LOUISVILLE, Ky. (WDRB) – Firefighters at Capt. Brian O’Neill’s station south of the University of Louisville used to respond to few drug overdoses, but an opioid epidemic fueled by prescription pills and heroin changed that.

As recently as 2012, crews with Engine 18 at S. Fourth Street and Montana Avenue made just seven overdose runs during the entire year. Since then, however, those calls have soared.

Engine 18 had responded to 152 overdoses through late October -- nearly twice as many than during all of 2016 – according to Louisville Division of Fire data. During some shifts, O’Neill said, crews might make four drug-related runs.

“Oftentimes it’s the same house, sometimes even the same person,” he said in an interview this summer.

Declared a national public health emergency by President Trump last month, the opioid crisis has slowly helped overdoses surpass other causes of traumatic death in communities across the U.S. In Louisville, more than three times as many people died in 2016 from overdoses than were murdered or killed in car crashes.

The epidemic has placed new demands on firefighters, who often arrive at overdose scenes before EMTs and police officers. Many now carry and administer the overdose-reversal drug naloxone and face new risks from fentanyl and other synthetic opioids that can be lethal in even trace amounts.

Fire departments in Louisville and surrounding counties are rapidly adjusting, conceding that these increasing dashes to revive people close to death have potentially wide-reaching effects on response times, recruiting and morale.

And there are no signs of a slowdown ahead. Louisville and suburban Jefferson County fire departments already have made more overdose runs so far this year  –- 2,018 -- than the 1,500 from all of last year, data shows. As a result, there will be at least a 35 percent increase in those types of calls this year.

In fact, Louisville firefighters at some stations are now dispatched to more overdoses than fires. The shift is largely symbolic, since the department’s workload long has been dominated by medical runs and other emergencies. 

But the rapid increase underscores how quickly heroin and other powerful drugs have taken hold in some neighborhoods. Meanwhile, fire officials say there have been cases of firefighters unable to leave an overdose scene for another call.

“That situation has happened … but the fact we were at the scene has not impeded our response,” said Capt. Sal Melendez, a Louisville Fire spokesman. “That unit may not have been able to respond readily at that moment because, again, you cannot abandon your patient.”

In those instances, he said, other units have responded. “Fortunately for the city of Louisville, all of our fire stations are strategically located for that reason,” he said.

So far this year, overdose runs have climbed sharply at Station 5 on East Jefferson Street just west of Interstate 65 near U of L’s Nucleus building. Firefighters with the two companies based there have made 152 such runs through mid-October, compared with 34 during all of 2016.

That’s already more than Engine 6 in the city’s Portland neighborhood saw when it responded to a city-high 124 overdose calls last year. By comparison, it made 101 runs for fire-related emergencies.

Dennis Hoover, who lives near the station at N. 25th Street and Griffiths Avenue, said he’s noticed people presumably on heroin and other drugs “falling all over the place.” That includes a woman who had to be revived with overdose-reversal medication.

“She fell out right in front of my house, was laying there,” Hoover said. “Cops and ambulances came and everything and shot her up and stuff, let her go. She came back the next day back on it again.”

At Engine 6, Capt. Eric Webber said those types of incidents don’t change the way firefighters respond, even if they are aware of the risks of needles and substances that can easily trigger overdoses through exposure to the skin.

“That is something that we do think about and we’re obviously always looking at the scene and making sure the scene is safe for us to even be there at the time,” he said.

Firefighters administer naloxone paid for and provided by Louisville Metro EMS, which has spent more than $502,000 on doses since 2015, according to agency figures.

South of Louisville, the Southeast Bullitt Fire Department outfits its crews with injectable naloxone donated from the Bullitt Opioid Addiction Team. Chief Erik Butler said his department also now responds to more overdoses than structure fires.

If his firefighters are tied up on an overdose run, Butler said the Shepherdsville Fire Department will respond to house fires “but it’s going to take them two or three more minutes to get there.”

Butler acknowledged that recruits and beginning firefighters may not truly understand the scope of the opioid epidemic.

“We’re probably slacking on that part,” he said. “Because, you know, these people come in. They want to be a firefighter. They want to do the car wrecks, they want to do the house fires. They don’t think about the EMS side of it. We really don’t promote that like we should.”

North of the Ohio River, Jeffersonville Fire Chief Eric Hedrick recalled responding to four or five overdoses when he started working in law enforcement in the mid-1990s. His department made 187 overdose runs last year, up from 157 the year before, its data show.

In 2017, Jeffersonville firefighters have made 105 such calls through late October. They carry Narcan – a brand name for naloxone – that is paid for by Clark County government, Hedrick said.

“There’s a financial burden,” he said. “Fortunately, not yet has it fallen on Jeffersonville and the City of Jeffersonville Fire Department.”

But there are other costs. While death and near-death experiences aren’t new to firefighters, the opioid crisis has exposed them and other first responders to intimate scenes of despair.

“It takes its toll on our guys as they respond daily to these calls,” he said. “I think it affects them.” 

One sticks out to Jeffersonville firefighter Joe Hurt, who said he responded to a woman who had overdosed in a hotel room. She was seven-months pregnant, lying on the floor with a syringe stuck in her arm. Children’s clothes lay nearby.

“Somebody’s really sick to be able to see that they’re pregnant, know that they’re pregnant, know that they’ve got children and still they’re going to put this needle in,” he said.

Hurt, who is president of the International Association of Fire Fighters Local 558 and a registered nurse, said the trauma from those situations can build up.

“Everyone has a bookshelf, and stress is like books,” he said. “And eventually everyone has shelf space that they run out of. So every time we respond to these we’re adding another book to our shelf.”

The International Association of Fire Fighters opened an in-patient, 64-bed treatment facility in Maryland earlier this year. The IAFF Center of Excellence for Behavioral Health Treatment and Recovery treats firefighters struggling with addiction and mental health issues, including trauma and stress from their jobs.

The increasing number of overdose calls has left many firefighters with a “sense of helplessness,” especially when they return time and again to revive the same person, said Dr. Abby Morris, the center’s medical director.

“They’re getting more and more calls, and they’re just chasing it and it’s not coming to an end,” she said.

Better training, access to mental health experts and efforts to remove the stigma of workplace stress can help firefighters cope with the demands of the opioid crisis, she said. So can providing naloxone to fast food workers, library staff and others who often call in overdoses.

And she said the extra workload alone can lead to “bell stress” – the quickened heart rate and other physical demands every time an alarm goes off.

“It’s chronic daily exposure to trauma and stress,” she said. “It’s chronic and persistent. It’s day after day after day.”

Reach reporter Marcus Green at 502-585-0825, mgreen@wdrb.com, on Twitter or on Facebook. Copyright 2017 WDRB News. All rights reserved.