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Librarians as First Responders

Public librarians have long wanted to be all things to all people, but emergency medical first responder may be going too far. In recent news, a couple of libraries are already training staff or are considering training staff to use naloxone on people who overdose on heroin.

In Denver, six people have overdosed on heroin at the main library this year, so it makes some sense they’re now stocking naloxone and teaching staff how to use it, but it seems a reach.

As one librarian said, “Definitely, over the last few years, my job has changed quite a bit…. This isn’t the kind of thing back in 1993 that we were being taught in graduate school.”

This raises a question, if it’s something that hasn’t and never should be taught in library school, then is it something librarians should be held responsible for?

According to the article, the “library also employs social workers.” Why do they employ social workers? Because librarians aren’t prepared to deal with the sorts of problems that social workers are. Librarians deal in information; social workers in whatever it is social workers do.

The same thing could be said about dealing with overdoses and administering drugs to people. Turning librarians and staff into first responders could be a big mistake. For example, what if the librarian thought it was a heroin overdose, but it was actually a fentanyl overdose? Would they know the difference?

It matters, because according to the CDC, “While NPF-related overdoses can be reversed with naloxone, a higher dose or multiple number of doses per overdose event may be required to revive a patient due to the high potency of NPF.”

NPF is “non-pharmaceutical fentanyl” for those in the know, which didn’t include this librarian. Hopefully the library staff is trained to just keep administering naloxone ever couple of minutes until the symptoms reverse. It’s apparently impossible to overdose on naloxone. It’s only money that could go towards library services, but saving lives is more important than anything the library does.

If the librarian didn’t administer enough naloxone to prevent a fentanyl overdose, would they bear any responsibility for the death, or at least for not saving the life?

The easy answer is no, but if they answer is no, the librarian isn’t responsible for the death, then librarians in general aren’t responsible for heroin overdoses. I certainly wouldn’t want it on my conscience if I tried and failed to reverse an overdose in the library.

On the other hand, what a bloody mess we’re in with opioid overdoses these days.

The CDC article had a map showing the number of fentanyl seizures in the last half of 2014 alone, and the midwest and northeast is being walloped, and that’s just fentanyl and just 6 months.

In addition to the six people have overdosed on heroin at the Central branch of the Denver Public Library this year, and they’ve “administered four doses of it” since getting the drug in late February. Clearly, the problem is real.

But it’s also part of the slippery slope. Right now it’s opioids, and library staff are supposed to be first responders to overdoses, presumably alongside calling 911.

Why stop here? Why not get rid of the security guards? Can’t library staff be trained in verbal de-escalation and combat tactics? In addition so the naloxone, can’t they carry mace and tasers?

Okay, maybe that’s too far down the slippery slope. Given how frustrated and passive-aggressive so many librarians are, the last thing we want is for them to be armed with tasers. That’s a recipe for disaster.

But it’s still bad when librarians get away from the provision of information services to the provision of all services. Why not open needle exchanges inside the library? Or drug treatment centers?

Is the goal just to make sure that people don’t die of overdoses in the library? Or is to help them before they overdose? Or is that the social worker’s job? It’s hard to tell anymore.

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Comments

  1. Firstly, didn’t you already cover this already? I’m getting some hardcore deja vu right now.

    I think it shouldn’t be our responsibility to be first responders. Like you said it’s a slippery slope. Maybe it could be a volunteer only program? But then again you run into issues like you said, what if it’s something different? What if they try but the drug overdosee still dies? Will the family have the rights to sue? I love they are trying to make a difference, but is that the best way to go about it in the long run. That’s the real question. I don’t know, though. We’ve had our fair share of drug and other issues at my work. Thankfully the police are right next door and a fire station is within 100ish yards.

    I personally wouldn’t want to be responsible for de-escalating a situation. We had a recent kerfuffle at my work, a couple were fighting outside. Really it was the boyfriend yelling and hitting his woman. So my coworker called the cops. Neither of us should have to worry about trying to de-escalate that. It might be good for use behind the desk, if we run into some volatile patrons, but not for anything like what happened to my coworker and I.

  2. Rick Ashton says:

    People are dying from the use of dangerous drugs. It’s happening in cars, houses, schools, and even in public libraries. I hope everyone can agree that this is a bad thing. Rather than stand around, wring their hands, whinge about some far-fetched fear of litigation, and pine for the mythical stress-free good old days, the leaders of the Denver Public Library are taking direct action to save lives. Of course library staff members should call the police and the paramedics when emergencies happen, and they should also try to act. I applaud librarians’ common-sense response to a really awful situation.

  3. anonymous coward says:

    If 6 people had heart attacks would they give mandatory training on how to save people from heart attacks? If 6 people had messed the chairs, would they give training on how to deal with that issue?

    Surely it’s the severity of the issue that’s caused the alarm, not the frequency, right? Perspective is good- if they had 100 people visiting a day and 6 all year OD, that’s an amazingly low rate. However, if you’ve got .001% of your population (and it’s really much, much lower than that) potentially dying in the library from something you can prevent… why not prevent it? We do with AEDs. The difference being AEDs don’t shock if there isn’t a problem. Noxalone nasal spray can be administered even if it’s not actually an overdose.

  4. mountain cat says:

    I want no part of employee expectations of this. How is one supposed to know if the person has had a heroin overdose? Or is it another drug? Or is it someone who has passed out because of a serious issue with diabetes and the insulin needles they carry make one assume it’s other drugs (which happened at our library)? Does Wal-Mart expect employees to run to the pharmacy and retrieve and use this? Your local fast food restaurants? An AED is one thing, as it can control and determine what is needed and instruct, and knowing how to clean poop off a chair (which we’ve done a number of times) while wearing gloves and using cleanser to sanitize is hardly comparable. I have no business administering any drug to a stranger whom I know nothing about medically. And while legal protections are supposedly in place, we know that in reality that is not always the case.

    • This. Very much this. Even with training I wouldn’t trust myself to administer any kind of drug like that to help someone with an overdose. If I were a nurse or emt that would be completely different. But I’m not.

  5. mama mia says:

    why don’t we just start employing nurses or physician assistants along with social workers. Hell, why don’t we just open up a hospital/homeless shelter/counselling service/hot meal service/laundromat and any other damn need not being met by society. Librarians will just do it all. WTF is wrong with us!!!! Some dmf overdosing in the library gets a 911 call. That’s it. I am not injecting anything into anyone.

    • anonymous coward says:

      ” WTF is wrong with us!!!!” That’s a great question. I can tell you, but you’ll never believe me.

  6. Wow, this one makes my head spin. It really bends the idea of what a library is to the point of totally breaking down what a library is vs.an emergency room or dozens of other social services. It just worries me as more libraries are put in the position where they have become a cheap way to avoid addressing those needs properly.

  7. anonymous, please, let’s hear what you have to say. Other than the fact that librarians are the world’s biggest enablers, what else?

  8. Your friendly neighborhood library assistant says:

    This is so ridiculous. It’s just another library trying to be the first to provide some sort of unnecessary service. Call 911. Get a trained medical professional. Libraries can’t be everything to everyone (although lord knows some of you try), and they definitely should not be an ER.

  9. Thanks for the article. Hadn’t heard of this service yet.
    Libraries, it seems to me reflect their communities, and the needs of those community members.

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