Nicolas La Salle Abran is always on the move.
As a supervisor with Urgences-santé, the paramedic service that oversees Montreal and Laval, he bears witness to the worst moments of people’s lives.
This can range from treating a patient undergoing a heart attack to being among the first to arrive at the scene of a grisly infanticide. The seasoned paramedic is also on the front lines of drug overdoses and “a lot of opioid intoxications.”
“It’s a lot more from before when I started in the ambulance,” La Salle Abran told Global News during a ride along in downtown Montreal as night turned to morning.
The supervisor, who is about to celebrate his 10th anniversary with Urgences-santé in Montreal, knew he was in for a busy Thursday shift. Leaves may be on the ground, but it’s unseasonably warm for early October.
“It’s really beautiful outside; there are a lot of people so we know it’s going to be big,” La Salle Abran explained.
On any given night, La Salle Abran is patrolling the streets to offer both help to his teams and those on the street. His first stop Thursday included a call to a supervised injection site where there was a possible drug overdose, followed by a suspected crack overdose at the back of a building in the Plateau-Mont-Royal borough.
In the car, La Salle Abran has access to a screen near his dashboard that lists the different kind of emergency calls pouring in. He pointed out that addiction isn’t limited to certain populations or areas, noting that one call about a potential drug overdose was in the city’s suburban West Island.
“Intoxication and addiction could be every day, everywhere or with anybody,” he said.
In August, the Montreal public health department issue a report saying that more than 75 per cent of the 175 fatal overdoses that occurred from August 2022 to July 2023 took place at home. The report noted that of those victims, nine per cent were homeless and that overdoses don’t discriminate when it comes to age, either.
The public health department also noted that “many lives” were saved by community organizations, paramedics, first responders and citizens during that period. In one case, on the ride-along with La Salle Abran, a concerned passerby came across an unconscious man and administered naloxone, a medication that reverses opioid overdoses, until paramedics arrived.
“As a citizen, you can intervene and maybe save a life,” La Salle Abran said.
Urgences-santé has tracked the rising number of interventions where paramedics administer naloxone since April 2015. Paramedics used naloxone 82 times in 2016 but that number has consistently been on the upswing in the following years. In 2022, a total of 291 interventions were recorded in Montreal and Laval.
The latest data, which was obtained by Global News, shows that 28 interventions occurred this past September — the highest number recorded for that month to date.
La Salle Abran described drug overdoses as difficult situations that are not only hard on those who consume, but also those who treat them. Not only must paramedics act fast and with precision, but they put themselves in their patients’ shoes.
“It’s sad and a tough life,” La Salle Abran said of those who struggle with addiction. “But at the end, our job is to treat them.”
“And at the end of the day, they are still human beings and we need to treat them with all our empathy, all of our professionalism and we’re going to take care of them the same way we are going to take care of everybody else.”
La Salle Abran said there could be a few reasons why opioid overdoses are on the rise, ranging from more drug users to incidents where a bad batch hits the streets. The majority of overdoses he sees arise from street drugs, though accidental prescription overdoses happen too.
“The more narcan, the more eyes we have on the streets, the more lives we will save,” he said. “We’re never going to stop drugs, but at least if can save people — we’re going to do it.”
La Salle Abran is one of five supervisors who oversee 80 paramedics on any given day. He provides support to patients and to the teams of paramedics in a job where there is a risk of post-traumatic stress disorder. Dealing with that risk sometimes means listening to colleagues after a rough shift, even offering them McNuggets.
“I’m taking care of patients, but I’m taking care of my own,” he said.
It’s far from easy, but La Salle Abran describes being a paramedic as “the best job in the world.” He said not only does he get to help save lives but he gets to listen to patients and help make them feel better.
“You make an actual difference in people’s lives,” he said.
Everybody, including those suffering from addiction, has a story to tell.
“We’re here to listen to them and we’re here to treat them.”