Annoyed Librarian
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Inside Annoyed Librarian

Libraries and Public Problems

Has there ever been a bigger example of library mission creep than the handful of libraries around the country that are now learning to administer Narcan?

The latest example is in New Orleans, where librarians aren’t dashing out into the park to save overdose victims as in Philadelphia, but they’re getting ready to.

It’s not so much trying to save people as some of the rationales for this being a library issue.

For example, one librarian says that “as a community we all need to come together and work towards helping with this sort of thing.” Is there anything in a community that this couldn’t be said about?

Should librarians be armed with rifles and shotguns so they can stop crime if they see it? There are probably plenty of robberies and assaults in New Orleans, and librarians should be there to help.

Another librarian provides a related rationale: “Because we work with the public and this is a public health crisis.”

That one opens up all sorts of possibilities. In many cities, obesity is a public health crisis. The National Library of Medicine calls it the “public health challenge of our time.”

According to them, “each year in the United States, 400,000 deaths and $117 billion in health-care and related costs are attributable to obesity.”

That makes the opioid crisis look like small potatoes in comparison.

If the National Library of Medicine thinks this is the biggest public health challenge, should the public librarians of the nation get involved? Where is the ALA statement on this?

Librarians could start handing out flyers about diet, exercise, and medical interventions to patrons. They could go out into the community and slap the Big Macs and super size fries out of children’s hands to try to prevent obesity before it even happens. They work with the public, after all, and it’s a public health crisis.

Another rationale is supposedly based on probability: “Being one of the only really open, public spaces, the library is probably going to encounter people in overdosing situations. Since we’re going to be the people that are there, it’s ideal for us to learn.”

Good talking points, but how likely? There’s evidence that people have been doing drugs in urban public library restrooms all over the country, but there haven’t been a lot of overdoses actually in libraries.

Of the 166 people who overdosed in New Orleans last year, none did so in a library.

A question that keeps nagging at me is why this crisis?

According to the New Orleans Director of Health, who taught the librarians, “Every family has someone they know being touched by the opioid epidemic.” I doubt that’s true, even in New Orleans.

But even if it is, it still pales in comparison to other problems, so why not address them?

According to the World Health Organization, alcohol abuse is a public health problem. It also possibly explains why the French Quarter smells like urine and vomit and why ALA avoid having conferences there, but that’s another matter.

Why aren’t librarians addressing that problem?

You can’t say it’s because people haven’t passed out drunk in the library, because people haven’t overdosed in the library either.

The only answer I can think of is that opioid abuse is the safe and sexy public health problem that librarians can involve themselves with and not have people get angry with them.

Even the people who abuse opioids probably don’t want to overdose on fentanyl, but people who drink too much might get mad if you tell them, and an angry drunk is the worst kind of drunk.

And even mention obesity as a public health issue and somebody will accuse you of “fat shaming,” as if being a hundred pounds overweight isn’t bad for your health and, if you’re the beneficiary of any kind of health insurance scheme, bad for everyone else as well.

Should we talk about guns? No, that can’t be a public health issue because the CDC stopped researching it as one.

But talking about opioid abuse is fine because it’s all the fault of Big Pharma, and unlike the crack epidemic there are a lot of middle class white kids affected, and probably some other things.

If the only rationale for public librarians getting involved with a problem is that it affects the public, then anything can be rationalized. Librarians seem awfully selective about that rationalization, but since they keep expanding their mission beyond library issues not nearly selective enough.

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Comments

  1. anonymous coward says:

    They picked it because it’s easy(easier?) and immediate.

    How about we work to accomplish our mission? That’s it.

  2. Rick Meyer says:

    Yes AL, and why learn CPR? Most people don’t have heart attacks at the library. It’s not really our mission to save heart attack victims anyway, amirite? Yes, Anonymous Coward, it is easy and immediate. Really easy, really immediate, low cost (sometimes no cost) way to prevent accidental deaths at the library. What a dumb idea, eh?

    Let the grownups talk now.

  3. J A Benton says:

    Narcan in libraries is simply another tool like AED equipment or CPR training in public spaces. You hope you never have to use them but if you have the tool when you need it, you can save a life. If you don’t, you may find yourself wondering what else you could have done and why you couldn’t help.

  4. super anon says:

    So do you think that having an AED in the building is “mission creep” too? It sure isn’t the “library’s mission” to help someone who’s having a heart attack on our floor, but I sure will do it anyway. I don’t see much difference between that and administering narcan if it’s made available. Both tools are very easy to learn to use, and can save a life.

  5. Having library staff trained to administer Narcan may not be part of the mission but it can be a critical tool in first aid and can literally save a life in seconds. You asked should librarians be armed to stop crime. However, no on being trained on giving Narcan is trying to stop the person using drugs. They are only reversing a deadly overdose.

    You mentioned obesity but no one is flat out blue and unresponsive from obesity. Oh wait. Then again if someone has a heart attack, due to obesity or any other cause, there are many librarians trained in CPR and/or have a defibrillator on hand. Frankly, I have worked in a library for well over 10 years and have never seen anyone have a heart attack. I have seen 2 overdoses at our library in the past couple years.

    In addition, if there was an easy and harmless nose spray that literally an 8 year old could administer that would save a person who was blue, not breathing, and dying for any reason, why would that not be in our tool box of first aid.

    I would also like to think if we had people walking in our libraries with gunshot wounds once a year or two we would start to address the best way to keep them alive until paramedics arrived.

    Finally, yes, there have been people using drugs in library bathrooms but it has only been within the last few years that many of those drugs, such as heroin, have started to be lace with fentanyl, which shuts down a person’s respiratory system in a matter of seconds. If you are not breathing, you will die. If you are passed out from drinking you are still a medical emergency but there is no tool available that I know of to reverse alcohol poisoning. Narcan is easy and safe to administer to anyone and it saves lives.

    This blog was pointed out to me because my son is alive today due to Narcan and is one year sober, living in recovery, and thriving. Because of my personal situation, I had Narcan on me at work at our library when a library patron was found blue and unresponsive in the restroom. I was able to administer and start CPR until EMS arrived. It saved his life. I cannot imagine watching a person die helplessly when it is so easy and available to act and make a difference.

  6. Hear, hear! While I’m not sympathetic to knowing how to use first aid and life-saving measures the need to be ready to inject someone with a spray or shot that we THINK are overdosing is a bit beyond the role of the librarian. This is especially the case with so much of the little things of librarianship being pushed to the back of our work. I say let’s make sure we are up to speed on doing the basics and vouchsafe the profession by addressing information needs, in the age of fake news that can’t be too tough to achieve, before we add on the task of anti-toxin administrator…what’s next are we going to have librarians take classes on calming down people on bad acid trips and reassuring people who are experiencing anxiety while smoking pot?

  7. We are not talking about doing social work with conscious patrons regardless of the situation. We are talking about saving a person’s life and when someone is on the floor of your library’s bathroom blue and not breathing you don’t ask yourself “Did I get collection order sent in?” You can administer Narcan nose spray to ANYONE who is unresponsive or not breathing. It does not affect anyone who is not having an opiate overdose and it cannot hurt the person needing medical attention.
    I sincerely hope that it is education, and not experience, that changes opinions and attitudes..

  8. Holly Eberle says:

    If you have the ability to save someone’s life would you seriously choose to instead watch them die, knowing that you could prevent their death? A human being stops breathing in front of you and your immediate gut reaction is “Whelp, I’m a librarian and according to my MLIS all I know about is books and blogging. Preventable death is justified as long as they’re on drugs.” The public library’s mission is to serve the public, hence the term public library. The McPherson branch in Philadelphia is located in a neighborhood that has struggled with heroin for a long time. Their public has drug abuse problems. Therefore, the public library will do what the public needs because it serves the public. Have you ever been to Philadelphia? I was there earlier this year and totally saw syringe/needle rigs on the ground, as well as billboards advertising treatment options, and hear AM/FM radio commercials/PSAs for treatment options.

    I’m not entirely certain where you are based out of, but it’s pretty accurate to say that most people have been affected by the opioid epidemic in some way. It kills more people than automotive accidents and gun accidents annually and is the #1 cause of death for those under 50 years old. It’s more prevalent in some states than others though, so I could understand if you think it’s no big deal. However, where I am from, there are drug overdoses in public libraries. I’m in IL and the Oak Park Public Library found a dead body (drug overdose) in one of their bathrooms. Have you ever seen someone on heroin in person, in front of you? Based on your writing, I am going to guess that you don’t actually know how to identify someone on heroin. The view you hold of this issue reveals ignorance and stigma. Are you aware that the taxpayer funded foster care system is extremely bloated with opioid orphans (many who are born addicted to heroin due to the mother’s habit) to the point where they aren’t sure what they are going to do moving forward? This is part of your own government, which affects you. Have you ever witnessed a DCFS supervised visit between parent and child in the children’s library? Have you ever met a child whose parents gave them up to pursue intravenous drug use instead? Have you ever met a teenager who goes hungry more often than not because their parents are spending all of their income on heroin? I hope you do someday, just so that you can understand more why this epidemic isn’t sexy and easy.

    I “picked” the opioid epidemic when my friend relapsed badly, overdosed for the third time, beat up his younger brother over drug money, was living on the street, and just signed all his parental rights away. His daughter was born addicted to heroin and her first week alive was spent detoxing and kicking the habit that was forced upon her without her consent. Trying to get him into treatment was not super sexy, especially since all facilities had a wait list so I essentially detoxed with him for a week until he got a bed. Track marks, skin abscesses, and vomit are not sexy. It’s not easy to help someone along with the process of detoxing from heroin because they can’t sleep, they can barely eat, and standing up or walking is not a guaranteed thing they can do. My friend has been off heroin since December 2016. He has a job and rents an apartment…so he went from leeching off society to paying taxes into society.

    I continue to “pick” the opioid epidemic because my county loses 1-2 people every week to a drug overdose. My library has fire extinguishers and though we have never had a fire, I think it’s probably worth having around and updating each year. Your profession has nothing to do with saving someone’s life in a freak emergency scenario. I would save one of my library patrons from a drug overdose not because I am a librarian, but because I am a human being. If I had the ability to save one of my library patrons from being burned alive in a library fire, I would also do that. I’m sorry that you believe helping people is mission reaching.

    • Well said, Holly. Thank you.

    • Holly made the point better than I can, but to add on:

      Overdoses are just another reality for people like public librarians who work with the public. There is a whole lot that public librarians deal with that is incidental to the job itself. I have called paramedics to respond to a passed out alcoholic. We’ve had to confront someone who was openly drinking alcohol in the building. And rolling loose cigarettes in the building. And walking around with AR-15s strapped to their backs (wish I was exaggerating on that last one, but I’m not). That’s not mission creep; that’s working in a building where the bar set on who can enter and stay as long as we’re open is very low. Each one of those things directly impacts the user experience of those people who were in the building to read, study, etc., so were thus public library issues.

      AL, you are looking at this issue the wrong way. Librarians aren’t stocking Narcan because we want to confront a fashionable public health problem. We are stocking Narcan because this particular health problem is so ubiquitous that it is also now increasingly a public library issue.

  9. Bonegirl06 says:

    Missed the mark on this one, AL. Narcan training is quick and easy, much like CPR. Treating obesity is hard and long-term. One of these things is not like the other.

  10. Chera Kowalski says:

    What we chose to do at McPherson Square in Philadelphia was in response to the multiple overdoses that occurred inside our library and the countless others that occurred outside in the park the library is nestled in. McPherson is located in Kensington, which is the epicenter of Philadelphia’s opioid and overdose crisis. However, unfortunately, heroin has had a dominant presence in Kensington for decades, and as this situation began to grow into an epidemic that has now become an overdose crisis because of the rise of fentanyl and other similar substances, we felt compelled to act – I personally felt compelled to act, and luckily had the support of my fellow colleagues.

    We work with the public, and some of this public consists of individuals living with opioid use disorder. We have witnessed so many people almost die in front of us and our patrons, including children and teens, as we waited for what felt like forever for a first responder to arrive because all day in the neighborhood there are overdoses, sirens, and Narcan – resources are stressed and limited because of the need. This is a reality for the community we serve, so we stepped up. This may not be the reality for all public libraries, but the ones that are facing an increased amount of opioid use in their spaces, choosing to be trained on Narcan is a compassionate, humane response to a life or death situation because that is what an overdose is – life or death. Narcan is right up there with CPR, AED equipment, and fire extinguishers, in my opinion – it’s an immediate, much needed response that can save lives in between the time it takes for professionals to arrive.

    And yes, obesity, alcohol abuse, and so on, are public health crises as well, and many public libraries are providing programming, resources, materials, and/or services in response.

    And yes, gun violence is a huge issue as well. In Chicago, community members are actually receiving training to assist with gun wound victims while they wait for ambulances to arrive. Maybe not librarians, but some of the public there is attempting to help during an emergency that can be lethal.

    And yes, the response to this epidemic is drastically different than that of the crack epidemic. The role of race and class is definitely one of the factors for this much more “gentle” response, and that needs to be unpacked and discussed more, especially as states, like Florida and others, begin to pursue charging low-level drug dealers, who are most likely to be a person of color and who do not typically know what is in the product being sold, with homicide and similar crimes in response to overdose deaths.

    However, pointing out other crises and failed efforts of the past to some of them should in no way be a reason for criticizing efforts being made by others with such a bitter, snarky tone. Public librarians are choosing to take a precaution to save a life in a moment of emergency even if there is very little likelihood of an overdose occurring in some of these libraries. There is nothing sexy about this.

    Annoyed Librarian, I really hope you take some time to reflect and learn more about the opioid and overdose crisis and how it is affecting certain communities, and why being trained on Narcan in those communities is an unfortunate necessity. And in moments of potentially lethal emergencies, someone’s life matters more than the library mission.

  11. We’ve had two OD’s in the library bathroom this past year. We have drunk people passing out on the furniture on a weekly basis.

  12. Sharon Smiles says:

    I work in Insurance. We were told to exclude liability of libraries. if there are any complications for administering narcan. . Just another thing to think about.

  13. Helen Freeman says:

    One big difference between heart attack help and Narcan administration is that if fentanyl is anywhere on the body and if it is touched or inhaled, the first aider can overdose. Plus you are asking people who have not signed up to be a first responder into that role, a role that has psychological consequences. Yes, it is traumatic to see someone die. But it is also traumatic to be ask to take on the responsibility of saving someone’s life. It is unfair to make librarians feel as though they are letting the community down if they don’t want to be EMTs. Librarians didn’t create this problem and asking them to solve it is the easy (and frankly cheaper) way out.

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