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Ohio official: Don't send medics for third overdose

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An Ohio city councilman has suggested a controversial solution to the growing opioid problem in his town: If an addict keeps overdosing, the city won't dispatch anyone to save their life.

Middletown City Council member Dan Picard is proposing to give drug users two chances. Paramedics would respond to an overdose twice, and each time the addict would receive a summons and be required to do community service after being treated.

But if they don't show up in court, don't complete the service and then overdose a third time? That's it. No one will come to help them.

So far, the proposal is only that -- a proposal. Picard said the city manager is still looking into the legality of the plan before the council can move forward.

Picard said his proposal isn't meant to be a solution to opioid abuse. He's concerned that Middletown simply doesn't have the money to keep treating overdoses.

According to the Middletown Fire Department, EMS units responded to 535 opiate overdoses in 2016, 77 of which resulted in death.

Picard said the city spent over $1.2 million responding to those calls. This year, the Middletown city manager estimates that cost will exceed $2 million.

At that rate, Picard said, it's inevitable the city will not have sufficient funds to keep responding. He hasn't calculated the cost of implementing his proposal, which would require keeping records of repeat offenders.

"Either we go down the road with my plan, or we don't, and we run out of money," Picard said. "In either scenario, they're not going to get treatment."

Opioid use is on the rise across the country, and overdose deaths are becoming more common in Ohio. In 2014, the state had the second-largest number of opioid-related deaths in the country. It had the fifth-highest rate of overdose. And the next year, overdose deaths in the state rose 11%.

One Ohio coroner's office barely had room for the 145 overdose-related victims it processed in January of this year. And in September, 21 people in Akron overdosed in a single night.

'I was trying to scare people'

Butler County, where part of Middletown lies, has the fourth-highest overdose death rate in the state. Even though the intention of the plan isn't to lower the number of overdoses, Picard hopes it will still have that effect.

"I was trying to scare people," he said. "I want the drug users out there to know that if you come to Middletown and you overdose, there's a possibility that we're not going to come."

Truth Pharm, a national advocacy group focusing on substance addiction and drug policy, wrote an open letter to Picard on the organization's website criticizing his approach.

"To suggest that you withhold emergency medical response to overdose patients is manslaughter at best and premeditated murder at worse," the letter read.

Truth Pharm wrote in the letter that it would provide information for people to sue Picard and "the entire town government" if the policy moves forward. Picard has acknowledged that he's considered people may try to take legal action if the plan moves forward.

Picard said there have been a lot of misconceptions about the details of his proposal -- more specifically, the details about exactly when the city would leave an overdosed user without aid.

He said that an EMS squad dispatched to the scene of an overdose would never leave a victim to die. Under Picard's rules, if a user overdoses for a third time, the city won't send someone again. If EMS workers are dispatched, he said, they are obligated to treat the patient they were called to help.