ARI SHAPIRO, HOST:
The fire department in Middletown, Ohio, is overwhelmed by emergency calls for people who have overdosed on opioids. A councilman there is worried that the city's budget can't keep up. He's suggesting a three strikes rule - overdose two times and paramedics will respond. The third time they may not. Esther Honig of member station WOSU has the story.
ESTHER HONIG, BYLINE: A fire truck rolls into Station 83 after responding to a call. Firefighter Bryan Oliver says this time it was a fire, but usually it's a drug overdose. On average, his station gets four to five overdose calls a day.
BRYAN OLIVER: We actually had one this morning. We rolled up and he's laying crunched up in a ball, and the typical agonal breathing, pale skin.
HONIG: According to the fire department, the city of about 50,000 has already seen nearly 600 overdoses this year. That's more than they saw in all of 2016. And that has a price. Each dose of Naloxone, an overdose reversal drug, costs about $30. And depending on the potency of the opioid, one patient may require several doses. The department estimates they'll spend up to $90,000 on Naloxone this year. That's 50 percent more than their entire budget for all the drugs aboard their ambulances. When a local councilman heard that, he says he came up with an alternative.
DAN PICARD: If we don't do anything the city's going to run out of money.
HONIG: Dan Picard says each overdose run costs more than $1,000. He counts the wear on the ambulance, the cost of the drugs and the medics. His idea - impose a three-strike policy. The first two times a person overdoses they would have to pay back every cent by performing community service. Now, if that same person overdoses a third time but they have not completed their community service, an ambulance will not arrive to help them. Picard says the plan has been called inhumane. But what happens when the city can't afford any emergency services at all?
PICARD: So not only will overdose patients be dying, accident patients will be dying. Heart attack patients will be dying.
HONIG: Picard doesn't even know if this idea is legal. From addiction treatment to a needle exchange, this year the opioid epidemic could cost Middletown over $2 million, 10 percent of the city's annual tax revenue. The chief of fire says the money will have to come from somewhere else. As EMS, they are legally and morally obligated to respond to an emergency. Firefighter Bryan Oliver says he can see why people in Middletown might support Picard's idea.
OLIVER: You know, you can drive down the road and sometimes there's somebody laying on the sidewalk. You know, they're just - they're tired of what it's doing to the community and the country.
HONIG: Out on Central Avenue, the city's main drag, John Blankenship is sipping an afternoon coffee. Like many people in the city, he's lost family to opioid addiction. His young son and daughter both died. Blankenship says the city may face financial ruin, but as a taxpayer and a father, letting people die is not an option.
JOHN BLANKENSHIP: God should be the only one to decide when somebody dies, not a councilman.
HONIG: City attorneys are researching Picard's three-strike plan. If they determine that it's legal, it will come up for a vote by city council as soon as next week. For NPR News, I'm Esther Honig in Middletown, Ohio.
(SOUNDBITE OF TYCHO'S "DYE")
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