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Nestled between fluid embalming catalogs and mortuary stretchers, two doses of naloxone, an opioid antidote, sit in a closet near the office of funeral director Jeffrey Gair.
"It's just in case," Gair told himself before locking the closet door every night.
The funeral director of the Peaceful Alternatives Timonium Funeral and Cremation Center has never opened the plastic case around the Narcan Nasal Spray, which is used to fight the effects of an opioid overdose.
Yet Gair sometimes wonders how long his reserve will remain unused.
While the number of drug-related deaths continues to rise in Maryland, funeral directors are calling themselves the "last responders" to the opioid epidemic. The nickname is a concern within the central Maryland funeral industry about the aggressive aggressiveness of licensed forensic pathologists who are preparing for overdose in their businesses.
They fear that synthetic opioids like fentanyl and carfentanyl are found on the body of a deceased person or on the clothes of a deceased, inadvertently exposing their staff or guests to the funeral home. These drugs can be lethal in amounts as small as a grain of salt when inhaled or absorbed through the skin. In Harford County, a sheriff's deputy and two emergency medical personnel were treated in May for being exposed after responding to an overdose reported.
The National Association of Funeral Directors recommends its members across the country to prepare for the fact that someone – a staff member or guest – might be exposed. Members should train their staff to administer naloxone and to recognize symptoms of overdose. The media in Chicago and Canada reported on funeral homes storing naloxone.
The question that David Weber, spokesperson for the Maryland Funeral Directors Association, has the most to hear from his peers is: "What else can we do to protect ourselves from harm?" exposure to opioids? "
Training staff to administer naloxone is probably the only option that funeral homes have not yet used en masse, Weber said. The owner of the David R. Weber Funeral Homes of Upper Fells Point and West Baltimore is seriously considering training in the administration of naloxone.
"I think it's at the dawn of a trend," Weber said. "I think it's going to happen."
Although naloxone storage is still apparently rare among funeral home operators in central Maryland, many of them told The Baltimore Sun that they were thinking about the decision.
Howard McComus of Funeral Homes of McComus, Harford County, announced this week that he plans to continue his research to train his staff in the management of naloxone.
"To be accountable to the community, that's something we need to tackle," McComus said. "I think in the near future we could go down that road."
Opioid overdoses in Maryland hit an all-time high in 2017, with more than 2,000 deaths. Maryland schools and libraries responded by having naloxone at hand.
Some funeral directors in Maryland have reservations about keeping naloxone. Weber wondered if his insurance company would oppose it as a potential liability, in the event that a person treated with the drug would fall ill or be injured. Funeral director Lee Stallings, owner of Stallings Funeral Home in Anne Arundel County, asked if the mourners were actually attending the funeral.
However, many funeral directors reported that their companies had launched opioid prevention and education initiatives in their respective communities, often partnering with law enforcement and medical staff to share information about the dangers of drugs.
In 2017, the Tri-County Funeral Directors Association, a professional Maryland organization, developed an advertising campaign called "We Do not Want Your Business" to raise public awareness of the opioid epidemic. and prevent deaths.
The association has also distributed to its members pamphlets entitled "Opioid Epidemic: How Funeral Directors Can Respond". It was published by the professional organization of the International Order of the Golden Rule, which has since sold to 23,000 copies nationwide. opioid exposure during the embalming process and a recommendation to train staff to the administration of Narcan.
Mr. Gair and five staff members of Peaceful Alternatives decided to attend free training on the use of nasal spray, a growing clientele comprised of overdose victims and their friends and relatives bereaved. The Maryland overdose intervention program offers the public free in-person training including doses of naloxone.
"You need to know that if you have a user whose services are reserved for your business, there could be other people present," Gair said.
Funeral directors in Baltimore and Harford counties said they were increasingly faced with incidents of drug use on their property or among the bereaved. The owner of Candle Light's funeral home in Catonsville has called police five times for individuals who were not invited to the funeral, who were using drugs on his property.
Staff members at Stauffer Funeral Home in Frederick County have pledged $ 10,000 to fund a documentary film on the opioid epidemic after a man struggling with this addiction is fell by chance in search of help.
At MacNabb's Funeral Home in Catonsville, a grieving woman who attended the funeral of a person who overdosed walked up to two blocks to a McDonald's restaurant. where she took an overdose in the bathroom. Police said that they were able to resuscitate the woman, but she refused treatment and left the restaurant alone.
"Before, the funeral parlors carried odorous salts. Now you wear Narcan, "said Jim Schwartz, MacNabb Funeral Director.
Over the years, national funeral standards have been met: Precautions for carrying special kits, including respirators and disposable suits, are a precaution for home care. Schwartz said.
Schwartz considered attending a naloxone training, but said that he felt safer knowing that the alleged overdose deaths in Maryland are first treated by a forensic doctor before that the body be transported to a funeral home.
The owner of Stallings Funeral Home stated that he saw little need to keep naloxone in his business. He added that the idea could have been evoked by firefighters and other first responders, some of whom were moonlit in funeral homes, who treated overdoses in their full-time jobs.
Forensic Pathologist Brandon McNair, who works for March Funeral Homes in Baltimore, has been a firefighter over the years. McNair said that he was not wearing naloxone at his funeral home work, but that he had usually identify signs of an opioid-related death when the family did not share the cause.
"We're so used to dealing with overdoses that we've come up with clues," McNair said. These could be the young age of the deceased, no evidence of illness or no mention of natural causes.
Gair said that no community, no age and no demographic group is immune to the opioid epidemic. No matter who could carry a lethal dose through his door.
He keeps the little bottle of Narcan close to him, but he tries not to think too much about who might need it one day.
"I never thought I could use this on myself or on staff," Gair said. "Nobody asked before. But it is possible.
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