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🎧 Episode Summary:

In this eye-opening episode of the Pre-Hospital Paradigm Podcast, Dr. Jon Hill and Scott Wildenheim are joined by Ashley Rosser and Leisha Starkey of Thrive for Change, a Cleveland-based harm reduction nonprofit. Together, they explore the real-life challenges and successes of harm reduction, tackling stigma, overdose response, safer use practices, and EMS integration. This episode bridges clinical EMS care with public health strategies, offering insights and tools for anyone committed to reducing overdose deaths and improving patient engagement.

🧭 Key Topics Covered:

🔓 Harm Reduction Defined

• Harm reduction as a public health strategy to prevent injury, illness, and death related to drug use
  
  

• Not about enabling drug use—about reducing preventable harms
  
  

• Focus on hepatitis C, HIV, and overdose death prevention
  
  

🧠 Lived Experience & Stigma

• Ashley shares her personal journey of recovery, overdose survival, and stigma in healthcare
  
  

• Discussion on stigma both in and outside the drug-using community
  
  

• How language and provider behavior affect outcomes
  
  

💉 Programs by Thrive for Change

• Naloxone distribution (20,000+ kits in 2024)
  
  

• Fentanyl test strips, syringe exchange, safer smoking kits
  
  

• Free weekly hot meal distribution with outreach
  
  

• Mail-order harm reduction supply service across 75+ Ohio counties
  
  

• HIV testing, referrals to MAT/detox, and clothing/gear donations
  
  

🆘 EMS & Community Overdose Response

• EMS perspective: airway and breathing before reversal
  
  

• Concerns about over-reliance on naloxone and bypassing basic care
  
  

• Police often first on scene—multiple naloxone doses common before EMS arrival
  
  

• Call for better public/EMS education on rescue breathing and staged response
  
  

🧯 CPR, Rescue Breathing & Bystander Action

• Advocating for community CPR training alongside naloxone education
  
  

• "If you're going to breathe for them, be ready to compress for them"
  
  

• Never Use Alone Hotline: a national virtual overdose prevention line
  
  

  • 📞 800-484-3731
    
    

  • Calls EMS if caller becomes unresponsive
    
    

📊 Outreach Impact in 2024

• 289 confirmed overdose reversals
  
  

• 62,000+ fentanyl test strips distributed
  
  

• 60,000 syringes, 8,800 safer use kits, and over 1,200 volunteer hours
  
  

• Nearly 1,800 hot meals served as stigma-free outreach cover
  
  

🏥 MAT & Treatment Navigation

• Discussion on person-first language and appropriate terminology
  
  

• Partnerships with MAT programs like Brightview and Centers for Families and Children
  
  

• Referrals and transportation support for detox, recovery, and primary care
  
  

🚨 Legal & Policy Barriers

• Syringe programs often opposed by law enforcement or local governments
  
  

• Risks for non-citizens and repeat overdose patients even under Good Samaritan laws
  
  

• 2024 Ohio policy flags non-fatal overdoses in the prescription reporting system (ORS)—raising privacy and stigma concerns
  
  

🌍 Global Harm Reduction Models

• Safe consumption sites in Portugal and Canada: linked to reduced deaths, increased treatment engagement
  
  

• U.S. alternatives: Never Use Alone hotline, but legal supervised use sites only in NY & RI
  
  

• Opportunity to mirror effective global approaches locally
  
  

🔄 Practical Takeaways for EMS & Public Health:

• Normalize and prioritize rescue breathing as first-line overdose care
  
  

• Build patient trust quickly in the field—soft skills matter
  
  

• Provide multiple options for harm reduction education, not just Narcan
  
  

• Use person-first, non-stigmatizing language: “person in recovery,” not “addict”
  
  

• Understand barriers participants face accessing help—even from EMS and hospitals
  
  

• Explore local partnerships with community paramedics and harm reduction orgs
  
  

• Support integrated care: outreach + treatment + basic needs
  
  

📚 Featured Resources:

• Thrive for Change: thriveforchange.org
  
  

• Never Use Alone Hotline: 800-484-3731
  
  

• Words Matter Language Guide (from NIDA)
  
  

• Project DAWN – Ohio’s free naloxone program
  
  

• SAMHSA – Treatment and education resources

From The Episode