that doesn't mean that when you buy a bag of fentanyl, that that bag is fifty to one hundred times stronger than the bag of heroin that you bought. But there's less active ingredient. And that's the real danger with fentanyl. Before, when we had heroin, a bag is so in where I'm from in Connecticut, people get these little wax full bags and they were like five dollars a bag. Now they're like two dollars a bag. Very small amount of powders in there when it was heroin. half of the powder was heroin and half of it was cut, sugars, other types of adulterants. Now with fentanyl, because fentanyl is fifty to one hundred times stronger, it's fifty to one hundred times less active ingredient. So it may only be two percent fentanyl, ninety eight percent active ingredient. And so the danger is, is that these drugs are not being manufactured in a pharmaceutical company where every single dose is exactly the same. They're being mixed on somebody's kitchen table in a blender made for protein shakes. So it's like when you make chocolate chip cookies. You get one cookie that has six chips in it, and another cookie has twenty chips in it. So when someone gets one bag of fentanyl and then they get another bag of fentanyl, they have no way of judging how strong that is. And because fentanyl tends to clump, if you get a bag that has ten percent fentanyl in it, It's going to kill you if you're using by yourself, even if you're experienced. So that's the real danger is that people cannot gauge their dose. The second part about the police officers. All right. This is a big myth that's out there. Fentanyl, if you can touch fentanyl, it's not going to kill you. It doesn't go through the skin. It'll bounce off the skin. Now, they have these things called fentanyl patches, which are pharmaceutically manufactured to go through the skin and And they take twenty four hours to work. So the problem is what's happened. A lot of police officers were told that fentanyl is dangerous. If you just touch it, it might kill you. So they go on the scene and they touch some fentanyl or something. And it's like, oh, my God, I'm going to die. And they get dizzy and they pass out. Someone who does fentanyl doesn't get dizzy and pass out. You know, so what they're having is something called the nocebo effect. A placebo is you take a placebo and somebody says, this is going to be good for you. And you take it and go, oh, I feel good. But with this, the nocebo effect, if somebody says this is going to kill you and so you touch it, you go, oh, my God, I'm going to die. And you have an anxiety attack or you have vasovagal, you pass out. But none of these police officers who have been so-called overdosed by touching it, none of them test positive for fentanyl at the hospital. So this is a big myth that's out there. The National American Academy of Toxicologists has issued a paper saying that this is a myth. And, you know, sure, you get some on your hands. You want to you want to wash it off. But for it to hurt you, it's got to get in your bloodstream. So if you trip and fall nose first into a scar face pile of fentanyl, you know, and you inhale it. or you lick your fingers or whatever, then you might have a problem. But just, you know, touching it is not going to cause you to overdose. Right. But you can't, sorry, Joe, but you, like, if you was, because obviously you get a contact high, if someone is, like, when you were freebasing stuff, that, if you're in a room with someone and they're freebasing fentanyl and they're rolling it on you, you are going to get a contact high. But what you're saying is it's gone out of control right now and people touch it Oh, my God, I'm going to die. No, not going to happen. Fantastic. You know, I wonder, too, Peter, have you come in direct contact with fentanyl now that you've been in this? Because I think this is important to show your firsthand experience and what that has been like for you being on the scene. Yeah. So about. I was saying about two thousand fourteen or so every now and then we get a big spike in overdoses. And what was happening then is people were adding fentanyl to the heroin. They were just putting a little bit in there. Over time, fentanyl has come in Connecticut and in much of the country to completely replace heroin because with heroin, they have got to grow a crop. They got to harvest the crop. They got to put it on the back of donkeys and get it over the mountains and then smuggle it, whatever. Fentanyl you can make in a laboratory. And because it's fifty to a hundred times stronger, it's fifty to a hundred times smaller. So it's so much easier for you to smuggle. And the profit is so much higher. So now very few people are getting heroin at all. If they say, you know, I want heroin, they're getting fentanyl. That's what it is. And as I said before, the danger with fentanyl is it's very hard to Very hard for them to gauge the dose. So, you know, all overdoses that I go on, you know, fentanyl's there. We see the bags all over the place. And what's interesting is in Connecticut, the bags are branded. So rather than a little plain white bag, it'll have a name on it. Tombstone, Rolex, Stranger Danger, Sweet Dreams. Um, so we see these bags all around. Um, and I've, you know, when initially, when I got the bags, I, at one time I had a bag and I opened it up, I poured it out onto my hand and it was, the powder came out onto my hand because there's so much it's, I've had people hand me a bag saying here, I found this on a scene and I'll say to you, you know, this is an unused bag that somebody dropped. Um, because it is not a whole lot of, of powder, but I, you know, I've, like I said, I've had it on my hands. I've seen it, uh, on the scenes. But it's not, like I said, it's not going to kill you unless you get it into your bloodstream. This is a really big thing for people to understand, especially when I'm doing interventions. There's a lot of kids that buy Xanax, and it's fake Xanax, and obviously it has fentanyl in it. Xanax obviously is going to put you to sleep. Fentanyl, opiate, it's going to slow you down. Here's a question that people always stumble with, and I want your perspective on it. why are they mixing fentanyl with Adderall? Um, so that's a, that's a good question. I guess you'd have to, you'd have to ask them, but there are, uh, there, the counterfeit pills is a huge issue. Um, so you, it used to be what would happen with somebody to the typical progression is, is somebody would, uh, they'd get in a car accident or something. They'd go to the doctor. He'd write them a prescription for Percocets or Oxycodone. They'd get the pills. They'd take them. They'd develop a tolerance. Over time, they'd need to get more. The doctor would cut them off. They'd be horribly sick. People say that withdrawal from opiates is like the flu times a hundred. And with the difference being, if you want your symptoms to go away, you don't lie in bed for three days having chicken soup. You immediately go out and get some more opiate and you're fine. So what people would do, then they would go and they would buy the pills on the street. So like a thirty milligram oxycodone went for thirty dollars. That gets very expensive after a while. So people then started buying heroin because the same dealer that sold the pills also sold heroin and heroin was cheaper and much stronger. So then they'd start out, you know, snorting the heroin. And then after time, they'd learn that they got a better bang by injecting it. So that was what they'd go through. What's happening now is that the pills that are out there, they're not the pharmaceutical pills anymore. The drug dealers, they've got their own pill presses, and they're just taking the powder with the fentanyl in it, and they're mixing it up and creating the pills that look just like the real thing. They're doing it with Xanax. We don't see it with the Adderall too much around here, but it's fake oxycodones. And so people are taking it thinking that it's going to be a legitimate dose, but they don't know that that pill might have much more fentanyl in it than it's intended. The DEA every year, you know, writes about how many counterfeit pills they get and what percentage of the counterfeit pills have at least two milligrams of fentanyl. And two milligrams of fentanyl is what they say is considered a lethal dose for some people. And it's like half of the fake pills have that much in it. So people have to be very, very cautious. If you're at work and your back is hurting, but you want to make it to the end of your shift, and your buddy says, here, take one of these, what he's handing you may not be something that came from the pharmaceutical company. It could be something that the drug dealers have mixed up, and it could quite well have the fentanyl in it. Are you seeing when you're going on the scene that it's more the powder that people are like injecting or are you seeing more of it's the pills? So when I'm on the scene, when the paraphernalia is there, most of the cases, it's the powdered wax bags that I see. Sometimes I see the pills. I see that on the needles a lot. So when somebody injects, it gets into their system much faster. So if they inject and they have fentanyl in it and too much, they're going to go down right there. Where somebody snorts it, they may not go down as quickly, and then they're not going to leave the paraphernalia lying out. Sometimes we see it. And the pills, I don't see the pills that much. But I have patients say to me, it's like, I don't know what happened. I don't use opiates. I just took his annex. You know, and it's like, well, that Xanax, where'd you get it from? Well, I got it from this guy I know. Well, that Xanax had fentanyl in it. Now, do you, all right, is it going to get better? Like, this epidemic is so bad. Like, it's just out of control right now with the cartel and the street drugs. Do you, I mean, you've been in the business for years. I'm an interventionist. Right. But you're on the front line. Yeah. So what's your perspective? So, In Connecticut, we sort of judge it based on the fatalities. And in Connecticut, we hit our twelve month rolling high in November of twenty twenty one, which is way earlier than most states nationally. I think it's sometime in twenty twenty three. Since then, they have the overdoses have been going down somewhat. And what a lot of that is being attributed to is. that the fentanyl purity is down. And when I say the fentanyl purity is down, I mean the amount of fentanyl that's in the package. What some of the dealers have been doing, you heard xylosine. So xylosine is this animal tranquilizer. And when it was first starting to appear, it was like, oh, my God, this is the apocalypse. This is the end of everything. To add this on top of fentanyl. But what was happening was is that they were adding xylosine which is more sedating, and fentanyl doesn't last that long. So xylosine gives the high more legs. It lasts longer. But they were putting in less fentanyl. So the chance that somebody would die was going down because there was less fentanyl. The xylosine is very, very cheap. So the dealers were making more money, and the product was less lethal. And also because xylosine made it last a bit longer, they weren't using it as often. So as the fentanyl purity has gone down, we've seen the death rate go down. Also contributing is the amount of naloxone that's out there now. Half the time when I arrive on scene, the person's already been revived, either by police and fire or by bystanders. Where in the old days I'd show up and the person would be unresponsive in a bathtub and people would be throwing water on them or trying to pour milk down their throat. or put ice in their pants, none of which are recommended. But now, because there's so much naloxone out there, a lot of people are being revived before we get there. The problem is, is if they use alone, there's nobody there to revive them. Right, yeah. I think that's huge what you just said. So you think we are doing a good job of educating the community that all of us pretty much need to be equipped with naloxone, Narcan, the overdose reversing drug, or it needs to be readily available at the library, grocery stores, things like that. Yeah. And people are doing a good job. There's like, there's naloxone vending machines now in a lot of places, you know, we track the overdoses, we find the hotspots and we try to make certain that naloxone is there. While the overdoses have been going down, it's still way too high. It's still way too high. And it's not cause for celebration at all. And I'm worried that, you know, with the talk of budget cuts in Washington, that a lot of these harm reduction programs and treatment programs may get cut. And that may take away some of the progress. You know what? I'm going to have you say that again because you coughed in the middle of that. And I don't want anybody to miss what you said. And that was so powerful. Can you repeat your concerns right now? So my concern now is with the talk of budget cuts in areas of harm reduction and drug treatment, that we may lose some of the progress that we've been making. I really think that this is a very important and it's a good bang for your buck. I mean, the amount of money that you invest in harm reduction or treatment is going to save a lot of money economically in addition to saving lives. And that's been proven by the various studies that they've done. This is really money well spent. I'm going to go back. You said something, you said a really great thing earlier and you said about shame and people use alone. I've always spoken about my sobriety very early on. I have no shame and it gives people permission. Do you think now more than ever, people like myself that come out and tell our story and give people permission are helps people because like you said if they're cutting budgets and people don't realize that there is help and you shouldn't be alone and you need education and you need these tools and we can get these tools it will start curbing that because people say hey I'm an addict there's a lot of addicts out there I can get help the stigma is huge so when I when I began as a paramedic when my very first emt class this guy came to speak to us and he's in a like you know a iron shirt with all the badges and stuff on it and he's telling us what we're going to face and he goes you're going to go out there and you're going to be dealing with drunks and junkies so when I go out there and I do an overdose it's like here's this guy he's he's a junkie a quote junkie you know and then I'd say to him what's wrong with you you're going to end up dead or in jail get your life together you know I'm shaming the guy now over time as overdoses increased and I started talking to people And learning about the science of addiction, another thing. And people would say to me, I used to be a normal person once. And now I hear their story. I began to understand that addiction is not a character flaw. That it's actually a relapsing brain disease, a chronic disease. And that people can, with help, overcome it. But it's not like you break your leg and you've got a cast on it and take the cast off and you're fixed. For many, it's a lifelong problem. Just as diabetes is a lifelong problem for somebody. know or asthma or stuff so so you know I changed over time but it is the stigma and I still see it a lot um you know in some of the the you know the cultural thing somebody goes to the er and you know they're sick or whatever and the nurse has a a coffee mug that says the tears of my drug seekers you know and it's just or the way that people are treated it can be horrible But if you treat people well and if you don't shame them, you know, and you help them get help. So now rather than saying just, you know, just say no, you're going to end up dead or in jail, I say, hey, listen, if you're going to keep using, don't use alone. Have Naloxone available. Do you know where you can get clean needles? Here's an address of this place, you know. over on Albany Avenue where they can help you out. They can get you whatever you need to try to get you to the next stage of your journey. So it's quite a change. But I've seen people recover. I've seen people who I picked up over the years, and I've seen them now. They're back with their families, and they have jobs. They're paying taxes, which people would like, and they've made it through. You know, I've also seen other people that haven't because it's a very, very difficult disease to overcome. You know, Peter, I want to, you know, you said it was the stories. And that's why we do shows like Addiction Talk is because of the stories changed your mindset about what you thought. Was there any one particular story that stands out to you? I'd love to hear it because it is powerful to change perspective by hearing and seeing something from a person's point of view. So one day I got called for a car accident. A car's into a telephone pole in front of a gas station. And I get there and I, you know, I open up the doors. A young woman, she slumped over. I see the needles on the ground and the floorboard. There's a bag called Sweet Dreams. So I give her some naloxone. I revive her. I get her in the ambulance and I start talking to her. And she's like, oh, my God, my father's going to kill me. You know, and I said, you know, no, you can't really say that. She goes, well, I just got out of, you know, I got up into rehab twice now, and now here I failed again. And it's, you know, I said, just, you know, relax, you know, you're okay. And then I started asking her if she had any other medical problems. She goes, well, I broke my back. And then I'm going, you know, she had looked really familiar to me. And then I got the story. So a couple of years back on a Friday night at a high school football game, I was there, halftime, cheerleaders. They throw two of them up in the air. One of them, you know, spins around and they catch her. You know, it's a beautiful night. You know, it's a beautiful, gorgeous night. You know, the dance is that night and everything's going on. And this girl comes down and they dropped her. And then they called me out onto the, you know, her father comes down from the stands. I come out there and, you know, we put her on a backboard and, you know, the father's being really nice. Are you okay? Okay. We get her in the ambulance, take her to the hospital. I give her a little something for her pain. And it was the same girl. And I said, well, what happened? She goes, well, I broke my back. I missed school. They put me on, you know, the oxycodone. I ended up getting cut off. And then the next thing, you know, she was like, you know, buying the stuff. And it's like, how would the trajectory of her life have been different if they had caught her? You know, everything pinned on this accident, you know. And so instead of, like, marrying the football hero and living in a house with a white picket fence, you know, all her dreams are going to a hole in her arm, you know. So one nice thing, which was good, when we did take her to the hospital this time, she's all worried about her dad. And then I'm there, and I see the dad come in. And the dad comes over and throws his arms around her and she's crying. He goes, that's okay, baby. I love you. We're going to beat this. You know, which was wonderful to see. One other quick story that also helped get me going. A guy overdoses, a car pulls into a hospital that's no longer an ER hospital, but it looks like a hospital. They throw the guy out. A security guard comes out, finds him, calls nine one one. We get there. The fire department's got there first, gave him some naloxone. He's coming around. And he says to me, oh, God, you know, what a scumbag I am. I'm supposed to take my daughter trick-or-treating tonight. And, you know, I start finding his story. And it turns out that this guy volunteered for the Army the day after nine eleven. He went over there. He got, you know, his truck hit an IED. Those are devices. He got an ambush. He's got, you know, we, we discovered this cause he, while we're putting the electrical heart electrodes on, he's got a little hole here, a little scar. What's that from? And then he tells us this story, you know, so he goes out and he leaves the, the, the service, you know, with an addiction, you know, and he's, he's for a couple of years now, he's been trying to get his life together. He's been, you know, sleeping on people's, uh, couches, he got arrested for a warrant for failure to appear for driving with a, you know, a car with a busted headlight. And so his buddies met him at the jail when he got out, and they gave him a little bit of a bag of fentanyl to celebrate. And his tolerance was down, so he took it, and then they threw him out of the car. But he says to me, what a scumbag I am. And it's like, this guy volunteered for us the day after I started asking people, and it was when I started asking people, how did you first use in the first place? And they would tell me, I got into a car accident. I fell off a ladder, you know. And everybody had a story. And it all came from that. And so I started to see people in a completely different way. So, I mean, I have a lot of them. But that's always now, whenever I have an overdose, I want to find out how did that person get started. And it's not like you just decided to be a juvenile delinquent and just shoot up heroin and go root around in garbage for your life. So it's learning about the people, beginning to see it through their eyes, that it totally changes your perspective. I love what you said. People don't understand when the cyclophama created oxycodone and they didn't realize they hit on two things. And I always say human motivation is to avoid pain and gain pleasure. And they knew that that painkiller was going to give you the pleasure and make you avoid pain. And it's a lot different because I genetically have alcoholism in my genes. I drink like an alcoholic. I never was into pain pills. Never really took them, never cared. But I had friends that never drank. that weren't even close to drinking. They could drink and not ever got injured playing rugby and sports and got hooked on pain pills. And what I'm trying to tell people, there's alcoholism and a fentanyl addiction or a heroin addiction is completely different. It's a different part of the brain. And once that locks on to the opioid receptors of the brain, it's different. And you can see that firsthand, right? Yeah, it's very difficult. The other thing that was interesting that, I learned is a lot of people would tell me that they had ptsd or they had a history of sexual abuse or there's some kind of childhood problems and what I learned was is somebody might have undiagnosed problems anxiety depression ptsd or whatever and they just don't feel right then they happen to break their leg playing sports they get the pill and for the first time they feel whole Because the pill is treating their emotional pain. One other story. You'll know about this guy. This guy, Austin Eubanks, I think was his name. He was at Columbine. So he and his best friend were there in the cafeteria when the shooters came in. His best friend was killed. He was wounded. This guy had never used drugs at all or drank or anything. He got put on pain pills. And he said that the pills helped him more with the emotional problems that he had, the emotional pain with the physical. So he ended up having a big struggle with substance use disorder. And then he broke free of it and became a national speaker. And he came to Connecticut and spoke before our state convention we had on this. And he was talking about just because somebody wears a coat and a tie... doesn't mean that they're not still having problems. And he said, this is really hard, you know, but you can overcome it with whatever. Like three weeks later, we read in the paper, he was dead of an overdose. It's just horrible. So how would his life have been different if not for that day at Columbine? What killed him? You know, the shooters who came in there got him in the end. Because that set him on a trajectory that he could have never imagined. You know, and there's people who have their own unique stories. And we see them out, homeless people out on the street now. And they're treated like trash. You know, and it's just like, what have they gone through with their lives? It could be you or I, you know, our neighbors, our friends, our family. You know, I mean, you touched on something I think that's really impactful because you said early on, you know, there was the stigma about who this impacts, who addiction impacts, who ends up on the street, who ends up homeless, but in your professional opinion and being on the front lines and hearing these stories, are you seeing it's people from all walks of life, people you never even think, can you, can you address that? Yeah, absolutely. Um, Like I said, when I asked him, tell me about your life beforehand. You know, I mean, I had one guy and it's like he had a shirt and it was like Tim's Tim's tree service and Tim on this side. And now he was like sleeping under a tree and his whole life had fallen apart because he got hurt. He had been had a home. He had a business. He had a wife. He had kids. He didn't choose this life. You know, he just got in that cycle. People, interesting thing. So we have in Hartford, we have a lot of methadone clinics. They open up early in the morning. And there's usually a long line. And we get called there sometimes for somebody not feeling well or whatever. But all you have to do is look at the faces in the line. You have people from, you know, teenagers to seven-year-olds. You have all races, you know, everybody possible in there from you have rich people, you have poor people. It's just it affects everybody. Let me jump into you talking about your book because you've got such an amazing story and your firsthand experience. And I really have to, I love the fact that you had the ability to change your perspective of how you look at addicts and how you've become compassionate and very kind and remove that. You know, I see people all the time, like just suck it up. I mean, you know, just toughen up. I mean, I'm an addict. And so I love that. So can we talk about your book and what inspired you to write your book? Sure. So in twenty twenty one, I wrote a book called Killing Season of paramedics dispatches from the front lines of the opioid epidemic, which was a lot of stories and talking about, you know, how I discovered all this stuff and the people I met. So then my editor thought that it would be a good idea to write sort of a guidebook for friends and family. Because what was happening for me is I'll go on a call and I'll find somebody, you know, the mother is like all upset. You know, I don't know what's wrong with my son. And we'll go in there and he's pinpoint pupils, barely breathing, blue. And I'll say, what does he use for drugs? And she goes, oh, he doesn't do drugs. And I'll give him naloxone and he'll come back around. And then he'll tell me, it's like, oh, I was doing so well. You know, I just slipped up. I was depressed about my, my old girlfriend or met, met somebody new. But then I would go and talk to the mother and she's like, but he's, he's clean. He doesn't do drugs anymore. And then I, so I had to have to tell her, I said, listen, this is what addiction is about. This is the science of it, how some of this works. And then I said, do you have naloxone? She goes, well, what do I need naloxone for? I said, well, Because you never know. I mean, relapse is expected in a lot of cases. It's part of the journey. So I would explain to her, this is before you could get naloxone over the counter, where you could get it. There's harm reduction places, health departments, or you can get a prescription from your doctor. You need to have it in your house. And here's how to use it. So a lot of the things that I would tell other people, I tried to put in the book. So the book is about who's at risk for overdose, how to recognize it, how to treat it, what happens at the hospital after an overdose, what treatment options are afterwards, what is stigma, how does stigma affect people, what harm reduction is, what the war on drugs is all about, and how it's really a war on people, and we need to change that. So, you know, it goes through all of that. And interspersed with each chapter, I have a real life story. I have to change the details a little bit. I can't use real people's names, obviously. But so that's what it is. It's basically for somebody who knows somebody who may have a problem. And so they could understand it. And there's a chapter on fentanyl. Like, what is the danger of fentanyl? And, you know, exploring the different myths and issues with it. Fantastic. So that's basically how this one came about. Well, I do have a couple of questions related to that because I want to get the name of the book out there. Friends and Families Guide to the Overdose Epidemic. Friends and Family Guide to the Overdose Epidemic. You can see for anyone who's listening, you know, that this could be a book. that everyone should probably have because we just never know. But my question is, do you think most people are just not educated or in denial? Because the mother, you know, I think it may be a combination of both, but I'm curious to get your perspective because the mother, even after her son overdosed, you gave him naloxone. She's like, oh, I don't need this. Why would I need this? So I'm curious, is it denial? No, I think it's a lack of education of understanding the disease. You know, like I said, it's with, if somebody breaks their leg, people think, well, I took them to the doctor, we got a cast on it, and now they should be better. You know, where with this, it's not. You're not just immediately better because you went to rehab one time. You're not immediately better because I gave you naloxone and now you're back breathing. It's a long journey. And it requires love and it requires patience. And I think just think too many people just don't know. They don't understand the science behind addiction. And they don't understand how this all works. So it's trying to teach them what I've learned over the years. Yeah, I think what you've done, especially with the guide, because they always say that the three most powerful things in anything is authority and expert, which you are an authority and expert, which is the truth. Story. You've got stories to talk about it and tools. And those three things, like I became an edition expert. I've got a crazy story, but I give people tools. And I think the way you shape it so beautifully, it just allows people, it's a perception shift. And what Joy said, like I deal with families and you'll see this. Because I work with paramedics all the time, especially if I've got to do an intervention or there's an overdose. And especially on the show, I work closely with the nurses who are like paramedics as well. It's like the families are codependent. And I'm like, you're not being caring. You're supporting your son who's completely in denial or your daughter. They're mainlining fentanyl in your house. Your credit card bills are out of control. They lock themselves in the room. And you're like, oh, yeah, but they're so sweet. I love them. No, you don't love them. You don't love them. You're not caring for them. That's not caring. You know what I'm saying? And I tell people, if you really care for someone, you have to set a bottom line. You have to say, no, I will not accept this behavior. And then we intervene. That's why I love when you said that. Because I had a client that was peeing dirty all the time. And I'm like, your son is on drugs. And I'm like... And it's like, so yeah, so it's, I think that's so amazing that you have those tools and you can keep giving those tools. I have a question for you. Do you, it's such a powerful program, what you're doing. Have you got any thoughts of trying to, do you try to get into the high schools? Do you try to get into the colleges? Because right now what I'm dealing with is so many young kids, so many teens having drug issues because of the internet, because of the dark web. So have you thought of getting it into a curriculum or something? So a lot of the local health departments that I work with have programs for the high schools and the colleges. I do think that we've done a good job in recent years, um, with the, with the prescribing when somebody's injured. So a lot of the people that years ago might have gotten thrown into this are not anymore. Um, one of the interesting things that a lot of people don't understand is a lot of the people who are dying are older. Um, the people in the fifties and sixties are an increasing amount of people who are, who are, um, A lot of them are people who have been struggling for many, many years, and now their systems aren't as strong, and they're encountering fentanyl, and they're more isolated, and they're alone. So in the area that I'm in, the fifty-five and up population, there needs to be a lot more focus on them. There's another question. What do you... Because it's very tough. I deal with a lot of people coming out of institutions. Have you thought of hitting in that area? Because there's so many people that, you know, they come out of jail and they don't have hope, they don't have resources, just education-wise. Yeah. So in Connecticut, pretty much everybody who gets out of a long-term jail is given naloxone when they leave. Still... the odds of somebody overdosing who have just gotten out of jail and dying are astronomical. Yeah. I've been on scenes where, you know, like a spare boarding house room and you get there and the guy's dead on the floor and there's the paperwork for his parole officer and there's unused naloxone there. You know, they gave him the naloxone that he used by himself because it's like, I just got out of jail. I can't let people know that I'm using, so I'm going to hide it. And the problem is when they've been out of jail for a while, their tolerance is way down. Oh, yeah. Yeah, so they may have been used to doing a certain number of bags, and they try to do even half that amount, and it's going to kill them because they don't have the tolerance anymore. Yeah. Hey, Mike. Yes. Can we pause for a second? Yeah. Figure out what happened to Joy. Yeah, no problem. I just didn't know. I was waiting for you, so I know we're recording, so I just wanted to keep it going until you're done. Yeah, no, thank you. No, no, I just, that's why I text Joy, like, how do you want me to do it? Like, I'll just keep talking until you intervene. I don't know why my, okay, my power went out. So good. I just, I kept it going until you guys said something, because I knew you'd want to wrap it, so I just kept on our format, so we're all good. It's like nothing happened. Okay, okay. So where are we? So basically I asked some questions about incarceration, education, like has he thought about using groups, his message to help, you know, kids or people that are incarcerated because I know you wanted to tie it around always to the last thing. You always like to leave with that last question. Did you already wrap it up or do I need to? No, I'm waiting for you to wrap it up. We paused before then. Yeah, I purposely kept the conversation where we're going. Okay. And acted like you didn't even, you asked the question. Okay, did you answer that question? Yeah, I jumped straight in off you. Whatever you left, I just pretended that you were still on. Because I'm used to it freezing. I'm used to it freezing. Okay, well, Peter, did you answer? I think, I can't remember where it went out. It was like the lights went out, then everything went. As soon as it went out, he answered the question. You were frozen at the end of the question. You're like this. Okay. Well, let me ask the question again just to make sure if Perry needs to go back and put it in. Are we still recording? Yeah. Yeah, we're still recording. So I'll answer that question again. Then we can add that in. And then we'll go with what Mike had. And then we'll just kind of wrap it out to make sure we didn't miss it. Yeah, and then you can finish it with what you usually say at the last question. Okay. So good. Yeah, good. Okay. I'm going to start. So, Peter, I think what's really interesting is, you know, hearing from the mother, do you think that for most people it's a lack of knowledge or education about the disease or denial? Because I thought it was really interesting that she said, why do I need naloxone after you revived her son? So I'm really interested to get your perspective on that. So, I mean, I think it can be both. In some cases, there is denial. But also, I think the problem with a lot of people is that they don't think of this as a chronic relapsing disease. They think that, okay, he's been overdosed. He's got naloxone. He's better. He's back. You know, it's like he broke his leg. We put a cast on it. Now the cast is off. Everything's fine. And what people need to understand, and they don't understand, is the nature of addiction. That addiction, in a lot of cases, rewires somebody's brain. And it takes time to rewire that back. So it's a tough thing. But it's really important that parents and friends understand that it's not just a simple one-time thing. That people don't use drugs just because they have bad character. Just because they've overdosed and been brought back doesn't mean that they're fine. um they they need help and just if they go into to rehab and you come out of rehab it doesn't mean that I don't need to worry about it like I just put a new roof on my house I don't need to worry about it for fifteen years you need to worry about it all the time but you need to treat them with love and with understanding um and and try not to shame people because what happens too often is is when people do relapse They want to hide that because they're worried that they're going to offend the people who love them. And so they use behind a locked door or they use in some place where they can't be found. So that's the tragedy of it is that stigma drives people away. And I think, you know, just a couple last questions is I think the fact that John Hopkins Press is behind this book, you know, when you think about John Hopkins, shows that there is definitely a need for this. And so what do you hope is the takeaway? If there, when people read this, when loved ones read this, what do you hope is that final takeaway from your book? The takeaway is, is that addiction is not a character flaw. That you should always have naloxone available. if you know anyone at all that has substance use disorder, and that you need to treat people with love and not with shame. Treat people as you would want your family to be treated, as your friends to be treated. Treat strangers and people in your community the same. As a paramedic, one of the things that I've learned over time, and this is from the Hippocratic Oath, from a part that a lot of people don't know about, It says into whatsoever house I enter, I will enter to help the sick. So the point is, is that this is not a character flaw. This is not somebody who's bad. This is somebody that needs love and that we need to bring them in and love them and treat them as we would treat someone with anyone with any other disease. And my final question is now when you walk into those homes, and you see the people who are impacted by this, how are you showing up today for them? Well, you know, as I said, you know, years ago I was completely different, but now, you know, I will, you know, sit down and talk with the family or with the friends. We now carry Naloxone that we can leave behind. So I will take out a kit and I will say, look, and look, here's the kit of Naloxone. Here's how it works. In this package here are some places where you can get help if you're looking for it. And I'll try to leave them, whether patient or family, not with a sense that what happened here was bad or shameful, but that this was something that happens to people and it can be dealt with. But it needs to be dealt with with caring and love and that there is hope for people. I love that. What a great way to end this. There is hope for people from someone who's on the front lines, who, as you said, saw a father or other people who you now see have recovered and have gone back to their lives and their families. And so this is not hopeless. We're so thankful for you and for your book and for sharing your story with us today, Peter. Thanks again, Joy and Mike, for having me on.