Rapid response teams that seek to connect overdose survivors to continued care have taken on many names and compositions, but leaders familiar with these efforts in North Carolina and Ohio say all of these teams should prioritize the services their communities' drug users want.
“You need to tailor this,” Robert Childs, technical expert lead at management consultant JBS International, said in a presentation on the concluding day of the virtual Rx Drug Abuse & Heroin Summit. At the individual level, moreover, “If somebody's ready for harm reduction, that's great, let's get them in harm reduction. If somebody's ready for treatment, that's great, let's get them in treatment,” he said.
“They may not be ready to stop using drugs, and we need to acknowledge that,” Childs said.
Harm reduction themes were prominent in the session co-presented by Childs and Jennifer Lanzillotta-Rangeley, PhD, a registered nurse anesthetist and an assistant professor at the University of Cincinnati. Ongoing services to improve quality-of-life outcomes for overdose survivors should include access to syringe services programs, drug testing strips, and the overdose reversal medication naloxone, they said.
Childs criticized programs that make support for overdose survivors contingent on their agreeing to enter treatment immediately. “It's important not to force people into decisions,” he said.
In North Carolina, 18 active post-overdose response team (PORT) programs seek to follow up with individuals within 72 hours of a non-fatal overdose. Some of these programs are led by paramedics, while peer and harm reduction specialists are at the helm of others. Initial outreach might occur with a team visit involving public safety and community outreach workers together.
Lanzillotta-Rangeley reported that among 500 follow-up visits conducted by the quick response team in Colerain Township, Ohio, more than half pursued further treatment.
The coronavirus crisis has forced outreach workers to get creative, to the point of some tossing naloxone kits into the open windows of passing cars to keep fulfilling that part of the harm reduction mission, Lanzillotta-Rangeley said.
She mentioned one significant impediment to understanding the full impact of the Ohio quick response teams. Because no standard instrument for collecting data exists, it becomes difficult to pinpoint the causes of the wide variation in performance among the teams.
“We don't know why some teams are doing better than others,” Lanzillotta-Rangeley said. “We don't know what best practice is.”