Opioid users are flocking to libraries in droves. Here's what happens when they overdose.

Last month, someone had a medical emergency at the Philadelphia Public Library, and distressed onlookers struggled with how to help.

Thankfully, someone who knew what to do rushed to the scene — another overdose, another librarian at the ready.

Ben, a librarian at a Midwestern public library, sees such overdoses on a weekly basis. "There are times it's happening multiple times a day," he says. "Not too long ago, we had two in the same restroom at the same time. We call security; security calls paramedics. Of course they always find somebody lying there."


Many of the people being asked to respond in the moment — to think clearly and decisively in a life-or-death situation, and sometimes even to administer life-saving treatment — are librarians.

But do we have a right to expect that of them? Do we have any choice?

While opioid overdoses happen everywhere, it's been impossible to miss the stories of overdoses happening in the restrooms of public libraries.

Boston. Cleveland. Chicago.

Curious as to why libraries have been so hard-hit, I reached out to librarians in several different cities, starting with Vermont librarian Jessamyn West.

"There are a lot of places that are de facto public meeting spaces because of how they're used. People hang out at the baseball field, or the Cumberland Farms, the bar, the church," West tells me.

But most of these places require people to be a client or established member of the community in order to belong. "The library doesn't," she says. "It really strives to be available to everyone."

Libraries are quiet, private spaces you can stay for extended periods of time and not be questioned. While you might need an access code to use a Starbucks bathroom, that's not a barrier you'll encounter at a library.

Ben has another theory as to why addicts head to the library: "If something happens, someone will alert the authorities."

"They know someone will have Narcan and help them out," he adds. Narcan (also known as Naloxone) is an opioid antidote.

I asked Dr. Chad Brummett, assistant professor of Anesthesiology at the University of Michigan School of Medicine, what happens without access to Narcan or knowledge of CPR. How much time does one have?

"With oral pills, the onset might be much slower. Unfortunately, a lot of overdoses we’re seeing right now are from heroin, fentanyl, or carfentanil, and that can be incredibly fast, like minutes, a minute," Brummett says. "If somebody has just shot up fentanyl, your timeline might be incredibly short."

Within the library community, boundaries are always being discussed and redrawn around which services libraries can and should provide.

Debate and dissent are common. While the American Association of Libraries states it is "crucial that libraries recognize their role in enabling poor people to participate fully in a democratic society," that doesn't mean every librarian will feel equally comfortable in that role.

"Being a librarian now implies being an expert in way too many fields: social work, child development, health care," wrote one member of a Facebook group for librarians.

A public librarian in Maine who spoke under the condition of anonymity shared that they "have found needles throughout the building (namely in the bathrooms, but not always)."

Another librarian at an urban branch told me, "This happens with great regularity here. I doubt, however, that you will get anyone in authority to talk honestly about it."

Annoyed Librarian, an anonymous Library Journal contributor, spoke for many when they expressed concerns about stepping into a first responder role: "Is the goal just to make sure that people don't die of overdoses in the library? Or is it to help them before they overdose?" they asked. "Or is that the social worker's job? It's hard to tell anymore."

Between January and March 2017, the Denver Public Library's Central Branch experienced six overdoses, including one death.

In a move that's made national headlines, its administration decided to stock Narcan and offer voluntary training to staff members who want to learn how to administer it. Chris Henning, a spokesperson for the Denver Public Library, says that while the administration expected some public resistance, they've received only positive feedback.

One of the reasons Denver has had such success rolling out their program is that they're among a growing number of libraries employing on-site social workers. Aside from their other duties, social workers at their branches offer daily drop-in hours. Their primary clients are homeless people seeking help with shelter, medical issues, and veterans benefits.

But social workers are a strategic investment, one not all library systems can afford or are willing to make.

If Denver and Philadelphia are arming staff with Narcan and training, should other cities follow their lead?

Why wouldn't they?

Based on what librarians shared with me, the most likely reasons are a mixture of bureaucratic inertia, ignorance of the true scope of the problem, and fear of negative publicity. "The administration seems [to have] turned a blind eye to it," says Ben, of his city's library system. "They don't have to deal with it. We deal with it on a very personal level because we see it every day and they don't."

It's worth noting that those heroic Philadelphia librarians didn't wait for Narcan training, instead reaching out to a local a needle-exchange program to show them how to administer it.

But even Narcan isn't a perfect fix: The antidote is effective at blocking the opioids only for a short time — typically less than an hour — so it's still critical to get someone who has overdosed to a hospital so they can be properly treated.

Ultimately, even with training and better resources, libraries are not well equipped to address the root cause of the epidemic.

And as long as they remain on the front lines, witnessing overdoses on the job, feelings of sadness and helplessness will weigh on some librarians.

"None of us [are] trained social workers," says Ben. "To maintain a certain level of empathy when you're seeing this day in and day out [is] taxing and difficult."

Is it fair to ask librarians to step into the chasm between where the social safety net ends and their real job — that is, the one they went to school for — begins?

After speaking with so many librarians, I still don't know the answer. What I do know is that many librarians are willing to do their best to help in these frightening and sometimes tragic scenarios, and for that they deserve not just our support, but that of their administrators, too.

"[Opioid addiction is] a tragedy," says West. "Everybody has to take partial responsibility for the fact that we have an overdose problem. The big thing is that librarians really care, and caring is hard when people are in pain."

This article originally appeared on Catapult and is reprinted here with permission.

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Judy Vaughan has spent most of her life helping other women, first as the director of House of Ruth, a safe haven for homeless families in East Los Angeles, and later as the Project Coordinator for Women for Guatemala, a solidarity organization committed to raising awareness about human rights abuses.

But in 1996, she decided to take things a step further. A house became available in the mid-Wilshire area of Los Angeles and she was offered the opportunity to use it to help other women and children. So, in partnership with a group of 13 people who she knew from her years of activism, she decided to make it a transitional residence program for homeless women and their children. They called the program Alexandria House.

"I had learned from House of Ruth that families who are homeless are often isolated from the surrounding community," Judy says. "So we decided that as part of our mission, we would also be a neighborhood center and offer a number of resources and programs, including an after-school program and ESL classes."

She also decided that, unlike many other shelters in Los Angeles, she would accept mothers with their teenage boys.

"There are very few in Los Angeles [that do] due to what are considered liability issues," Judy explains. "Given the fact that there are (conservatively) 56,000 homeless people and only about 11,000 shelter beds on any one night, agencies can be selective on who they take."

Their Board of Directors had already determined that they should take families that would have difficulties finding a place. Some of these challenges include families with more than two children, immigrant families without legal documents, moms who are pregnant with other small children, families with a member who has a disability [and] families with service dogs.

"Being separated from your son or sons, especially in the early teen years, just adds to the stress that moms who are unhoused are already experiencing," Judy says.

"We were determined to offer women with teenage boys another choice."

Courtesy of Judy Vaughan

Alexandria House also doesn't kick boys out when they turn 18. For example, Judy says they currently have a mom with two daughters (21 and 2) and a son who just turned 18. The family had struggled to find a shelter that would take them all together, and once they found Alexandria House, they worried the boy would be kicked out on his 18th birthday. But, says Judy, "we were not going to ask him to leave because of his age."

Homelessness is a big issue in Los Angeles. "[It] is considered the homeless capital of the United States," Judy says. "The numbers have not changed significantly since 1984 when I was working at the House of Ruth." The COVID-19 pandemic has only compounded the problem. According to Los Angeles Homeless Services Authority (LAHSA), over 66,000 people in the greater Los Angeles area were experiencing homelessness in 2020, representing a rise of 12.7% compared with the year before.

Each woman who comes to Alexandria House has her own unique story, but some common reasons for ending up homeless include fleeing from a domestic violence or human trafficking situation, aging out of foster care and having no place to go, being priced out of an apartment, losing a job, or experiencing a family emergency with no 'cushion' to pay the rent.

"Homelessness is not a definition; it is a situation that a person finds themselves in, and in fact, it can happen to almost anyone. There are many practices and policies that make it almost impossible to break out of poverty and move out of homelessness."

And that's why Alexandria House exists: to help them move out of it. How long that takes depends on the woman, but according to Judy, families stay an average of 10 months. During that time, the women meet with support staff to identify needs and goals and put a plan of action in place.

A number of services are provided, including free childcare, programs and mentoring for school-age children, free mental health counseling, financial literacy classes and a savings program. They have also started Step Up Sisterhood LA, an entrepreneurial program to support women's dreams of starting their own businesses. "We serve as a support system for as long as a family would like," Judy says, even after they have moved on.

And so far, the program is a resounding success.

92 percent of the 200 families who stayed at Alexandria House have found financial stability and permanent housing — not becoming homeless again.

Since founding Alexandria House 25 years ago, Judy has never lost sight of her mission to join with others and create a vision of a more just society and community. That is why she is one of Tory Burch's Empowered Women this year — and the donation she receives as a nominee will go to Alexandria House and will help grow the new Start-up Sisterhood LA program.

"Alexandria House is such an important part of my life," says Judy. "It has been amazing to watch the children grow up and the moms recreate their lives for themselves and for their families. I have witnessed resiliency, courage, and heroic acts of generosity."

When "bobcat" trended on Twitter this week, no one anticipated the unreal series of events they were about to witness. The bizarre bobcat encounter was captured on a security cam video and...well...you just have to see it. (Read the following description if you want to be prepared, or skip down to the video if you want to be surprised. I promise, it's a wild ride either way.)

In a North Carolina neighborhood that looks like a present-day Pleasantville, a man carries a cup of coffee and a plate of brownies out to his car. "Good mornin!" he calls cheerfully to a neighbor jogging by. As he sets his coffee cup on the hood of the car, he says, "I need to wash my car." Well, shucks. His wife enters the camera frame on the other side of the car.

So far, it's just about the most classic modern Americana scene imaginable. And then...

A horrifying "rrrrawwwww!" Blood-curdling screaming. Running. Panic. The man abandons the brownies, races to his wife's side of the car, then emerges with an animal in his hands. He holds the creature up like Rafiki holding up Simba, then yells in its face, "Oh my god! It's a bobcat! Oh my god!"

Then he hucks the bobcat across the yard with all his might.

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Images courtesy of John Scully, Walden University, Ingrid Scully
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Since March of 2020, over 29 million Americans have been diagnosed with COVID-19, according to the CDC. Over 540,000 have died in the United States as this unprecedented pandemic has swept the globe. And yet, by the end of 2020, it looked like science was winning: vaccines had been developed.

In celebration of the power of science we spoke to three people: an individual, a medical provider, and a vaccine scientist about how vaccines have impacted them throughout their lives. Here are their answers:

John Scully, 79, resident of Florida

Photo courtesy of John Scully

When John Scully was born, America was in the midst of an epidemic: tens of thousands of children in the United States were falling ill with paralytic poliomyelitis — otherwise known as polio, a disease that attacks the central nervous system and often leaves its victims partially or fully paralyzed.

"As kids, we were all afraid of getting polio," he says, "because if you got polio, you could end up in the dreaded iron lung and we were all terrified of those." Iron lungs were respirators that enclosed most of a person's body; people with severe cases often would end up in these respirators as they fought for their lives.

John remembers going to see matinee showings of cowboy movies on Saturdays and, before the movie, shorts would run. "Usually they showed the news," he says, "but I just remember seeing this one clip warning us about polio and it just showed all these kids in iron lungs." If kids survived the iron lung, they'd often come back to school on crutches, in leg braces, or in wheelchairs.

"We all tried to be really careful in the summer — or, as we called it back then, 'polio season,''" John says. This was because every year around Memorial Day, major outbreaks would begin to emerge and they'd spike sometime around August. People weren't really sure how the disease spread at the time, but many believed it traveled through the water. There was no cure — and every child was susceptible to getting sick with it.

"We couldn't swim in hot weather," he remembers, "and the municipal outdoor pool would close down in August."

Then, in 1954 clinical trials began for Dr. Jonas Salk's vaccine against polio and within a year, his vaccine was announced safe. "I got that vaccine at school," John says. Within two years, U.S. polio cases had dropped 85-95 percent — even before a second vaccine was developed by Dr. Albert Sabin in the 1960s. "I remember how much better things got after the vaccines came out. They changed everything," John says.

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