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PEWAUKEE - Health officials in Waukesha County are increasing awareness of the opioid epidemic in a wide range of settings: college campuses, weekly recovery groups, community events. But that awareness outreach also includes a few unexpected places. 

Libraries. 

Library directors from across the county met Friday at the Pewaukee Public Library to learn more about the epidemic and a common overdose antidote, naloxone.

Working with library directors isn't a response to an uptick in overdoses in county libraries, said John Kettler, mental health and substance abuse supervisor for Waukesha County Health and Human Services. Libraries attract a wide range of the public and are just one of several places the county can use to muster awareness.

The county has already hosted a few public training sessions where people learn the symptoms of an overdose and receive a free sample of naloxone, more commonly known by its brand name Narcan. 

“It doesn’t take long, and it’s an opportunity to save lives," Kettler said.

A small number of library systems in large cities nationwide have begun training staff to administer Narcan in response to the opioid epidemic.

In 2006, two people in Waukesha County died from a heroin overdose. In 2015, 20 people died from the drug.

Kettler said he'd like to see library directors bring Narcan training or information sessions to staff and library patrons. Narcan training also could be offered to people who often work with drug users, such as homeless shelters or social service centers. Hotels or gas stations also could have their employees learn to administer the antidote.

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Health education specialist Lee Clay gave library directors a demonstration Friday on how to use Narcan. She said training more people to use the antidote and identify symptoms of overdoses is just a small piece of responding to the opioid epidemic, but it's an immediate and relatively easy step to get more people involved. 

"This is something we can do to save lives now," she said. 

Clay said having Narcan on hand is similar to having access to a EpiPen to treat a severe allergic reaction or a defibrillator. Narcan is another way to be prepared for emergencies.  

Administering the drug is simple. Narcan often comes in a nasal-spray form, so Clay demonstrated how to tilt a person's head back to spray the antidote up the nostrils. Clay also advised doing rescue breathing before and after giving a person Narcan.

"One click, one dose. That's it," she said. "That's how easy it is." 

Kathy Klager, a library director for Sussex, said she doesn't plan to make Narcan training a requirement for her staff, who are already trained in CPR. But she said she'd like to have her library host a public information session about Narcan and opioid addiction in the near future. 

"There are a lot of people who could benefit," she said. "The information component is really important." 

Milwaukee Public Library spokeswoman Eileen Force Cahill said in an email that the library has been in consultation with Milwaukee health and police and fire officials and are not currently planning on training staff in administering Narcan.

"We have not had an overdose in or around MPL branches or Central Library," she wrote. "Additionally, we have very good response times by fire and police when we do call for service due to a medical or other issue."

Narcan has no negative side effects if it's accidentally administered to someone who isn't overdosing. Two doses of the antidote in nasal spray form cost $75 under public-interest pricing. 

Waukesha County officials announced a work plan to combat opioid overdose deaths in the county earlier this year. The free public training is funded through a federal grant from the Substance Abuse and Mental Health Services Administration.

Sheriff's deputies and other emergency responders in Waukesha County are already trained to administer the drug, a common practice in other parts of the country. 

Librarians trained around U.S.

Addressing the opioid epidemic through libraries isn't unique to Waukesha County. A few libraries across the country have already trained their staff to use Narcan.

An overdose death in a library in downtown Denver prompted the city's library system to start offering the training, said Chris Henning, community relations director for Denver Public Library.

Libraries attract people with a variety of backgrounds. It's not surprising that the opioid epidemic has spilled into libraries, he said. 

“Anything that happens out in society is going to find its way through our doors,” he said.

Since January, there have been 14 overdoses in Denver libraries, Henning said.  

“Librarians never thought this would be something they’d have to deal with," he said.

Almost all staff members at a handful of libraries in Philadelphia are trained to administer the drug, said Marion Parkinson, a library supervisor for the Free Library of Philadelphia. In four libraries Parkinsonoversees at least one person has overdosed in the last two years. One library had four overdoses in roughly one month in 2016.

“We looked at another summer coming, and we couldn't do it again," she said.

Parkinson offered Narcan training to her employees in late February. One employee has used Narcan on eight people since then, though all of those overdoses happened in a park outside the library. 

Drugs have always had a grip on the community she works in, Parkinson said. First it was heroin. Then it was crack. Now it's a little bit of everything, she said. Preparing for overdoses is part of the library's responsibility to serve its patrons, she said. The last thing she wants is for children at the library to see someone die from an overdose. 

“We’re constantly looking at the needs of the community," she said. "These are the needs. This is what we're working with." 

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