Five Things To Read This Weekend

Our suggested readings this week revolve around a central theme: as opioid deaths reach historic highs, promising new overdose prevention programs are taking shape—and federal funds and opioid litigation settlement dollars could help launch more of them.

1. Overdose Deaths Soared During The Pandemic

• Over 107,000 Americans died last year from a drug overdose. That’s more than in any other year in our country’s history.

• Just six states saw a decrease in overdose deaths from March 2021 to March 2022 as overdose fatalities rose in most states, according to data released this week by the Centers For Disease Control and Prevention.

2. In Huntington, West Virginia, Quick Response Teams prevent deaths in the state with “by far the nation’s highest drug overdose death rate.”

• The QRT team “consists of a paramedic, a counselor, a law enforcement official, and a faith-based organization member” and it “attempts to conduct home-based outreach to the person who has overdosed and their families within 72 hours of the overdose to provide educational materials and encourage them to initiate post-overdose treatment services.”

• Connie Priddy, the program coordinator for the Huntington QRT, told the Herald-Dispatch that she attributes the decline in overdose deaths in the city and county  to programs like the one she runs: “We are the one that will connect them to treatment, but we’re also just there to check on them to make sure they’re OK … and I think that’s mattered.” 

• The program was just replicated across West Virginia and Dr. Rahul Gupta, the director for the White House Office of National Drug Control Policy said that the program is so promising it “should be developed as a model, not just for the state of West Virginia, but for the entire country.”

3. Florida Launches “First of Its Kind” Coordinated Opioid Recovery Network Modeled After A Successful Overdose Prevention Program in Palm Beach County.

The Palm Beach Model. When a person overdoses in Palm Beach County, Florida, emergency responders from the fire department take the patient to a speciality emergency room called the Addiction Stabilization Unit at JFK Medical Center. Here’s what happens next:

“For patients arriving after an overdose, medication assisted treatment is provided within the first few hours of arrival to take away the cravings, minimize withdrawal symptoms and increase the probability the patient will comply with a longer-term treatment plan after discharge. Once a patient is stabilized and opts to explore long-term treatment options, medical staff recommends the care best suited for the patient. Many of the patients from the unit have received a warm hand-off to the Health Care District’s [medication assisted treatment] program, which is conveniently located in an outpatient clinic adjacent to the hospital.”

Dr. Belma Andric, the county’s chief medical officer, described for the local ABC affiliate how the program works and why it’s different from most overdose prevention programs: 

“The uniqueness for this is we provide a one-stop shop where you can see primary care, psychiatrist, pharmacy, therapy, group sessions, connection to any high level of care if necessary … We have care coordinators who help navigate the system if they need housing, if they need transportation, we connect them with agencies who help them get jobs and this place is really for them to come back whenever … That is unlimited, as long as it’s needed. Addiction is a life-long illness and we treat it that way, no different than diabetes or high blood pressure or kidney failure.”

The Palm Beach Model Goes Statewide. “We have to work to try to break the cycle of addiction,” Governor Ron DeSantis said last month while announcing that the state would model the successful approach in Palm Beach County through pilot programs in a dozen additional counties. “We don’t want Floridians to receive overdose treatment and then simply be sent back into the world for this to happen all over again so we’re trying to give them the tools they need to navigate their path to a productive, drug-free future.” You can read a two-slide powerpoint presentation about the initiative here. 

• Worst, first: Escambia County, which leads the state in opioid overdose deaths, is one of the pilot project sites. David Torsell, the head of the county’s Emergency Medical Services, explained to the the local CBS affiliate why he believes the program will save lives: 

“There is something that is missing, and whether it be following through, case management, wrap around services, whatever you want to call it, if someone goes to a hospital and is treated for addiction, and then is discharged and given a referral to go somewhere for long term addiction therapy, you’re not going to see them again until they come back for their next overdose … Nobody is following up. They get a little piece of paper that says, ‘Your follow up is this day. Go here. Good luck to you.’ The missing piece is somebody following up with these patients as soon as they leave the hospital, or even before they leave the hospital and introducing who we are and telling them that we are going to follow them through this process. Whether you are living in a camp, couch surfing, or homeless, we are going to know where you are and we are going to stay with you through this process.”

4. “Demand [is] so big for Austin’s first Narcan vending machine, it's restocked daily.”

• Lucas Hill, director of the Texas Opioid Training Initiative, recently told the Austin-American Statesman, “We need naloxone everywhere. We need it easily and freely accessible.” That’s why first responders in Austin, Texas all carry—and regularly administer—naloxone, which is a life-saving drug that reverses the effects of an opioid overdose. But it can be more difficult for members of the public to obtain the drug themselves—its $100+ per dose price tag at the pharmacy makes it cost prohibitive for most people and the state-run free distribution program ran out of money at the beginning of the year due to high demand. That’s where NICE (or, Narcan In Case of Emergency) comes in. The group set-up a vending machine that dispenses single-use cost-free doses of Narcan. Em Gray, who founded NICE, recently told the Austin-American Statesman that the project has been overwhelmed by demand—“I thought I had enough (Narcan supply) to get through a couple of months … But I have pretty much blown through that in a week.” 

5. Both federal funds and opioid litigation settlement dollars could help cities and counties launch new overdose prevention programs.

• The Biden Administration renews America’s commitment to harm reduction. 

  • In May, the President announced $1.5 billion in state opioid response grants. Then, last month, Biden issued a proclamation on overdose awareness week that describes the White House’s  commitment to “prevention, treatment, harm-reduction, and recovery support services” —which the President backed-up with a proposed budget that includes additional “$24.3 billion to support the expansion of evidence-based prevention, treatment, harm reduction, and recovery support services.” 

  • The FDA also issued its new framework for preventing overdoses which now includes “encouraging harm reduction through innovation and education,” such as “increasing the distribution of naloxone.” 

• Billions of dollars from the national opioid settlement could be used to fund overdose prevention efforts. 

  • As Route 50 explains, “This summer, the first payments from the national opioid settlement were sent to governments and as of September, $310 million has gone out to 27 states. The national settlement resolves opioid litigation brought by states and local governments against the three largest pharmaceutical distributors [as well as] Johnson & Johnson. According to the agreement, the distributors and Johnson & Johnson will provide for payments totaling $26 billion, with more than $23.9 billion available to fund efforts to stem the crisis.”

  • New York City will use $150 million in opioid settlement dollars to fund overdose prevention centers, expand access to mobile harm reduction clinics, and allow for 24/7 operations of emergency department substance use response teams at several hospitals. | Rhode Island is using $2.25 million of opioid settlement dollars to fund an overdose prevention site. “You can’t get people into recovery if you don’t save lives,” Rhode Island Rep. John G. Edwards said to the Providence Journal. “There are so many people affected. It’s important to get this center open.” 

  • Overdose prevention sites are critical, but are just one potential use of settlement dollars. “The settlements will allow for a broad range of approved abatement uses by state and local governments, [... including] a wide range of intervention, treatment, education, and recovery services so that state and local governments can decide what will best serve their communities.” Launching or expanding programs similar to the ones we describe above—from CORE in Florida to NICE in Austin to QRT in Huntington—could be a good fit for some of these funds.