With compassionate outreach, a city cuts its drug overdose rate in half

Why We Wrote This

As the scale of the national opioid crisis becomes clearer, some are overwhelmed by what seems like an insurmountable challenge. But one city has found a way to counter that hopelessness, and now others are following suit. 

Christa Case Bryant/The Christian Science Monitor
Paramedic Larrecsa Cox heads a new Quick Recovery Team in Huntington, W.Va., that visits residents within 72 hours of an overdose. Here, she is driving home Jim Ward, an individual she helped when he was in the final stages of being hired for a new job as a cook. (Days later he got the position and began working.)

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It’s a simple idea: compassionate outreach for those dealing with substance abuse, well after the sirens stop wailing. But a West Virginia city that has formally embraced that idea has seen its high overdose rates drop by more than half since last year. Since December, a Quick Response Team – composed of a paramedic, police officer, and mental health specialist – has been sent to the listed address of every individual who has overdosed. They visit within 72 hours, offering treatment options and support. In just a few months, the city has seen a change. Those who have overdosed say they feel genuinely cared for, while those who have become wearied by the toll of 911 calls are now met with gratitude. “For so many years, we didn’t see the patients being receptive,” says QRT coordinator Connie Priddy of Cabell County EMS. “And now, because we’re working on changing how we approach it, their way of accepting us has changed.” The West Virginia Legislature recently allocated $1 million to implement similar programs across the state, and communities have until early June to apply for funding.

Jim Ward and his girlfriend were awash in cash thanks to their regular trips down south, where they would buy thousands of prescription opioid pills from unscrupulous doctors and sell them back home in West Virginia for $220 apiece. But when they found out she was pregnant, they stopped all that.

The only problem was, the money stopped, too.

Mr. Ward lost the house he owned. He began sleeping at abandoned homes, and though he enrolled in some treatment programs, he was never able to stick with it – sometimes abusing the medication they gave him to get high again. He overdosed so many times he lost count. He and his girlfriend broke up.

“It’d gotten to the point where my mom didn’t want to have anything to do with me,” he says. Then one day in January his mother told him a few people had come looking for him.

They were from the Quick Response Team (QRT), a new initiative from the city of Huntington to follow up with every overdose survivor within 72 hours.

At the heart of the QRT model is a simple idea: compassionate outreach for those dealing with substance abuse – well after the sirens stop wailing. It has uplifted both first responders and those struggling with addiction, with each side able to see more humanity in each other. Those who have overdosed are amazed to see police officers or paramedics arrive on their front stoop not because someone called them with an emergency but because they wanted to check in. And those who have become wearied by the toll of 911 calls – being spit on, hit, or numbed by reviving the same people over and over – are now being met with gratitude.

“For so many years, we didn’t see the patients being receptive,” says QRT coordinator Connie Priddy of Cabell County EMS. “And now, because we’re working on changing how we approach it, their way of accepting us has changed.”

“[First responders] are having people say to them, ‘This is the first time that someone has cared enough to come and do this, you’ve saved my life, thank you,’ ” says Karen Yost, chief executive officer of the Prestera Center, which is partnering with Huntington’s QRT and implementing a similar program in Charleston, W.Va., beginning June 1. “Now they’re beginning to see light at the end of the tunnel.”

The program, together with Huntington's other initiatives, has caught the attention of the federal government.

“I came to Huntington because it’s one of the best stories in the United States in terms of recovery. If we can turn around overdose numbers here, we can do it anywhere,” said US Surgeon General Jerome Adams on a visit May 10. “I’m here to learn about what's working so I can share it with Washington, D.C., and the rest of the nation.”

‘I was very proud’

Huntington’s QRT is composed of a full-time paramedic, Larrecsa Cox, and rotating shifts of police officers and mental health specialists.

Ward recognized Ms. Cox when she showed up at his mother’s house in January with the QRT; he’d first met her in an ambulance on one of his overdoses. This time, she was there to help him find a detox center. She drove him across the border to a Kentucky facility, the only place with an available bed, and drove him home again the following week. He says he hasn’t gotten high on opiates in the four months since, and he’s been a steadier presence for those in his life – including his 5-year-old son.

“One of my friends – seeing me get clean made him want to get clean,” says Ward, who texted Ms. Cox this week to tell her he’d just landed a job and worked 30 hours in his first three days.

“I was very proud,” says Cox, noting that getting clean is only part of the battle. “There are things the drugs have masked for so long, and once the drugs are gone you have to face them.”

It’s not just Ward who is getting his life back on track. Cox and her QRT colleagues have gotten about a third of the more than 230 people they’ve visited since December into treatment. Their work has helped Huntington – whose overdose rate had climbed steadily for years – cut that number by more than half since last year. Now, the model is set to spread across West Virginia, with the legislature allocating $1 million for a four-year pilot program. Communities have until early June to apply for funds, which will be administered by the state’s Office of Drug Control Policy.

Susie Mullens, interim director for ODCP, says they hope to see Huntington’s success replicated. “We certainly hope to see that around the rest of the state … the decrease in the overdoses, and community enthusiasm for bringing hope to the communities through the Quick Response Teams.”

The making of a QRT

Huntington made headlines in August 2016, when 28 overdoses occurred in one afternoon in the city of 50,000. Though first responders were able to save all but two individuals, the city concluded that wasn’t enough. They needed to help such individuals not only stay alive, but reclaim their lives.

Last year Bob Hansen, who had just been appointed director of addiction services at Marshall University in Huntington, heard about an interesting model in a community outside Cincinnati called Colerain. They had formed a Quick Response Team in July 2014 and had had an 85 percent success rate the first year in getting those they visited into treatment.

Colerain’s QRT only went out once a week, and their overdose numbers were only about a tenth of Huntington’s, which is the main city in the hardest-hit county of the hardest-hit state in America. But the principle seemed sound, so Huntington decided to create its own program modeled on Colerain’s.

It had no budget for it however. So the city applied for two federal grants in hopes they’d get one of them. By September, both came through and they had $1.3 million – enough to fund a five-day-a-week team for three years.

“The thing I so admire about Bob Hansen’s leadership is they were able to develop a full-time team,” says Shana Merrick of the Addiction Services Council in Greater Cincinnati, who helped implement the Colerain program and came to Huntington last spring to share their experience. “We were never able to do that in our region.”

A standard for the state – and maybe the nation

The team starts work at noon. Earlier than that, and they have trouble rousing the folks they want to help. They add the latest EMS records of overdoses to their chart, and set out on visits around the city.

On a recent Wednesday afternoon, Cox visited a homeless shelter with Prestera recovery coach Sue Howland and Lt. Eric Corder of the police department to try to find a man who overdosed a couple of days ago. This is their second attempt to locate him. Cox sits in the back seat of the cruiser flipping through her handwritten charts of everyone who has overdosed recently, but there is no address listed for him. Ms. Howland gets out to look for the man, but to no avail. She spots another individual they’d helped though, and goes over to chat with him, just as she would with a friend.

“Nobody is better than anyone else,” she says, explaining her approach. “Everybody puts their socks and shoes on the same way.”

Practically everywhere she and the QRT team go, they’re greeted by smiles and hugs from those they have helped.

But new cases can be tough.

After leaving the homeless center, they drive across town and knock on the door of a house they visited recently to see if the adult son is home this time. No, the mother says, peering out from behind the glass front door – he left at 6 a.m. for work and won’t be back until later tonight.

Is there a better time they can come? No, she says, still behind the glass door. He works seven days a week.

The QRT doesn’t believe her story, but there’s not much they can do other than reiterate their offer to help, and leave a card with their phone number.

It’s 5 p.m. and there’s no one else on their list for today, so they head home through the flowering streets of Huntington, where the spring sunshine and freshly unfurled leaves give an aura of hopefulness even to the run-down homes and yards.

No one is ready to declare the opioid crisis vanquished. But they’ve seen the community rally together to not only come to grips with the problem, but find solutions.

“When this [crisis] started, we got bombarded with: ‘Why are you wasting taxpayers’ money?’ ” says Gordon Merry, director of Cabell County EMS, who is happy to tell them the overdose rates are coming down. “When I go to lunch now, people ask me, ‘How are we doing on overdoses?’ ”

That community buy-in and willingness to work across all sectors – and most of all, to take on not only the opioid crisis but what Mayor Steve Williams calls the disease of hopelessness – could make Huntington a model not only for West Virginia but the country.

“If we find a way to be able to defeat this here,” says Mayor Williams, “then that becomes a standard that can be utilized certainly throughout the rest of the state, but I believe that it [also] becomes a standard that the rest of the nation will be able to follow.”

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