N.C. Community Paramedics Help Combat Opioid Crisis

Star-News, Wilmington, N.C.

After six months, Wilmington's efforts to guide opioid users toward treatment is off to what local officials are calling a promising start.

The 2017 state budget included $500,000 for Wilmington to be the pilot city for a quick response team—a group of local health experts who would contact opioid overdose survivors in an effort to direct them toward treatment.

According to an update prepared for the N.C. General Assembly by Coastal Horizons, 53 of the 66 survivors who have come into contact with quick response team staff ultimately sought treatment. Coastal Horizons has two peer support specialists and two therapists who receive referrals of people who may be ready to receive treatment from paramedics, the New Hanover Regional Medical Center Emergency Department and nonprofits, among other places.

During a presentation at Coastal Horizons this week, Kenny House, the organization's vice president of clinical services, said, "This effort says, 'No, we're not waiting for you to walk in the door. We're going to intervene at a community level.' ... There's simply not funding and person power to be able to go out there into the community and find people, generally."

The October 2016 death of Mason Morgan Richardson, who was riding in a car stopped at the intersection of Shipyard Boulevard and Oleander Drive when the car was rear-ended at full speed by one driven by Jonathan Hayes is widely viewed as the event that galvanized political will among Wilmington-area legislators. At the scene of the accident, Hayes was revived with Naloxone for the fourth time.

Following Mason's death, law enforcement, medical and nonprofit personnel engaged in weeks of sometimes-tense meetings, with the quick response team gaining momentum.

"You'd encounter someone that had overdosed in the community—if they refused treatment at the scene, we were left as a community to wonder what happened to these people after the fact," said Tony McEwen, Wilmington's assistant to the city manager for legislative affairs.

Less than six months after Mason's death, Rep. Ted Davis, R-New Hanover, introduced a bill that would have created the pilot program, with co-sponsors included Rep. Deb Butler, D-New Hanover, and Rep. Holly Grange, R-New Hanover. While the bill was left in committee, it was rolled into the state budget.

After hearing Monday's update, Davis said, "I think it's great because it's showing that we're making progress, it shows that what we're doing with the quick response team is working."

Sen. Harper Peterson, D-New Hanover, asked Monday how the program's outreach is being conducted.
"We are a model," Peterson said. "In response to this crisis, we are a model for other communities, so the success stories we have based on that aspect of it in terms of resources, money, complimenting their strategy is, I think, important for other communities to see."

The Coastal Horizons team has, according to the report, passed out 400 flyers in places such as fast-food restaurants, gas station bathrooms and doctor's offices, among others, while members of the team said Monday they have also placed flyers in areas known for being frequented by users.

New Hanover Regional Medical Center's community paramedics also partner in the program, with 126 overdose reversals since August. Of that group, 14 were immediately incarcerated for other reasons, leaving a pair of paramedics to follow up with the remaining 112—and about 58 of those agreed to a follow-up from the community response team, which happens three to five days after an overdose.

Sarah Rivenbark, a community paramedic, said, "We talk to them about, are they ready for treatment? If they are ready for treatment, we ask if we can refer them over to the quick response team."

In total, about 15 of the 53 people who sought help from the quick response team were referred by community paramedics. Quick response team staff connect users to a wide variety of resources, including medication-assisted treatment, primary care and psychiatric services, among others.

"The more people we can get to touch," House said, "the more people who aren't ready for treatment will become ready because they realize it's not this big unconquerable ogre—that treatment is really friendly for them and their family members."