Former North Adams first responder featured on “This American Life” says harm reduction saves lives amid opioid epidemic
Over the weekend, public radio’s “This American Life” reported about an overdose prevention hotline saving the life of a North Adams, Massachusetts woman.
WAMC listeners may remember Stephen Murray from coverage of his advocacy for supervised consumption sites and increasing access to the lifesaving overdose reversal drug naloxone. Murray’s work in public health is informed by his own experience struggling with substance use. While he’s relocated to Eastern Massachusetts, Murray’s current job is very much a continuation of the work he did while living in North Adams.
“I'm the Harm Reduction Program Manager at Boston Medical Center, and I'm the director and founder of the Massachusetts Overdose Prevention Helpline, which is a 24-hour toll-free hotline that's run by peers that provides virtual drug use spotting service," he told WAMC. "So, if someone is using drugs alone, we stay on the phone with them, and in case of an overdose, we're there to activate emergency medical services. I'm also a former paramedic and lieutenant in Berkshire County, where I worked as a first responder for almost a decade.”
It was during that time in the Berkshires that Murray was inspired to launch a local chapter of the helpline.
“One of the things that I noticed was that people who died from overdose, the thing that they all had in common was that they were either alone or they were in a place where somebody didn't know that they were using," he explained. "And so, naloxone distribution is incredibly important, but just as important is having somebody who recognizes that that person is having an overdose and then can actually push the plunger. So, when I first heard about the Never Use Alone hotline, I immediately was like, oh my God, this could be the missing link of how we can help protect people who are alone, by having them activate the EMS system. So of course, as a paramedic, I jumped on the idea.”
While on duty in North Adams one night, Murray responded to the call that “This American Life” would eventually immortalize.
“When we arrived, nobody answered the door when we were knocking," he remembered. "And so, I let myself into the house, started looking around, and eventually found Kimber on the floor in the back bathroom, and she was blue. I was able to detect the pulse. So, I actually ended up dragging her out into the living room so that we can actually work on her. Her bathroom was quite small. And so, we ended up giving her naloxone and delivering rescue breaths with a bag valve mask for several minutes. And when she came to, I said, you know, it's really important that the person that calls 911 for you stays with you. They can't get in trouble, we have a good Samaritan Law here, and it's really unsafe for them to leave after they've called for help, because what if we couldn't find you? In Kimber looked at me and she said, well, nobody was here. And I said, well, who called? And she said, well, you've probably never heard of it, but the Never Use Alone hotline. And it was just like, what? Like, you call the hotline that I had been publicizing here, and I'm the one to respond to the overdose? It dawned on me right in that moment, this was a special situation.”
Murray got a text from a friend who had been working the Never Use Alone hotline that Murray had helped bring to the Berkshires.
“Jesse said, you’re not going to believe this, I had an overdose, and I'm pretty sure it's in the town that you work in," Murray told WAMC. "And I was like, no way, you're the one that took the call? And she's like, wait, what? And she said, I'm the responding paramedic? And then we cried, we cried on the phone together. It was one of the most emotional experiences of my life realizing that we could design a public health intervention, and it actually can be put into practice, and then it can work. That was my cue that it was time for me to shift out of frontline EMS and really devote myself full time to public health. And I actually left EMS pretty much fully within three months of that call.”
Murray says the experience underscored several major points: that harm reduction works and saves lives, and that overdose is a preventable disease.
“But what needs to happen is there needs to be somebody supervising that person while they use drugs, who can either respond in an overdose or get someone to respond," he said. "So, for us on the hotline side, we fill a really important void for folks because we can be accessed anywhere. We've had people call from alleyways, we've had people call from high rise apartment buildings, and we've had people call from their parents’ basement.”
Another takeaway is about the dangers posed by a toxic drug supply.
“Right now, we have xylazine as an adulterant in the supply, which causes very extreme sedation," explained Murray. "And so, not only is overdose a risk, but the risk of someone being assaulted, sexually assaulted, being a victim of theft, dying from hypothermia because they're outside and don't realize that they've been out for a long time, heatstroke, dehydration, these are all things that we're worried about with this drug supply. And so, I really think it's imperative that we're talking about providing safer supplies of drugs for people who are using that are tested, and that are have some level of quality control.”
Murray says he’s certain that harm reduction-informed approaches like supervised consumption sites and making sure no one uses drugs alone are proven strategies in the effort to save lives.
“We've reversed more than 1,000 overdoses at those sites," he told WAMC. "Those sites are really, really important, especially in urban areas where you have sort of critical masses of folks who are using drugs, who are publicly using drugs, or who are recently housed and have gone into their own sort of solo space where they're at a higher risk for fatal overdose. And so, that has to be part of the solution. And I really, really hope that here in Massachusetts, the next time you and I decide to talk about this topic, it's because we're celebrating the opening of the first site.”
He's also confident about which approaches are misguided.
“The ideas of prohibition and thinking that we can solve, solving the issues of drugs, I guess, in general, through law enforcement and arresting- We know that these things don't work," said Murray. "It hasn't worked. We've been trying this for – well, in this country – for more than 50 years, if not longer. But that approach has shown to just put people in jail, where they're at higher risk of overdose when they're released. And so, I think that taking a public health harm reduction approach is the only way that we can really move forward.”
He also credits former Berkshire District Attorney Andrea Harrington – ousted after one term by tough-on-crime candidate Timothy Shugrue last year – for making it clear to him that she would provide legal cover for the helpline to operate in Berkshire County.
“As someone who has five kids and a mortgage and has escaped being criminalized for my drug use when I was younger, I really didn't want to end up in jail," Murray told WAMC. "Having someone in a position to make that decision, who could protect me from that, and to let me know that what I was doing was covered under her interpretation of the Good Samaritan Law- That was an incredibly important feature of why this hotline was able to even come about.”