Project Arkansas First Responders Comprehensive Addiction and Recovery Act (Arkansas FR-CARA) will provide immediate intervention to rapidly increasing preventable deaths in Arkansas as a direct result of misuse and abuse of prescription opioid medications. Immediate intervention methods will entail providing Naloxone and training to active volunteer firefighters and all first responders in the highest risk regions of Arkansas. Statewide delivery of resources and training will be performed by moving throughout the state counter clockwise with the implementation beginning primarily in rural regions identified as most at risk. Populations served will be all populations residing in areas identified as rural regions throughout the state of Arkansas. A regionally focused approached will specifically target the highest risk areas first and continue to work throughout the state. This will ensure optimal intervention methods, alleviation of health inequalities as well as overall reduction of overdose mortality rates in these high-risk regions. These rural region improvements will be a direct result of education and increased awareness to this growing drug overdose epidemic. By the end of grant year 1, 80% of all active volunteer firefighters in North Central Arkansas will be provided with Naloxone(NARCAN) for opioid overdose reversal. By the end of grant year 1, 90% of all homeless shelters in North Central Arkansas will be equipped with Naloxone (NARCAN) for opioid overdose reversal. By the 4th year of the grant, 75% of all homeless shelters throughout the state will be equipped with Naloxone (NARCAN) for opioid overdose reversal. By the fourth year of the grant, 50% of opioid overdose victims seen by law enforcement and active volunteer firefighters will be referred to opt into a treatment and recovery centers as an alternative to incarceration. By the fourth year of the grant, 50% of all opioid overdose victims will have conducted a follow-up consultation with the Program Director.
The Special Enforcement Bureau (SEB), of the Los Angeles County Sheriff’s Department (LASD), is designated as this Department’s Program Managers for the opioid overdose mitigation response defined by Sheriff Jim McDonnell. The Unites States has seen a dramatic increase in the opioid-involved overdose rates. In fact, more than half a million people have died from drug overdoses in the last fifteen years. An average of 91 Americans die every day from opioid overdoses. Public health officials have called the current opioid epidemic the worst drug crisis in American history, killing more than 33,000 people in 2015, alone. In fact, for the first time, deaths from opioid overdoses surpassed automobile deaths and gun homicides. LASD intends to address this national crisis by introducing Narcan dispensers to all patrol oriented personnel immediately. Narcan is the generic name for the pharmaceutical drug Naloxone, which rapidly blocks or reverses the effects of opioid medication. The immediate demand for Narcan has driven the costs of these lifesaving medications to an extremely high cost. The First Responders: Comprehensive and Recovery Act (FR-CARA) grant will help sustain the intended distribution of over 5,500 two (2) dose packages. With a shelf life of two years and treating overdoses in the field, this medication will require stock replenishment over the course of the program. The LASD program intends to train the 5,500 patrol deputies and monitor this program, in depth, for the next four years. The ultimate goal is to routinely deploy Narcan in the field as first responders. If awarded the FR-CARA grant, this will help facilitate and maintain a lifesaving program. It will enable LASD to provide a beneficial emergency service to the 10 million Los Angeles County populace.
The objective of Project FRIEND is to create in infrastructure in which San Francisco's base designated hospital serves as a center for opioid overdose treatment education, naloxone distribution, and facilitation of resource utilization for opioid dependent individuals. San Francisco serves as an ideal geographic location for implementation as it has not only seen an unprecedented increase in opioid use disorders in the last decade, but is also a city affected by the usage of increasingly potent opioids. This proposal involves a three-phase process: construction of an education curriculum/training program for certified and non-certified first responders centered in naloxone administration and distribution, the establishment of a naloxone access point for first responders, and the facilitation of resource utilization for those with opioid overdose events in the pre-hospital setting. Project FRIEND aims to provide a model for successful collaboration at various sectors of the public health community.
The City of Meriden is experiencing an increase each year in the number of residents who lose their lives due to opioid overdose. The City, in working with community partners, recognizes the need to streamline referral mechanisms to increase the chances that persons with Opioid Use Disorder (OUD) are able to recover by accessing services. Residents with OUD need a peer connection to help them find and then maintain their recovery; anecdotal evidence exists that persons arriving in the Emergency Department (ED) with opioid overdose are more likely to link to treatment with the help of a peer. To curb the misuse of opioids in our city, Meriden needs to enhance prevention efforts in schools in order to bring home to kids and their parents the dangers that may lurk in their medicine cabinets; further education on the dangers of prescription drug misuse are imperative to the safety of future generations. The Meriden Opioid Referral for Recovery (MORR) project focuses on first responders using Narcan™ to reverse opioid overdose and then making the connection to services for their client by accessing the Rushford Mobile Crisis Unit. Rushford will provide direct access to a clinician who will provide the initial assessment and appropriate referral to treatment. In addition, Rushford will provide clients in the MORR program with a Case Manager who will be a peer trained as a Recovery Support Specialist in order to give persons looking to find their recovery the opportunity to make a connection with someone who has been where they are. Statistics collected by the City of Meriden Public Safety Committee on the use of Narcan™ showed that the drug was administered 140 times in 2016, most frequently in the City of Meriden downtown area. This is a 13% hike from 2015 when the drug was used 124 times. The City theorizes that this may be due to the mix of fentanyl into the heroin being acquired by those with OUD; this additive increases the potency of the drug 100%. The Meriden Fire Department (MFD) added Narcan™ to their units in January of 2016 and administered it 81 times; 80 of those who received the opioid antagonist survived. The City of Meriden has a complete emergency responder system approach to handling emergencies involving persons overdosing from opioids, however, the City has identified disconnects in the circle of care whose resolution would allow persons handling OUD to recover rather than be administered another dose by emergency personnel the next time they experience an overdose. The MORR project will help the city create a replicable model that will streamline processes between first responders who are reversing overdoses to prevent death, and clinical and peer supports that will help persons with OUD to recover. We know that treatment is effective and recovery is real, the City of Meriden is committed to identifying a path that lets residents with OUD reclaim their lives and rejoin our community.
The First Responder-Comprehensive Addiction and Recovery Act Cooperative Agreement Grant aims to take a systems of care approach to combat opioid overdose deaths in the state of Delaware. The goal of this project is to decrease mortality and morbidity form suspected opioid overdoses. Measurable objectives used to meet this goal include enhancing the acute response (EMS and Law Enforcement and Emergency Departments) to opioid overdoses by improving statewide planning and preparedness efforts within the healthcare community through Coalition development,providing ongoing training and technical assistance support to the first responder community, increasing the availability of naloxone to the first responder community, and reviewing best practices and lessons to implement overdose prevention strategies through the first responder (EMS and Law Enforcement) communities. Grant funds will be used to advance and evaluate state level interventions and education for preventing opioid overdoses. Grantees will train and provide resources to first responders and members of other key community sectors at local governmental levels to carry and administer a drug or device approved or cleared under the Federal Food, Drug and Cosmetic Act for emergency treatment of known or suspected opioid overdose. Grantees will also establish processed, protocols, and mechanisms for referral to appropriate treatment and recovery communities.
As our nation and communities become gripped by the opioid crisis, law enforcement is challenged to be on the front-line of fighting this self-described pandemic. The presence and increased use of fentanyl, and its evil twin carfentanil, goes beyond drug use by a select group of the population into possible terrorist implications. The fentanyl is infused into almost all of the heroin sold locally and can be deadly in very, very small doses. What makes it even more dangerous is that when airborne, the inhalation or touch of the fentanyl can cause critical injuries, including death. Because of its lethality, the drug can be used to make dirty bombs and could kill hundreds of people in a matter of minutes. The individuals who deal this dangerous substances have been known to arm themselves with NARCAN and throw fentanyl in the faces of law enforcement causing them to pass out within seconds. Law Enforcement charged with the responsibility of getting the dealers of this poison off the streets must be armed with the appropriate protective measures, which they currently are not. This gap places officers in a high degree of danger, renders law enforcement unable to abate deadly overdoses and save lives, and gives criminals the ability to avoid apprehension. NARCAN Nasal Spray (NARCAN) is a prescription medicine used for the treatment of an opioid emergency such as an overdose or a possible opioid overdose with signs of depressed respiration and severe sleepiness or non-responsiveness. NARCAN can be both a protective measure for law enforcement to deal with fentanyls or anticipated fentanyl exposures as well as an intervention to individuals who may be in an active overdose. The issuance of NARCAN to individuals pending medical response could save many lives. Administration by law enforcement allows the drug to be administered much earlier than waiting for the arrival of medical personnel to dispense the antidote. The deployment of NARCAN reduces such apprehension and allows the responders to feel protected and equipped to avert loss of life for him/herself and others. The protective measures that NARCAN provides allow safe investigative and intelligence gathering without the fear that comes from interaction with such a dangerous substance. With more robust efforts we can likely experience dramatic decreases in the prevalence of opioid use and distribution. The goals of the project can be achieved through a tandem process. The deployment of the NARCAN to our sworn first responders will allow them to intervene in the case of accidental overdose. This is likely to save many lives as victims will have rapid access to time sensitive medical interventions that can abate death. Additionally, the protective factors that NARCAN provides, will minimize deputy apprehension associated with entering into or interacting in a patrol or investigatory function where these dangerous opioids are present. Certified Peer Recovery Specialists (CPRS) will be hired by BARC to liaise with overdose patients whom BSO EMS has transported to hospital emergency rooms in Broward County. CPRS will be trained by BARC personnel on techniques for communicating with individuals who are just coming out of an opioid overdose, benefits of Medication Assisted Treatment, substance abuse treatment options available, and post meeting follow up with patients. The CPRS will follow the individual through the admissions process at BARC to ensure engagement in treatment. In circumstances where the individual does not show for an appointment at BARC, the Specialist will alert BSO EMS and if appropriate, the CPRS and EMS will complete a team welfare check on the individual at the address provided during enrollment. The CPRS and BSO EMS will attempt to re-engage the individual into care 3 times, with welfare visits, calls, and attempts to reach family.
Jacksonville Fire and Rescue Department will use the awarded resources to purchase life-saving naloxone for the Safe and Healthy Neighborhoods Project. The naloxone is a vital piece in the city’s ongoing, comprehensive plan for prevention, interdiction, rescue, and recovery of overdoses related to heroin and opioids. The city’s size, high rates of abuse, and existing recovery infrastructure will result in substantial returns on this investment. As part of Mayor Curry’s citywide initiatives for safe and healthy neighborhoods to be supported by data-driven, successful programs, the Jacksonville City Council has enacted a pilot program to connect patients and families with treatment and recovery services while reducing recidivism rates and deaths. Through an emergency investment of over $1.4 million, the City of Jacksonville is partnering with local emergency departments and treatment facilities to provide inpatient and outpatient services for overdose victims. The naloxone requested in this funding opportunity is necessary for our first responders to keep these victims alive for recovery. Community members are also contributing as local non-profit, Drug-Free Duval’s North Florida Opioid and Heroin Task Force launched its campaigns earlier this year to begin to provide communitywide collaboration for prevention and education. JFRD has the overwhelming task of providing rescue services to the largest city in the contiguous forty-eight states. Covering 841 square miles of urban, suburban, rural, river and beach, the JFRD service area is just as diverse as the population. To ensure the best service to all parts of Duval County, the city and JFRD have transformed all of their response vehicles to Advanced Life Support status. The majority of funds in this grant opportunity will be used to secure 2mg/mL syringes of naloxone for distribution to JRFD rescue teams. As this program proceeds, recidivism and death rates will fall while rescuers improve effectiveness and efficiency in delivering naloxone. The devastating effects of this epidemic on the Jacksonville community are comparable to the worst in the nation. With our rescue teams responding to an average of two calls per hour for suspected overdoses, Duval County’s rates of abuse are among the highest in the country. JFRD estimates over 4,000 incidents of suspected overdose per year, and, over the next four years, administering almost 17,000 doses of naloxone for incidents across the Duval County service area. The community requires a significant investment in naloxone to reverse these overdoses so that victims can participate in recovery. Jacksonville is resolved to overcome this health crisis. The people are in place; the foundation is set. The funding from this project will provide the resources to activate the city’s comprehensive plan to combat this epidemic.
The Columbus Consolidated Government is seeking funding to equip first responders in our area with life-saving Naloxone. Currently, no first responders in the area have the medication nor are they trained to use it. The Columbus Consolidated Government seeks to serve over 300 individuals with this program and save at least one hundred lives. The population of focus will be first responders and families of opioid addicts. The project will first train and ensure first responders have Naloxone on hand. At the same time, the program will conduct community outreach to families and friends of opioid addicts to provide education, referrals and life-saving kits. The project will work to train all first responders in the area to include: the Columbus Police Department, the Muscogee County Sheriff’s Office, the Muscogee County Marshall’s office and the Columbus Fire and EMS Department. Once in initial trainings are complete, the Coordinator and the Trainer will work to establish this training as an annual ongoing in service required by local first responders. In addition to the training, statistical analysis will report the continued need for the program and will work towards sustainability through departmental budgeting. If used, first responders will be able to provide referral information on the spot to overdose victims and their families or significant others. This information will include linkages to evidence based treatment facilities in the area, Medication Assisted Treatment facilities in the area and programs like our local Drug Court. As a part of the community outreach program, informational gatherings will be held in the areas of highest need in Muscogee County. Local media outlets and 12-step meeting houses will be used to advertise local events. At said events referral information to treatment centers, education about addiction and recovery and linkages to family resources will be available. Also at these community meetings life-saving kits also containing Naloxone will be made available to addicts and family members of addicts. The goals of the project are: Goal 1.1 : Increase the number of First Responders in Muscogee County with access to naloxone from zero to 75 persons in year 1. Goal 1.2: Increase the number of first responders with access to naloxone from zero to (75) individuals in Year 1, (150) individuals in Year 2, and (225) individuals in Year 3 and 4. Goal 1. 3: Increase the number of first responders trained to identify an overdose and administer naloxone from zero to (75) individuals in Year 1, (150) individuals in Year 2, and (225) individuals in Year 3 and 4. Goal 1.4: Increase the number of community advocates and family members of addicts who have access to naloxone to 50 persons per year. Goal 1.5: Reduce opioid overdose deaths in Columbus, Georgia by 20% annually.
Iowa’s First Responders Comprehensive Addiction and Recovery Project (FR-CARP) will be implemented by the Iowa Department of Public (IDPH) Bureau of Emergency and Trauma Services (BETS) in collaboration with the IDPH Division of Behavioral Health. The project goals are to build a sustainable collaborative system in Iowa that educates and enables first responders to assess, treat, and refer patients to treatment following opioid overdose and to build a sustainable system in each Iowa service area that demonstrates cooperation and collaboration between first responders and substance abuse treatment programs. These goals will ultimately demonstrate a decrease in the overall opioid overdose rate of deaths in Iowa. Upon notice of award for this application, BETS will employ a State FR-CARP grant coordinator to administer and evaluate the project. BETS currently partners with local boards of health and emergency medical services through seven primary service areas in the state and an additional five subservice areas for preparedness, response and emergency medical services (EMS). The FR-CARP will be administered through these existing public health emergency response contracts with the service and sub service areas. BETS will execute a response contract with each of the twelve service/sub service area fiscal agents, to administer local responsibilities of the FR-CARP. Each service area will identify a local FR-CARP grant coordinator to collaborate with the state FR-CARP grant coordinator to meet project goals and objectives. The priorities of the project will be: 1) develop relationships between first responders and substance abuse treatment centers 2) develop training curriculum for first responders to include data submission and entry requirements, recognition of symptoms of opioid overdose, opioid antagonist medication administration, medication side effects, medication contraindications and mechanisms for treatment program referral 3) complete these training sessions in each of the service areas in Iowa. IDPH will finalize an agreement with the Iowa Department of Administrative Services for the service area fiscal agent to purchase intra nasal Narcan for the participating first responder entities. Before the end of project year one, Narcan doses will be purchased and distributed to the first responder agencies that have completed training. The FR-CARP will be sustained throughout the four-year project period using these priorities, goals, objectives and benchmarks to continuously evaluate and improve relationships and capabilities of first responders to assist in mediating the disastrous effects of the opioid crisis.
Responding to an extremely high and increasing number of overdose deaths in Chicago, the Chicago Police Department (CPD) proposes: 1) training and equipping patrol officers to carry and administer naloxone to reverse opioid overdoses; 2) improving linkage mechanisms connecting overdose victims to treatment services; and 3) working with other stakeholders to identify issues and implement solutions along the entire opioid overdose response continuum. The primary goal of the CPD Opioid Overdose Reversal Project (COORP) is to save lives by improving first responder response to opioid overdoses across the entire City, but initially within data-driven (e.g. overdose incidents and deaths) pilot program boundaries (estimated to include 6 of Chicago's 22 Police Districts). This will ensure that opioid reversal capabilities and treatment linkage services are quickly delivered where they are most needed, on Chicago's West and South Sides, home to approximately 500,000 residents who are disproportionately: under-employed; under-educated; under-served by social services; and often traumatized by exposure to high rates of violent crime. The following program strategies will be implemented: • All officers "working the street" in six pilot Districts, and eventually across the entire City, will complete an approved Narcan training curriculum and be equipped with FDA-approved Narcan Nasal delivery devices. • Coordinated CPD and CFD policy and standard operating procedures will determine that the first ""first responder"" on the scene will administer naloxone as trained. • CFD EMS personnel will transport overdose victims to emergency rooms (ER); a ""linkage to services"" protocol will be initiated by CFD personnel at the overdose scene or en route to the ER, or by hospital personnel; and everyone receiving naloxone will receive a brochure listing treatment options and contact information. • District police and outreach staff will educate community on topics that include: Illinois Good Samaritan Act; how to prevent an overdose; how to report an overdose; how to access naloxone and respond to an overdose; and how to access treatment services. CPD proposes training and equipping (with an FDA-approved naloxone nasal spray device): 1) 6,300 district officers in all 22 police districts, beginning with a pilot program featuring an intensive linkage effort in 6 districts with extremely high rates of overdose incidents; and 2) 1,800 recruits before they graduate from pre-service training and ""hit the streets"". CPD's COORP is supported by: Chicago Fire Department (co-response partner); University of Chicago Urban Health Lab (Evaluation Partner); Chestnut Health Systems (Outreach & Linkage Partner); Chicago Department of Public Health (Clinical Partner); and the Illinois Department of Alcohol and Substance Abuse (DASA). Objectives include: ensure CPD and CFD consistency and coordination in opioid overdose policy and practice; Narcan training/equipping 8,100 police officers; providing 26,000 overdose victims with linkage information and linking 400 of those individuals per year (1,600 total over four years) to medication assisted treatment (MAT); preparing and using linguistically diverse and culturally sensitive Chicago Opioid Overdose Prevention & Treatment informational brochures for community education; and continuous COORP quality improvement through data collection and analysis, and a vigorous local project evaluation.
In response to the Substance Abuse and Mental Health’s Funding Opportunity Announcement, the Lexington-Fayette Urban County Government (LFUCG) in Lexington, KY is submitting an application for a project entitled, First Responders and Community Partners Overdose Prevention Project (FRCPOPP). In 2016, there were 162 overdose deaths in Lexington, KY. The number of overdose deaths experienced in Lexington has increased 100% since 2013 when the city experienced 81 overdose deaths. The same is true for naloxone administrations by the Lexington Fire Department (LFD). The LFD administered 653 doses in 2013 and 1,550 doses in 2016. In response to this epidemic,the Lexington Police Department began carrying naloxone in 2016. This project will work with the community to strengthen the prevention and intervention infrastructure in an effort to reduce overdose fatalities. The project will strengthen the infrastructure by achieving three major goals. First, the project will provide training on the signs and symptoms of an overdose and how to administer naloxone to the Office of the Fayette County Sheriff. Following the training, naloxone will be distributed to the deputies who come in contact daily with those experiencing an overdose. Equipping the Office of the Sheriff with naloxone will likely reduce the number of overdose deaths in Lexington. The second component of goal one is to supply the Fayette County Health Department’s (FCHD) Needle Exchange Program (NEP) with naloxone to distribute to those who request it. The NEP at the FCHD had a naloxone distribution component until April 2017 when funding for the program ended. From September 2016 to April 2017, 925 naloxone kits were distributed to exchange participants. Approximately 50% of that naloxone accounted for refills given to participants who administered the lifesaving drug on someone experiencing an overdose. Refills were given to prevent future fatal overdoses. The NEP reaches those at great rick of overdose, there for it is an ideal place for naloxone distribution. This program will undoubtedly reduce the number of overdose fatalities. Second, the project will establish processes, protocols and mechanisms for referral to appropriate treatment and recovery communities. This will be done by developing strategies to reach those at greatest risk of overdose and those who have survived a previous overdose and by providing education on grant activities to local substance use disorder treatment and recovery services, harm reduction programs, emergency departments, health clinics and other key partners that may serve as referral sources and/or treatment or recovery service providers for those in need of services. Additionally, policies and strategies will be implemented, using promising and evidence-based practices, which increase treatment and recovery services admissions to those that survived an overdose and to those at risk of overdose and are ready to go to treatment by providing referral to substance use disorder treatment and recovery services and to provide access to naloxone to project participants that do not enter services after surviving an overdose. Third, the project will provide education on Kentucky’s Good Samaritan Law that permits bystanders to alert emergency responders to an overdose or to administer naloxone without fear of civil or criminal penalties. Although the law has been in place since March 2015, many in the community are unaware of it and others are afraid to utilize due to misinformation regarding the law. Successfully implementing the above mentioned goals will assist in the reduction of overdose fatalities in Lexington, KY. The project will be evaluated by the University of Kentucky’s Center on Drug and Alcohol Research.
The purpose of the BFD Recovery Assistance program is to reduce and prevent opioid overdoses. This will be attained by addressing the following goals: 1. Improve access to recovery services and support for affected families; 2. Increase access to naloxone; and 3. Collaborate and coordinate with other first responders and community stakeholders. Goal 1. Improve access to recovery services and support for affected families: Strengthen current mechanisms for connecting individuals receiving opioid overdose reversal drugs to follow-up treatment, recovery and prevention services with achieving the following objectives: 1.1 NRI Coordinator: By Month 4, add a full-time Narcotics Related Incident (NRI) Coordinator position to improve the flow of information and analysis on NRIs to and from all partner agencies and organizations. This will support the rapid identification of individuals and communities that could benefit from post-overdose outreach and coordination services; reduce redundancy and inefficiencies in the outreach system; and identify critical program needs in real-time. 1.2 Post-overdose outreach: In collaboration with BPHC, expand the BFD’s existing in-person, home-based outreach following a 911 call. The targeted outcome will be to conduct home visits within 72 hours of the 911 call for at least 75% of calls from identifiable residential addresses. Goal 2: Increase Access to Naloxone: Through collaboration with other first responder agencies both within the city of Boston and with agencies serving residents of the city of Boston (i.e. local, state, and quasi-municipal agencies), identify gaps in the current system for supplying naloxone on a city-wide basis. 2.1 Conduct an ongoing assessment with Advisory Council members of gaps and shortcomings (including addressing updates to medical directives that all first responder agencies must work under) in the current system for supplying naloxone to first responders and other key sectors, and purchase and distribute naloxone to address at least 75% of these identified gaps. 2.2 Working with BPHC, develop a training program for both first responders and other key sectors such as local community groups. The training will be coordinated by BFD and BPHC, with BFD serving as the lead agencies for first responders. BPHC will conduct training for all community groups, with BFD providing overviews on efforts of first responders during these community-based sessions. Goal 3. Collaborate and coordinate with other first responders and community stakeholders: Improve the City of Boston’s allied approach to combating the opioid crisis through collaborative, data-driven, decision making. 3.1 Hire a Program Manager/Lead Evaluator to provide comprehensive program management, coordinate program services with other agencies, and lead the development of a cross-departmental data collection, monitoring and tracking system 3.2 Convene a city-wide Advisory Council with representatives of key agencies in the effort to address the opioid crisis.
In Baltimore, a city of 614,000 residents, nearly 25,000 people are estimated to misuse opioids, and many of them are not connected to adequate treatment or social support services. Since 2011, the City has experienced a four-fold increase in total overdose deaths from 167 in 2011 to 694 in 2016. According to data from the state of Maryland, 2089 people lost their lives to overdose statewide in 2016. Of these deaths, 33% took place in Baltimore City, though the city comprises only 10% of the state population. Baltimore City carries a heavier burden of overdose fatalities compared to every other jurisdiction in the state, with a per capita overdose death rate of 113 per 100,000. To build on Baltimore’s nationally recognized response to this epidemic and reverse the alarming rise of overdose deaths in Baltimore City, the Baltimore City Health Department (BCHD) and partners the Baltimore City Fire Department (BCFD), the Baltimore Police Department (BPD), and Behavioral Health System Baltimore (BHSB) request $1,993,726 over four years ($498,431.50 per year) to augment the life-saving capabilities of Baltimore City’s Emergency Medical Services (EMS) by developing and implementing an Overdose Survivor Expansion Program (OSEP) designed to improve linkages to recovery services for individuals who experience non-fatal opioid-related overdoses and increase the capacity of first responders to reduce opioid-related fatalities. This will be accomplished by: • Developing and implementing procedures for obtaining consent for outreach services from overdose survivors treated by EMS and BPD in the Central District of Baltimore • Dispatching a real-time targeted overdose outreach team to respond alongside first responders to opioid-related calls in the Central District • Offering case management to people revived from overdose by first responders in the Central District • Implementing a real-time monitoring capacity for tracking SUD treatment system capacity and usage • Developing and distributing culturally and linguistically appropriate public education materials to individuals following non-fatal overdose, with information about SUD treatment options, harm reduction practices and programs, and other Baltimore City recovery services • Developing and providing enhanced “Behavioral Health First Aid” training to BCFD first responders on naloxone administration for the emergency treatment of known or suspected opioid overdose • Ensuring that an adequate supply of naloxone remains available for BCFD first responders to meet the growing number of opioid-related overdoses across the City
The Opioid Overdose Prevention: Medical Outreach and Education Project will provide increased overdose prevention education, including naloxone training and distribution, to Portland’s at-risk residents. This medical outreach will be conducted by skilled paramedics who are currently employed by the Portland Fire Department. Paramedics will spend fifteen hours each week at the Oxford Street Shelter, Maine’s largest emergency shelter. The Oxford Street Shelter is located in an area of Portland, the Bayside Neighborhood, which has been disproportionately impacted by the opioid epidemic. In addition to providing overdose prevention education, the paramedics will have the ability to make referrals to primary care, substance use and mental health treatment services and recovery services. Partnerships with the Oxford Street Shelter, the Preble Street Resource Center, Greater Portland Health and the Portland Recovery Community Center will enhance the continuum of care Portland is seeking. Further, overdose prevention education and naloxone distribution will be available to other key community members. These members include social service agencies serving Portland as well as the friends and family members of our high-risk community members. Through this project, we intend to serve approximately 400-500 unique individuals, annually, with a total of 1600-2000 over the life of the project. Throughout the implementation of the project, demographic data will be collected on all participants. Additionally, the number of referrals to primary care, substance use or mental health treatment and recovery services will be collected and reported. For the naloxone distribution portion of the project, number of naloxone trainings and kits, reported reversals and kit refills will be collected and reported.
Detroit Community Opioid Response Initiative (DCORI) seeks to reduce the rate of opioid overdose fatalities in Detroit by 10% by September of 2021. This initiative empowers community members closest to a potential overdose episode with saving opioid reversal and treatment resources. It relies on the strength of community leaders to intervene in the most hard to reach cases, and provides them the knowledge to bring loved ones and neighbors into care. This initiative focuses on populations of highest risk, including re-entering citizens, IV drug users, and people experiencing homelessness. Between 2011 and 2015, the number of opioid-related fatalities in Detroit tripled, from 40 in 2011 to 127 in 2015. Detroit’s current population of 672,795 residents is spread thinly across a city that has a carrying capacity of 1.8 million people. The sheer size of the city and varying levels of population density pose unique challenges for municipal service provision, including emergency response. Over 40% of residents live below the poverty line. Educational attainment in the city is low--only 12.7% of residents hold a bachelor’s degree or higher – and unemployment is high, ranging from 10-15%. DCORI strives to: 1. Increase the number of community access points for naloxone, including community pharmacies participating in a statewide standing order for naloxone distribution. 2. Train members of block clubs, neighborhood patrols, and family members of known or suspected opioid misusers on the use of narcan. 3. Establish referral pathways for first responders to connect opioid misusers to treatment. DCORI expects to train 4,000 community members over the course of the project, and will distribute up to 1,500 doses of naloxone per year through trained community first responders. Success will be measured by a reduction in rate of fatal opioid overdoses. The team will track outcome metrics, including total number of overdose responses and number of overdoses successfully reversed through the use of naloxone. It will monitor the number of community members trained as first responders and assess retained knowledge. Partners in this collaboration include the Detroit Health Department and Emergency Medical Services, Wayne State University Center for Urban Studies, University of Michigan Injury Prevention Center, and the Detroit Police Department, and the Detroit Wayne Mental Health Authority.
The NYSDOH AIDS Institute Office of Drug User Health is applying for Funding Announcement SP-17-005, First Responders–Comprehensive Addiction and Recover Act (FR CARA) Cooperative Agreement, partnering with Erie County Department of Health (ECDOH) to implement a FR CARA initiative in the Western NY 8-county region. Western NY is currently experiencing a disproportionately high opioid misuse and fatality epidemic. Erie County is one of four Western NY counties designated as a High Intensity Drug Trafficking Area as part of the NYNJ-HIDTA. This project addresses two overarching goals that are consistent with CARA’s: a) to reduce the number of opioid overdose fatalities by training and supplying first responders and b) to enhance the connection of first responder rescues to follow-up treatment. This project will achieve these goals by pursuing four objectives: Obj 1- Make opioid overdose reversal supplies available to first responders and key community sectors; Obj 2- Train and provide resources for first responders and key community sectors to carry and administer emergency treatment of opioid overdose; Obj 3- Establish processes, protocols, and mechanisms for referral to appropriate treatment and recovery; and Obj 4. Evaluate program impact. ECDOH will work closely with various subcontractors to expand naloxone access and support peer-based care coordination through emergency departments (EDs) to conduct post-overdose counseling and facilitate access to treatment for people who use opioids. ECDOH will increase the number of first responders in the community who are trained and equipped to recognize and respond to an opioid overdose with naloxone administration, prioritizing firefighters, who are most often the first responders in rural communities in Western NY. ECDOH will coordinate overdose response capacity in EDs, including naloxone distribution and peer-based linkage to care and treatment, along with post-overdose counseling and piloting of buprenorphine administration. The University at Buffalo's (UB) MD Emergency Physician group (comprised of seven hospitals) will be contracted to provide naloxone and offer buprenorphine. The Addictions Hotline in Erie County will coordinate with the ECDOH ED Peer Navigators Program (PNP) to provide patient-centered care within 72 hours of being seen in the ED.?ECDOH ED PNP will coordinate access to three subcontracted substance use disorder (SUD) treatment providers and one community based organization (CBO), who are also NYS Opioid Overdose Prevention Programs and provide buprenorphine services (Lake Shore Behavioral Health, Inc., Promesa, Inc., Evergreen Health Services, and Catholic Health System). ECDOH will provide training and resources to first responders, increasing naloxone training sites. ECDOH will partner with subcontractors to provide training to implement naloxone, buprenorphine and care coordination services. ECDOH will coordinate activities with support from the NYSDOH, including oversight of an Advisory Council, utilizing the current Opiate Epidemic workgroup, as well as evaluation by the UB Family Medicine Primary Care Research Institute.
The Erie County Health Department (ECHD), located in Sandusky, Ohio, is serving as the lead applicant for this proposed project. ECHD has secured partnerships with First Responder agencies throughout Erie, Huron, and Ottawa Counties to train and equip First Responders to administer Naloxone to suspected drug overdose victims. After a person has been saved, they will be referred to the Circle of Care. Locally, ECHD championed this model of recovery utilizing key partnerships in the community. The Circle of Care begins with medically supervised detoxification at ECHD, then refers persons to the appropriate post-detox treatment (inpatient, intensive outpatient, etc.), secures housing in sober living communities or recovery housing in Erie County, and finally, the model ends with long-term recovery support services provided by Recover Community Organizations. The project is titled “Saving Lives: Erie, Huron, and Ottawa Counties.” The populations to be served include Erie, Huron and Ottawa Counties. The US Department of Commerce, Economics & Statistics Administration & the US Census Bureau, has designated the counties as Micropolitan Statistical Areas, therefore, our project shall be considered to be a rural community. We anticipate our project expanding to other rural Counties in years 2 – 4. ECHD has trained and equipped 466 First Responders and 168 community members with Naloxone since 2015. Combined, the First Responders have reported over 300 overdose reversals using Naloxone. Even with these 300 confirmed reversals, Erie County’s drug overdose death rates have nearly doubled since 2015. And, the number of Emergency Department visits due to drug overdoses has more than tripled since 2015! This fact serves as justification that ECHD’s current efforts and capacity need to be enhanced and expanded upon in order to reverse the current drug epidemic. Huron and Ottawa Counties have seen similar trends as well as their drug overdose death rates and Emergency Department visits due to drug overdoses have increased since 2015 as well. ECHD operates a fully-funded Federally Qualified Health Center (FQHC) on its main campus in Sandusky, Ohio. Sandusky is a designated Medically Underserved Population and is designated as both Mental Health and Dental Health Professional Shortage Areas. The FQHC serves over 4,100 unduplicated patients per year. There are no private providers accepting new Medicaid or self-pay patients within Erie County. ECHD’s FQHC provides a broad range of primary care, oral health care, and behavioral health care services. Because ECHD operates an FQHC, we have the ability to integrate primary care and oral health care into the drug overdose survivor’s treatment regimens. A plethora of research indicates that people with access to preventative and diagnostic health care are more likely to be in control of their health, which, in turn, grants them a greater opportunity to effectively manage their recovery. People with access to quality health care, face fewer health challenges compared to people who have limited ability to access or afford health care. We believe healthy people have a superior quality of life, and healthy people in recovery have fewer challenges to live a prosperous life. ECHD has a strong track record of training and equipping First Responders with Naloxone. In addition, we have built a medically supervised detoxification facility, secured affiliation agreements for post-detox treatment, and we are in the process of acquiring property to renovate into recovery housing and sober living communities, finally, we have strong existing partnerships with RCO's in Northwest Ohio. Our project will save thousands of lives, improve quality of life, and improve virtually every sector of society through this project.
The grant is collaboration between three hospitals, two governmental agencies, a behavioral health treatment agency, law enforcement and emergency responders across Huron County Ohio. The grant provides Narcan and training to support the first-line responders. Each hospital will act as a Narcan repository along with the Huron County Sheriff, Huron County Public Health and the Norwalk Police Department. The Norwalk Police Department, the Huron County Sheriff, and Firelands Counseling & Recovery Services will participate in a Quick Response Team for Norwalk residents who experience overdoses. The objective is to reach out to the individual and family and provide information on treatment and support services. A resource packet will also be used by the emergency departments and the Quick Response Team to provide educational and support materials to individuals at risk. Trainings to be provided include: Mental Health First Aid which promotes empowerment and strength when discussing mental health or substance use disease. After completing the eight-hour course, participants receive a certificate of completion, highlighting their new knowledge on mental health first aid, which may help them save a life. The training provide individuals with a greater understanding of suitable language to use when discussing mental health and substance use challenges Crisis Intervention Training for law enforcement. This 40-hour training should work to improve the quality of services for persons who are vulnerable to crisis. The methods reflect generally accepted approaches to working with individuals who have mental, addiction and emotional problems, whether or not they are in crisis. CIT methods provide for a forward-thinking approach, rather than a reactive approach, to stabilizing individuals in our community. The added training would create a stronger and more emphatic approach to dealing with mental health and addicted individuals in our community. Sensitivity Training for Fisher Titus Hospital Staff. These two-hour trainings will promote the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care. The trainings will offer a user-friendly format for providing comprehensive — but by no means exhaustive — information on advancing and sustaining culturally and linguistically appropriate services within health and health care organizations. This training will be mandatory for all employees and optional for partner employees.
The Lancaster County Drug and Alcohol Commission proposes to implement the First Responders – Comprehensive Naloxone Distribution and Recovery Service Initiative in Lancaster County, Pennsylvania. The project will save lives by reducing opioid overdoses and overdose deaths by increasing access to naloxone; training first responders on the use of overdose reversal drugs; and establishing and standardizing processes, protocols, and mechanisms to better ensure effective referral to treatment and recovery. The project will serve the population of Lancaster County, located in South Central Pennsylvania, with a population of over 550,000 residents. There are 60 municipalities in the county, including Lancaster City- the county seat. While approximately 88% of the county’s population is white, the Latino population in Lancaster County has grown by 68% in the last 10 years. The opioid epidemic is disproportionately impacting the county as evidenced by a 33% increase in the number of drug related overdose deaths in the County between 2014 and 2015, and a 37% increase in the number of overdose/poisoning related EMS calls. Three goals have been identified for the project: 1) Increase access to naloxone in Lancaster County to reduce the number of deaths due to opioid overdose; 2) Enhance connectivity of services to benefit local opioid abusers and their families at all points of entry into the system, and 3) Facilitate train the trainer programs in both English and Spanish to first responders, treatment facilities, and recovery support providers to provide hands-on experience administering naloxone. To accomplish this, the project team will work toward several measurable objectives including the distribution and track the use of 2000 naloxone kits; work with first responders, treatment facilities, emergency departments, and recovery houses/emergency housing to standardize processes and mechanisms for referrals and “warm handoffs.” The project team will also develop a hands-on train the trainer program for first responders, treatment providers, and recovery support service providers to augment the Pennsylvania DDAP online training module. The project will be advised by the Joining Forces Coalition, a community collaborative comprised of leaders of key organizations and other coalitions who are committed to coordinate efforts to reduce deaths from opioid and heroin overdose throughout Lancaster County. The Advisory Council will function as a public-private partnership to collaborate with the community to reduce deaths from opioid and heroin overdose in Lancaster County. Combined, these efforts will result in improved outcomes in the community, including improved access to life-saving naloxone through distribution and training, and a coordinated approach to referral and connection to information and resources. An anticipated 275 first responders will be impacted per year, along with 5,000 substance misusers/abusers per year, for a total of 1,100 first responders and 20,000 substance misusers/abusers impacted over the project period.
The following application, titled Strategies to Coordinate Overdose Prevention through Emergency Medical Services (SCOPE), is being proposed by the Westmoreland Drug and Alcohol Commission, Inc. (WeDAC). This project will train emergency medical service (EMS) first responders on (1) using naloxone for overdose reversal and training patients and families on how to use “leave-behind” naloxone kits; (2) using motivational interviewing to conduct referrals and “warm handoffs” to help patients access substance use disorder and/or mental health (SUD/MH) evaluation and treatment; and (3) implementing community-based paramedicine (CP) and harm reduction follow-up procedures with patients who do not wish to pursue treatment. Four Champion EMS agencies will be participating in the training program: (1) Mutual Aid Ambulance Service in Westmoreland County, PA; (2) Butler Ambulance Service in Butler County, PA; (3) Citizens’ Ambulance Service in Indiana County, PA; and (4) Washington Ambulance and Chair Service in Washington County, PA. The project is estimated to affect a total number of 300 patients via the Champion EMS agencies who overdose and refuse transport in these counties each year for a total estimated number of 1050 patients over the lifetime of the project. The demographics of this population are primarily white, male, and between the ages of 25-54. The program will train enough EMS first responders so that by the end of the grant period, 95% of EMS overdose calls are responded to by a trained EMS first responder. The goals and measurable objectives of this program include but are not limited to: (1) increase the number of overdose reversals via naloxone; (2) increase the number of “leave-behind” naloxone kits issued to patients and families; (3) increase the number of referrals and “warm handoffs” made to care management entities; and (4) increase the number of overdose calls responded to by CP trained first responders. WeDAC will be collaborating with the Single County Authorities (SCAs) in the participating counties, who will provide care management services to patients referred by EMS first responders during the course of the program. WeDAC will also be collaborating with the Pennsylvania Opioid Overdose Reduction Technical Assistance Center (TAC) based out of the University of Pittsburgh School of Pharmacy, Program Evaluation and Research Unit (PERU), who will be providing and completing implementation, technical assistance, and project evaluation activities.
The goal of the project, “A Comprehensive Response to the Opioid Epidemic” is to reduce opiate-related overdoses and deaths in Allegheny County, Pennsylvania. Its strategies for accomplishing this goal are to make naloxone consistently available to trained first responders and other individuals who are most likely to encounter people with opioid use disorder; and strengthen the infrastructure that supports this targeted naloxone distribution and that directly connects people who have suffered overdose to treatment and recovery supports. The project will serve an estimated 12,000 individuals over four years (2,000 per year, through reversals and 1,000 per year through outreach, education and training). The Allegheny County Health Department (applicant) will target high-risk areas of the county and people who have had an opiate-related overdose. It is therefore expected that the demographic profile of the overdose victims the project serves will mirror that of overdoses in the county to date (male, between the ages of 24 and 34, living in neighborhoods with higher rates of poverty). In addition to these characteristics, close to 40% of the population will have been detained in the county jail and used publicly-funded behavioral health services. To achieve its goal, the project relies upon the close collaboration that exists in Allegheny County among local governments, first responders, peers, members of community organizations, county-based Centers of Excellence (COEs), and university researchers. With this network of partners, the county will achieve these measurable objectives: • Reliably distribute naloxone to the current 71 municipal police departments who are part of the county’s network and an additional 35 police departments. • Reliably distribute naloxone to an additional 15 of the county’s EMS departments, located in hot spot communities, for their “leave-behind” use with overdose victims and family members/friends. • Reliably distribute naloxone to at least 50% of the county’s fire departments. • Reliably distribute naloxone to at least 20 community organizations to outfit outreach staff in hot spot communities. • Train community members in targeted areas who will be using naloxone in the value and use of naloxone, how to track and report to ACHD on its use, and in the referral system that links individuals and families with COEs and other recovery resources. • Ensure that the Centers of Excellence or other treatment and recovery resources are serving the individuals who have had a reversal of overdose due to opioids. • Complete the development of the county’s infrastructure needed to support these objectives.
Drug overdoses are a leading cause of death in Philadelphia, 80% of which involve opioids. Despite the rising number of overdoses, an increased proportion of persons are refusing transport to the hospital by first responders following a non-fatal overdose. Augmenting First Responder Services proposes to enhance first responder services through the implementation of a specialized Overdose Response Unit. This multidisciplinary unit will consist of a medic, peer specialist and a social services expert, and will provide overdose education, naloxone, harm reduction information and treatment resources to individuals who refuse transport. The Overdose Response Unit will also be responsible for following-up and providing linkage-to-treatment services for individuals interested in treatment, as well as engaging the community in the ZIP code with the greatest burden of overdoses with overdose education and naloxone distribution. Because the Philadelphia Fire Department (PFD), which runs the city’s overworked emergency medical services (EMS), is challenged by both limited data analysis and first responder burnout, Augmenting First Responder Services will also provide PFD with analytic support and resiliency training.
The Mental Health and Anti-Addiction Services Administration (MHAASA) of Puerto Rico, which is the Single State Agency (SSA) for Puerto Rico (PR) for the Substance Abuse Prevention and Treatment Block Grant (SABG) and is submitting this SAMHSA First Responders – Comprehensive Addiction and Recovery Act (PR FR-CARA) application under the Funding Opportunity Announcement (FOA) Number No. SP-17-005 for 2017. The proposed project will finance training to first responders and members of other key community sectors on devices and methods for administering Naloxone for emergency treatment of opioid overdose, and the development of protocols for referral to appropriate treatment and recovery services proposed. Opioid overdose continues to be a major public health threat in Puerto Rico. It has contributed to 45 deaths during 2016 for a rate of 1.3 per 100,000. From 2000 to 2015, nearly 4,300 people died from drug overdoses of which 14.8% were females and 85.2% males. The distribution by age group is as follows: 2.3% ages 0 through 19, 47.5% ages 20 through 39, 42.0% ages 40 through 59 and 8.2% ages 60 and over. The geographic areas that have higher rates of overdose deaths are the metropolitan areas of the island which are: San Juan with 20.0%, Bayamón with 7.1%, Ponce with 6.9%, Caguas with 6.3 and Carolina with 5.0%. In terms of race, 82.0% were identified as whites, 10.6% as African Americans and 7.4% of other race, all being Hispanics. Recent reports from the Drug Enforcement Administration (DEA) highlighted that adulterated fentanyl, which, in its legal form, is used as an analgesic prescribed for severe pain, came to Puerto Rico at the end of the 2016. This opioid-based drug is 50 times more potent than heroin and only 2 mg, which is the equivalent of 3 or 4 grains of a sachet of sugar, is enough to kill a person. The potent narcotic is distributed adulterated in the streets of PR, and nine deaths have been linked to its use in areas of Mayagüez and Manatí. Danger for Puerto Rico increases with the confirmation that the drug is being prepared in clandestine laboratories in the Dominican Republic. This scenario must be closely observed because the criminal organizations on the contiguous island could be using Puerto Rico as a bridge to distribute fentanyl to the US. This current threat is being addressed, and will be reinforced with the proposed project. The purpose of SAMHSA and its Center for Substance Abuse Prevention (CSAP), stated in the First Responders – Comprehensive Addiction and Recovery Act (FOA-p. 4) No. SP-17-005, is to “allow first responders and members of other community sectors to administer a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose”. The purpose of the MHAASA, serving as the Single State Agency (SSA) for Puerto Rico under SAMHSA, is to establish and implement a coordinated multi-agency effort to train, administer and empower first responders in the use of Naloxone to prevent opioid overdoses in Puerto Rico.
Rhode Island First Responders Opioid Overdose Prevention Project The State of Rhode Island is mourning the death of 336 Rhode Islanders who lost their lives to overdose in 2016. Today, the Rhode Island governor, Rhode Island Department of Health, Rhode Island Department of Behavioral Health and Developmental Disabilities, RI state representatives and leaders across our state have gathered to encourage collaborative models that work towards a common goal: to reduce and eliminate overdose deaths in Rhode Island. The First Responders Opioid Overdose Prevention project is designed to address the opioid crisis by improving state infrastructure to enhance the first responder’s role in response to an overdose. Overdose fatalities are preventable if first responders have appropriate training and resources to respond. Overdose prevention education and naloxone distribution are feasible and cost-effective techniques that have been shown to reduce fatal overdose in communities and increase enrollment in drug treatment programs. The purpose of this project is to prevent death and mitigate overdoses by implementing three key focus areas: equipping law enforcement with naloxone, developing the first responder workforce and increasing referrals to treatment and recovery services. During the first year, preliminary and conservative estimates indicate that funds will be used to serve at least 2,000 First Responders who would impact the lives of all Rhode Islanders who experience an overdose. Also, about 500 law enforcement officers will participate in a pilot that embeds a behavioral health care coordinator within their departments to enhance opportunities for referral and promote pre-arrest diversion efforts. Currently, the cities of Warwick, Providence and West Warwick are implementing this model. The goal is to expand the pilot to Cranston, Central Falls and Woonsocket, RI. A county model will be carried out in Washington County with the initial involvement of Narragansett, Richmond, North Kingstown, South Kingstown, New Shoreham and Hopkinton, RI. Over the course of the four years, the goal is to train all first responders and to expand service to the entire state. Major activities include developing a naloxone redistribution system for law enforcement agencies. The Center for EMS (CEMS) will undertake a competitive hiring process to select a full-time Training Coordinator who will oversee all training functions and will streamline education opportunities into a multi-tiered system of learning for all first responders. Other activities include incorporating community leaders in response to interventions processes and creating a culture of safety that focuses on the mental health and resource supports for our first responders. A critical undertaking will be the evaluation of the pilot sites and overall project. Therefore, CEMS will hire an epidemiologist/evaluator who will critically review grant funded reports and analyses, and advise key project staff and sub recipients regarding surveillance data.
The proposed FRONTLINES Project, First Responder Opioid overdose Naloxone Training and Linkage Into Needed Evidence-based Services, is a collaboration between the City of Houston Health Department (HHD), Houston Fire Department (HFD), Houston Recovery Center (HRC), and Baylor College of Medicine (BCM) to ensure: 1. all HFD response units are equipped with naloxone opioid overdose kits; 2. all HFD first responders are trained in recognition and pre-hospital management of a person with opioid overdose, including proper administration of naloxone, and 3. all opioid overdose victims HFD treats are offered linkages to opioid use treatment services in the community and ongoing case management through the Houston Recovery Center. Since 2011, opioid overdose rates have increased by over 120% in Houston. HFD has responded to 545 opioid related overdose calls during the first 6 months of 2017. Additionally, the high potency, synthetic opioids, fentanyl and carfentanil, which have been linked to increased opioid overdose death rates in numerous communities across the country, have been detected this year in Houston area drug seizures. Currently within HFD, only Advanced Life Support (ALS) response units are stocked with, and paramedic first responders trained in use of, naloxone. ALS response units comprise 20% of the total response units in HFD. The HFD responds to all suspected opioid overdose victims and they are transported to local, hospital-based Emergency Centers for further care. However, many leave the hospital without formal referral or direct linkage into evidence-based opioid use disorder treatment services. This project will provide linkages to treatment through case managers from the Houston Recovery Center (HRC). FRONTLINES addresses these barriers by effectively addressing the opioid epidemic in the City of Houston by increasing HFD first responder access to, and training in use of, naloxone for opioid overdose victims and by partnering with the HRC’s robust peer recovery and case management services. To ensure every opioid overdose victim HFD responds to can access needed and desired care within the Houston community. The proposed program delivery model builds in sustainability in the use of a train-the-trainer model for naloxone opioid overdose training delivery within HFD divisions and automating the linkage of overdose victims from HFD to HRC. The FRONTLINES Project builds on existing community resources and expertise to better equip the City of Houston to respond effectively and compassionately to the opioid overdose epidemic within our city.
The purpose of the Virginia First Responders Project for Opioid Overdose is to train first responders and other community sectors about opioid overdose, the use of naloxone for overdose reversal and available treatment resources in communities that can assist people in addressing opioid addiction. It will also ensure that first responders can carry temperature controlled naloxone kits to have it available while on duty. Approximately 3,500 people will participate in training and 7,000 people will be provided with naloxone. Project goals and objectives include: Goal 1- Equip more first responders and community sectors with naloxone for emergency treatment of known or suspected opioid overdose. Objectives: 1) Increase amount of naloxone (Narcan) available for use by first responders 2) Increase numbers of first responders and members of other key community sectors equipped with naloxone. 3) Increase the number of opioid overdose reversals by first responders in order to decrease death rates. Increase the number of First Responders and members of other key community sectors trained in OONE. Goal 2 - Train and provide resources for first responders and members of other key community sectors to carry and administer naloxone for emergency treatment of known or suspected opioid overdose. Objectives: 1) Include education on opioid use disorders, evidence based practices, and benefits of incorporating use of naloxone among first responders in all trainings. 2) Increase training capacity by adding a Project Coordinator at DBHDS. 3) Train a minimum of one OONE Master Trainer in each targeted area of the state. 4) Increase the number of First Responders and members of other key community sectors trained in OONE. 5) Increase the availability of resources to support first responders carrying and administering naloxone by providing items such as temperature controlled storage units and appropriate personal protective gear. 6) Improve and expand data collection methods used for planning, resource allocation, and tracking to gather comprehensive data on training and naloxone use in targeted areas. 7) Establish a system of support and technical assistance for implementation, maintenance of program initiatives by the end of year one. Goal 3-Establish processes, protocols, and mechanisms for referral to appropriate treatment and recovery communities, which may include an outreach coordinator or team to connect individuals receiving opioid overdose reversal drugs to follow-up services. Objectives: 1) Establish an outreach team to identify treatment services in the targeted areas and develop a comprehensive referral guide to include public providers (CSBs), community providers, private providers, and peer resources for use by first responders. 2) Develop procedures for referrals that can be used statewide. 3) Distribute the resource guide at 100% of trainings providing enough for further distribution at participants’ respective organizations. 4) Increase the number of individuals referred to treatment by first responders by 10% each year. 5) In the targeted area CSBs collect and review data quarterly related to referral from first responders and follow-up to treatment.
The Harm Reduction and Recovery Initiative will take a three-pronged approach aiming to reduce morbidity and mortality related to opiate use and overdose by facilitating harm reduction and recovery services within the communities throughout Fayette County, West Virginia (population 45,869) and then expanding the services to surrounding counties within southern West Virginia. The term harm reduction refers to policies, programs and practices that attempt to reduce the harm associated with the use of psychoactive drugs among people who are unable or unwilling to stop using them. 1) The first approach will be to provide training to first responders on the use of naloxone, a medication approved by the Food and Drug Administration (FDA) to prevent overdose by opioids. Naloxone will be provided to first responders through this initiative. First responders include firefighters, emergency management personnel, law enforcement, school faculty and nurses as well as family caregivers. First responders will be trained using the five essential steps located within SAMHSA’s Opioid Overdose Prevention Toolkit 2) The second approach will be to provide harm reduction services with the use of a mobile unit traveling and stationed on certain days throughout Fayette County initially and then expanding into surrounding counties. Services provided on the mobile unit will include syringe exchange, sexually transmitted infection testing, including Hepatitis B and C testing, HIV testing, syphilis, chlamydia, and gonorrhea (with treatment as indicated), contraception, naloxone training and distribution, and information and referral for recovery and rehabilitation services with navigation assistance and follow up. It is expected that there will be 1,000 encounters the first year. 3) The third focus of the project will be entirely on prevention. Education will be provided in the schools and the communities throughout the county, with a total target population of 45,869. The partnership with CODA Mountain Academy will allow the opportunity to refer children and adults to a program that has proven to decrease absenteeism and behavioral issues.
First Responder - Comprehensive Addiction and Recovery Act Cooperative Agreement – FOA Number: SP-17-005 Project Abstract Summary The West Virginia Bureau for Public Health Office of Emergency Medical Services will utilize the funds from this grant opportunity to expand upon efforts and activities already in place through a variety of other grants currently in progress in multiple state and local entities. The purpose of this project is to implement the activities outlined, in order to, turn the tide on the opioid epidemic. To achieve this purpose of this project, a phased, county-level approach is being proposed that initially engages and assesses the highest risk communities, selects those at greatest need, and develops a systematic process for collaborative planning, implementation, and evaluation of tailored, naloxone distribution and patient intervention programs. Each program will feature development, implementation, and evaluation components that, dependent upon need, may include: 1. EMS agency naloxone distribution program; 2. Linkages to integrate emergency treatment, preventive services, and law enforcement encounters with referral and care management systems; 3. Targeted EMS provider and/or community education programs. The goal of this project is to reduce the number of prescription and illicit opioid overdose related deaths and adverse events among persons 18 years of age and older in WV. Initially this will take place in a limited number of high risk communities with the ultimate goal of reaching all regions of the state.