Patrons Under the Influence of Drugs: What Libraries Can Do About It

One topic you don't hear too often is what to do about patrons who come in under the influence of drugs. At our recent YA Collaborative Group meeting, we invited two Community Police Officers to talk to a room full of teen and youth librarians about this important topic. They shared some great tips that I'd like to share with all of you, too.

1. No matter how small your library, you are not immune from the drug epidemic

• Across the United States, we have an opioid crisis. So much so that Marijuana isn't even much of a concern anymore. 

"Prescription opioid overdoses now kill more people in the United States every year than all other drugs combined, including illicit drugs. Collectively, drug overdoses are now the leading cause of death in the majority of states and kill more Americans every year than car crashes." (ncsl.org, 11/24/2015)

• With these scary statistics, we all need to work together to end this crisis. Ignoring this problem won't make it go away.
• Does your library policy cover drug use? Our presenters recommended including something that states: that if a person is suspected of drug or alcohol use, library staff will activate the EMS system (basically calling 911).
• Update: since this article has been published, many more overdoses have happened in libraries. The question isn't "if", but "when" will this happen at your library, too.
• Norfolk man dies after heroin overdose inside Slover Library
• Medical examiner: Man died of heroin overdose at Oak Park library
• Man overdoses in Cambria County library bathroom
• Life-Saving Librarian, Narcan Prevent Overdose Death
• Children Discover Couple Passed Out From Drug Overdose In Local Library

2. Partner with your community officers or school resource officers.

• You can ask your local law enforcement for regular walk-throughs to your library to see what's going on and to get to know patrons and staff.
• If they unable to visit frequently, at least get their contact information. If you suspect a patron is using drugs but have no proof, you can still call and ask them to have a chat with the patron, especially if they are a teen/child. Chances are, they are already on the police's radar.
• Due to this crisis, thirty states have passed drug overdose immunity and good Samaritan laws. Basically, law enforcement is shifting their focus from arresting people for drug crimes to getting them the help they need. So now, if you call 911 for a drug overdose (for you or someone you are with), you won't be charged for low level drug possession and use offenses. They are hoping this change will encourage more people to seek help when they need it. (ncsl.org, 11/24/2015) 
• So in these states, don't worry about getting someone "in trouble". That isn't the focus anymore.
• Feel comfortable in trusting your gut -- if something feels off, you are most likely right. Asking for police to come in for a chat isn't going to hurt anything, and that's what community police officers do. (Please call the main office line and not 911 for non-emergency matters.)
• People under the influence of drugs will often try to refuse medical attention because they don’t want to be arrested for possession.  It’s important that they know about the drug overdose immunity and get the medical help they need.

Image from http://www.ncsl.org/research/civil-and-criminal-justice/drug-overdose-immunity-good-samaritan-laws.aspx

3. Know what to look for:

Symptoms of opioid use/overdose:

• Pupils are like pin-points.
• Person is lethargic.
• Person may collapse (people suffering from an overdose usually die from respiratory failure – they may have a pulse, but they're not breathing).
• Excessive scratching.
• Keep in mind that people with certain medical conditions might display similar symptoms when they are experiencing an issue related to their condition (such as diabetic shock, so you should check for an insulin pump or medic alert bracelet).
• Recognizing Opioid Overdose
• Prescription Painkiller Addiction Effects, Signs & Symptoms

Synthetic marijuana is also becoming an issue:

• It’s technically legal.
• It can be purchased at some convenience stores.
• It can produce really bad effects.
• People under its influence tend to exhibit very bizarre behavior.
• Synthetic Marijuana

4. What to do if someone in the library is experiencing (or appearing to experience) an overdose:

• Call 911 immediately.
• If their heart is still beating but they are not breathing, you can use a Narcan (a nasal spray that is used to reverse the effects of opioids).
• Narcan can be purchased over the counter at stores such as CVS and Walgreens.
• It costs about $30.
• It’s safe to use even if turns out the person is not experiencing a drug overdose. (There are no ill effects)
• The effects are only temporary!  It lasts about 30 minutes so the person would still need immediate medical attention.
• After administered, the person will most likely be combative when they first revive because they will be confused as to what’s happened.
• There is some concern that towns might be sued if they administer this to a person without their consent, but the officers said that the Good Samaritans Law should protect from any lawsuits. 

5. Behavior you should look for if you suspect someone is dealing or hiding drugs:

• They keep hold of their stuff at all times.
• They walk around a lot (in and out of rooms, going into the bathroom frequently, etc.).
• They use their cell phones a lot.
• They’re scratching themselves a lot.
• If you suspect that a patron has a drug problem, don’t hesitate to contact officers (especially Community Officers and School Resource officers) so that they can privately talk with them to try to help them.

6. Did You Also Know...?

• You can order professional brochures on drugs and other topics from samhsa.gov for just the cost of shipping. They also provide free downloads, too.
• Tips for Teens: The Truth About Heroin/Club Drugs -- (Free Downloads)
• Alcohol and Drug Addiction Happens in the Best of Families -- (Free Downloads!)
• Some schools have allowed Teen, Children, and Youth Librarians to participate with teachers during their professional development days to learn more about these kinds of topics. Free training! And possibly, a chance to network with more people in your community.
• Reach out to drug rehabilitation centers for any possible trainings. Our local center is actually offering a free Narcan training next week and giving out two free doses of Narcan to all participants. That's a $60 value!
• Please consider keeping a Narcan on hand. They last a long time, and you could possibly save a life.
• This is a great chart about the different types of drugs and their indicators: Cumulative Drug Symptomatology Matrix

Special thanks to Amanda Maclure for taking such great notes at our YA Collaborative Group Meeting and letting me use them here. Also, thank you to our local police department for coming out and talking to us about this.