Push


by April Schoen with Tonya Wells

Southeast Graduates Are Challenging Social Issues and Changing Lives

 

Ten minutes. That’s the goal. 

It’s such a short amount of time, but almost anything could happen in 10 minutes. Only 10 minutes to get on scene, get back in the truck and get back on the road. That is, if everything goes as planned.

THE EMT

For Brad Basler, emergency medical technician at Cape County Private Ambulance and a 2009 Southeast graduate, every second of those 10 minutes counts. Even in the middle of the night. When the call comes in, Basler goes from a deep sleep to leaping from bed because he knows there is no time to waste. He fights his fatigue in the driver’s seat of the ambulance, but his mind prevails over exhaustion with the help of flashing lights and sirens wailing in his ears. Basler goes over the dispatch in his mind, preparing himself for each step he will take when he arrives. Female, late 20s, drug overdose, infant in the home. The last detail hits Basler the hardest.

As the ambulance arrives, Basler and his partner see the fire department is already there, ready to break down the door. The patient is on the bed, and her three-month old baby is lying next to her.

“I felt more worried about the baby. At that point, you get angry, because they just left their baby there,” Basler says.

Thankfully, a family member comes to care for the unharmed child. Swallowing his frustration, Basler focuses on what he has to do to keep his patient safe. She is in and out of consciousness, but as the medics assess her vitals, they gather she has overdosed on a combination of prescription drugs and alcohol. Moving quickly, Basler and his partner load her into the ambulance and rush to the hospital to have her stomach pumped.

“It’s very common that people overdose on prescription drugs,” explains Basler. “We run about 20 calls per week that are drug-related and about five of those are overdoses.”

While there are many combinations of drugs and alcohol that can result in an overdose, heroin is rapidly beating them all. This highly addictive killer can hook a user with one hit, is easily accessible and is uncontrolled, meaning the potency of each dose can be different from the last. Heroin is also no longer a drug for just the rich and famous. It has been flooding communities in every state, big or small, and affecting all demographic groups. Heroin has become a rampant and unforgiving plague, killing 80 people a day in the United States and leaving millions of family members and friends without their loved ones. It is destroying homes, schools and towns across the country in ways that no other drug has.

According to a January 2016 report put out by the Centers for Disease Control and Prevention (CDC), “More persons died from drug overdoses in the United States in 2014 than during any previous year on record. Opioids, primarily prescription pain relievers and heroin, are the main drugs associated with overdose deaths.”

With statistics like these, the task of taking on such a tyrant seems impossible, and for first-responders, repeatedly seeing the worst effects of heroin firsthand can become a burdensome weight to carry. Basler says one of the challenges of his job is keeping his emotions in check.

“If you walk into a scene and are emotional when you see that person, it is 10 times worse. You push it down until you get off scene, so you can take care of the patient.”

To cope with the feelings of anger, sadness and disappointment that can come with responding to overdose emergencies, Basler explains he has to remove the event from his mind. Often, cranking up the stereo in the ambulance and stopping for ice cream after a call helps to take him out of what he has just experienced, but it is not always an everlasting solution.

“I chose this career because I am pretty compassionate,” explains Basler, but for a new EMT, compassion becomes a hurdle he must clear in order to handle this type of job.

“The hardest thing for me is actually to not freeze up when I see stuff. That’s how it is for me now, but that’s what will change with experience. It takes a while. All the schooling helps a little bit, but the more you see it, the more you can disconnect from that emotional level. That’s the hardest thing.”

It may be difficult to see past the extreme pressure and stress put on emergency medical service employees like Basler, but he says he has hope for his patients after he leaves them at the hospital and his job is not all frustration and grief.

One of the most important contributors to Basler’s optimism comes with the availability of naloxone, or Narcan. Naloxone, often called a “miracle drug,” is given to reverse the effects of narcotics in patients who have overdosed. Basler says naloxone binds to cells, so opiates cannot and is even strong enough to push opiates off cells. It brings slow heartbeats back up to speed and restores slowed or even nonexistent breathing.

Basler explains, “There are a lot of times when people are unresponsive and don’t look like they are going to make it, so you start pushing some of that [naloxone] and their vitals start to bounce back.”

Another result that makes this drug such a miracle is how quickly it can bring patients back to life.

“We’re in a confined space with them and don’t want someone to be unconscious, but if you slam a whole bunch into them and they pop up and are mad because you took their high away, then you have a whole different problem.”

To avoid that confrontation, medics push the naloxone slowly to gradually bring the patients back to consciousness until they are alert. Basler says it only takes about two minutes for the antidote to take effect for most people, and the patient is already en route to the hospital.

“Sometimes, you get a patient’s pulse back in the truck and are able to find out how they are doing a few hours later. That’s why so many people do this job. There are those few times when you actually win, and it’s a big win,” he says. “It’s always good to hear that the patient survived and we did everything right.”

Even in cases when Basler loses a patient, he still feels his work possesses meaning.

“Every once in a while, we will have a family stop by, and even though we might not have been able to save their family member, they are appreciative of what we do. They say that in the rush of the incident, we gave them some hope.”

Basler meets those who are suffering from drug addiction during the worst moments of their lives, but that is only a quick snapshot of the agony, fear and helplessness that accompanies this disease. Southeast alumna, Holly Rehder ’08, spent her entire childhood in a world surrounded by drug abuse growing up in Sikeston, Missouri.

THE REPRESENTATIVE

“Watching my sister, her friends, my mother’s boyfriends and other family members abuse drugs while I was so young was very scary to me,” says Rehder. “My mother struggled with mental illness but was a very loving and concerned mother. She was on a plethora of prescription medications for many things. My older sister was raped by one of my mother’s boyfriends, and I’m not sure how many molested her. She began running away at a young age. I was sexually abused by a family member at 11 or 12. He was under the influence of drugs but also had a history of sexually abusing my mother as a child.”

As Rehder got older, living in such a ferociously dangerous environment, she could see that people who were addicted to drugs did not have control of situations surrounding them and decided she never wanted to lose her control if she ever needed to defend herself or her younger sister.

“I grew up knowing I had to protect myself and as soon as I was old enough to get out, I was getting out,” says Rehder.

After escaping the toxic world of her youth, Rehder determined she would do everything she could to provide her children with the safe, happy childhood she did not get. Unfortunately, she was unable to completely sever herself from the overshadowing disease of addiction.

“My daughter was an excellent student. She was a very hard worker. She had a bubbly personality and was very sassy,” Rehder remembers. “In high school, Rachel worked multiple jobs from the time she was 15, and she was on the church drama team.”

Rachel grew up with a loving and supportive family in a small community and had all the ability and drive to graduate high school and study physical therapy in college. Rehder traveled to all of her volleyball games, attended class holiday parties and worked to teach her the strong values of honesty and hard work. Rehder felt Rachel’s potential for success in life was sky-high, and she was right on track to make it happen until what seemed like an insignificant accident turned into a tragedy.

Rachel was a senior in high school when she cut her thumb at work and was given a prescription of Lorcet (an opioid mixture of acetaminophen and hydrocodone) at the emergency room. Rehder says just a couple months later, Rachel became detached from her family and left home. She then removed herself from all family events and became uninterested in attending church, something she had always loved. It was then Rehder learned Rachel had become addicted to prescription opioids.

Rachel attended classes just enough to graduate high school. After feeling obligated to honor her parents’ wishes, she began college classes the next fall, but after only two weeks, her priorities had shifted completely.

“Her drug addiction just spiraled,” Rehder says. “When she couldn’t afford the pills anymore, when she got to taking so many OxyContin a day that she couldn’t afford it, she switched to meth.” From meth, Rachel’s addiction steered her to shooting up bath salts. Heroin wasn’t far behind.

The 2016 CDC report states the heroin epidemic is part of a larger substance abuse problem, and people who are addicted to prescription opioid painkillers are 40 times more likely to be addicted to heroin. Prescription opioid painkillers (hydrocodone/Vicodin, oxycodone/OxyContin, morphine/Kadian, codeine, etc.) are considered one of the main contributors to becoming addicted to heroin because the chemical makeup of both are extremely similar.

Dr. Jeremy Barnes, professor of health promotion at Southeast, explains how heroin and opioid prescriptions similarly affect the body. “For many people, the opioid compound acts the same way as endorphins, which creates a feeling of happiness and well-being.”

That feeling of euphoria does not always last long for an addict, he says, and unlike the effects of other drugs, their bodies suddenly become intensely reliant on the chemical reaction from heroin and opioids to feel “normal.”

Rehder says she had a front row seat for how an addict reacts. “What happens is, you’re on top of the world and you’re feeling great. You’re bouncing all over the place when you’re on this [heroin]. As the high starts to leave you, you get grumpier and grumpier until you’re angry and that anger starts coming out. You start acting very erratic. Once you do fall asleep, you sleep for a very long time and when you wake up, you’re very sick. You have to take more drugs to be able to get out of bed.”

Rehder knows addicts aren’t necessarily choosing to reject values to become an addict. In reality, it is the chemical reaction in addicts’ brains that take over and can physically disable them. She says she knows her daughter never wanted to become an addict, but her brain was no longer reacting to life rationally and her body could not function without the drugs.

“When you ask a 16-year old ‘what do you want to be when you grow up?’ they say doctors, attorneys, a nurse or a business owner. None of them say, ‘I want to be a drug addict,’” Rehder says. “They are playing with fire, and they don’t realize it.”

Knowing her daughter suffered from a disease for which there was no easy cure didn’t make it any easier. Rehder says she vividly remembers once receiving a phone call in the middle of the night from Rachel. She was high, crying and running from her boyfriend who was trying to beat her up. She was unsure of where she was, hiding in someone’s shed. Rehder prayed with her daughter over the phone and tried to find out where she was, but the cell connection was lost and Rehder was left with pure terror.

“It rips your heart out. You have this child, who you love, in danger and scared and reaching out for help, but I had no way of knowing her whereabouts. She called me the next day, after I had sent her text after text, and apologized. At this point being the mother of an addict, your heart has been on a roller coaster for so long that all I felt was relief we had survived another day,” says Rehder.

Although Rachel has been struggling with addiction for 13 years, she has been successful in her recovery for the last two. Rehder says she sees more and more of Rachel’s old personality show through every day.

Thankful her family has made it through, Rehder found a platform to share her story. She has been the Missouri State Representative for District 148 in Southeast Missouri since 2012, and her experiences have influenced her to push for change in the legislature regarding drug monitoring and prevention.

“Our backgrounds are very different, the people elected, and I think it is important to use our backgrounds to help educate each other. I feel very strongly that God didn’t give me a microphone to keep my mouth shut,” Rehder concludes.

Rehder is far from the only Southeast alumnus for whom drug prevention is a mission.  Many health and human service employees are working to deal with this issue on the front end.

THE ADVOCATE

Emily Nolen, a 2015 Southeast graduate, is one of those individuals working toward building stronger prevention programs. She is the project coordinator of the Southeast Regional Support Center (RSC) housed on the campus of Southeast Missouri State University. The Southeast RSC is a Missouri Department of Mental Health organization implemented to provide substance abuse prevention programming in the region along with 10 other offices across the state.

Earning a bachelor’s degree in psychology and previously working in a substance abuse treatment center, Nolen is no stranger to the realities of drug abuse. With deep curiosity for human thought processes, addictions and behaviors coupled with a craving to help others, Nolen immersed herself in the field of social services. She has worked closely with children and women with mental illness, battered women and women and youth dealing with substance abuse.

“Many times, those who have substance abuse issues are abandoned by family, friends and society, leading them down an even worse path. It became a passion of mine to understand and offer any help I could when all others had failed them,” says Nolen.

Similar to emergency medical service employees, the emotional toll working with addicts has on social workers and counselors is immense. Nolen says working with clients while helping them and seeing them through their struggle, but not having the complete control to get them through it, is a major challenge.

“I have definitely had moments in which I struggled and felt as though I was not making a bit of difference or helping anyone at all,” she says. “When working in a treatment center, many people continue to return to treatment over and over. That was very discouraging to see a person continue to make the same choices and not see their full potential, as I did.”

Nolen recalls a pivotal event in her time at the treatment center:

“One of my first clients spoke with me at length about not wanting to return home because she was scared. She was scared she would fail and begin using again. I later found out she was also scared of the consequences she would face upon returning to her hometown because she owed people money for drugs. Because she had completed the treatment program and had nowhere else to go, she went home and her fears became reality. I found out she had been murdered within a week by someone she owed money to. It definitely changed my perception and affected me deeply. I felt very sad for this woman and her family and thought about how I could help in more ways if a similar situation ever arose again.”

Despite the trials and heartache Nolen has experienced and witnessed while working with addicts, she remains positive and hopeful in her future goals.

“Since I have seen what can happen, I am very passionate about working to prevent as many individuals as possible from beginning a life that leads to such despair and hardship.”

Now, Nolen’s role in prevention includes gathering information about and learning the needs of different communities in Southeast Missouri. She analyzes this information and determines which evidence-based programs may be beneficial for successful substance abuse prevention.

Nolen is in the early stages of developing programming under a new, five-year grant called Partnership for Success. With this grant, RSCs from across the state will be providing drug abuse prevention education to youth, ages 12-18, through media campaigns.

“We are starting with kids really young, so we can build sustainable programs when the grant is over.”

In the face of an ugly drug like heroin, Nolen fears “someday soon, everyone will know someone, whether it’s a family member, friend or acquaintance, who has been addicted to heroin or died from their addiction. People tend to want to push it under the rug, and they don’t really want to talk about it and face it.”

Nolen’s positive attitude about the battle against heroin and prescription opioid abuse is tangible.

“We’re in this together. Everyone is doing a little something, and I’m glad there is attention on it. Together, we can make some kind of difference.”

Causes for substance abuse are complex and comprised of many factors, such as geographic location, resources, socioeconomic status, social expectations/norms and biological makeup. Knowing the complexities of the issue forces advocates to develop prevention plans including support and progress in other social areas of decline such as crime, education and culture.

THE ALUMNI

Through the creation of advisory boards, Dr. Morris Jenkins, dean of the College of Health and Human Services at Southeast, is collaborating with more than 70 individuals, who also want to make a difference, in Cape Girardeau, St. Louis and the Missouri Bootheel. The board in Cape Girardeau has been active for many years, so in efforts to build advisory boards in St. Louis and the Bootheel, Jenkins went to the Cape members to seek advice.

The majority of the board members are Southeast alumni and have backgrounds in nursing, criminal justice, social work, communication disorders, recreation, education and even interior design. The enthusiasm is apparent in all three of the boards as they join forces to make social changes, one of which includes providing substance abuse prevention.

While the St. Louis and Bootheel boards have only been implemented for one year, Jenkins says the groups have begun strategizing on ways to gain funding for communities facing high substance abuse rates. The boards are also collaborating with superintendents, principals and teachers in each region to encourage young people to consider higher education for their futures and to explain that continuing education becomes an asset for individuals who are at a high risk of becoming addicted to drugs and alcohol, as it can further a sense of purpose, goals, higher self-esteem and achievement. Jenkins says the groups have been researching the effects of drugs and alcohol on communities overall and posits that education is the most important form of prevention.

“We are trying to educate people about prescription drugs and even over-the-counter drugs that can get people high,” he says. “If it impacts someone’s life, it’s something that is a problem.”

Jenkins’ career in law and education relating to social issues continually motivates him. He sees a need to “take action under a concept called ‘restorative justice,’ so instead of sending people into the system for substance abuse, we come up with a way the community can deal with the issue.”

Jenkins relates it to his own personal experiences.

“As a society, we criminalize a disease. I’m a prostate cancer survivor, and I had a relapse. So, it’s like punishing that. I did everything right after I recovered, and then it popped back up. Alcoholism and drug addiction are the same. To get society to understand that is very important because it’s not a moral deficiency to be an addict. We are taught to shame the addict, but it’s a disease and it’s something we need to consciously educate people about.”

Jenkins says he’s proud of his former students working in the field of health and human services. Whether battling drug addiction or any of society’s other ills, it is a career path with a payday often measured only in incremental wins and the passion of the people called to both challenge themselves beyond the realm of the imaginable and better the lives of others.

 

If you or someone you know is experiencing substance abuse, visit drugabuse.gov to learn more about addiction and how to seek help.

If you are interested in becoming involved in the advisory boards mentioned, contact Dr. Morris Jenkins at 573.651.2178 or mjenkins@semo.edu.

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