Door -to-Door Opioid Outreach in Plymouth County
By TIMOTHY J. CRUZ
October 2017, page 34-35
JUST A FEW HOURS have passed since family members found their 20-year-old loved one unconscious on the bathroom floor, suffering from a suspected, non-fatal drug overdose. There is a knock at the door. It is a plain-clothed Plymouth Police officer and a recovery coach. The family invites the officer and coach in and they all sit down together at the kitchen table to discuss what to expect next and possible
treatment options. This is the scene being played out each day by police departments throughout Plymouth County, where an initiative is sending teams knocking door-to-door in an all hands on deck approach in the battle to combat opioid addiction.
In 2015, along with Sheriff Joseph McDonald, I formed the Plymouth County Drug Abuse Task Force, an effort to engage all community sectors to work on the opioid issue. The Drug Abuse Task Force brings law enforcement, the medical community, educators and substance abuse experts together to share information and track the current trends of the opiate epidemic. Two of our police chiefs, co-chairs of our Public Safety Committee, had been successfully running programs on their own – one initiative where follow-up visits are made with a victim hours after an overdose occurs, and another, offering community outreach and programming to families. Under the collaborative efforts of the task force and leadership of Police Chiefs Michael Botieri and Scott Allen, the two programs merged, and Plymouth County Outreach (PCO) was born.
The intent of the combined outreach effort is to provide a human touch in the critical hours of need after an overdose, and to connect family members and friends of those with substance use disorders with existing treatment resources and support in Plymouth County. Each day, police departments review all reported overdose and overdose death reports for the previous 24-hour period and determine where
follow- up is necessary. Within 12-24 hours of a suspected drug overdose, an outreach team consisting of a plain clothed police officer is paired with an on-call health care representative – either a licensed clinician or recovery coach – to conduct home visits of overdose survivors. The team attempts to meet with the person who overdosed, but oftentimes it is a sit-down with family members to discuss next steps, their options and potential treatment for the victim. Still other outreach team members find their visits involve simply listening and lending support as family members share their tragic stories of loved ones trapped in the throes of addiction.
The second piece to PCO is outreach at regional Drop-In Centers, which act as resource fairs for people with SUDs and their families. These Drop-In centers are open to anyone looking for information about treatment and the setting provides a unique opportunity. Medical personnel and law enforcement officials answer any questions, explain the science of addiction, discuss treatment options and payment options, and assist with getting individuals into treatment. There are currently three regional Drop-In Centers operating within our county that meet up twice a month.
In conjunction with PCO efforts, the Plymouth County Drug Abuse Task Force also funded a new regional database that brings a unified system of overdose incident documentation and systematic follow-up to all law enforcement agencies In Plymouth County. After an overdose, information is shared among our PCO membership throughout the county, including identifying the overdose victim, medical services rendered, and confirmation of Fentanyl, Heroin or other opioids and drug evidence found at the scene. Since its implementation in April, the database has allowed for police departments to more accurately track county-wide overdose numbers, establish overdose histories with victims, as well as closely monitor the use of Narcan and check the prevalence of non-fatal overdoses. Because many overdose incidents occur outside of a victim’s hometown, the database has become an important law enforcement tool for information sharing between police departments so that they can assist in connecting the overdose victim with follow-up visits.
The PCO program was first piloted in two Plymouth County towns before the initiative took off. Today, all police departments in the 26 towns in the county and the City of Brockton, and four of our five hospitals, have signed onto participate in PCO. The model is one steadily gaining interest around the state of Massachusetts and beyond. Through social media and our many community coalitions, we are able to get
the word out about our Drop-In Centers and outreach efforts and we continue to build upon and expand PCO. Through our door-to-door, follow-up visits, we find that 90% of the time, we are able to make contact with individuals within the crucial 12-24 hours after an overdose. Since the start of Drop-In Centers, we estimate that approximately 900 individuals have visited and those numbers continue to grow each week. Last month, my office sponsored a Recovery Coach Academy that consisted of five days of training for 13 police officers and civilian volunteers. The academy included training for those in recovery. We are hopeful that very soon, these folks will be assisting us with overdose outreach visits.
While we continue in our traditional roles as law enforcement, this epidemic has forced us to be innovative and develop ways to stay one step ahead. My Office now has a designated Opioid point prosecutor who is focused on drug trafficking cases and those involving subsequent offenders and gangs. Several years ago, we studied how Adverse Childhood Experiences and trauma affected children growing up in domestic violence situations. Today, we are using that model to educate school administrators on the link between opioid addiction and youth.
Plymouth County consists of a diverse array of 27 communities, ranging from small New England towns to urban commercial areas. One thing that they all have in common is opioids and families in search of any and all help. The Plymouth County Drug Abuse Task Force and Plymouth County Outreach are efforts that I am proud to be a part of. There is still work to be done, but we are on the right path here in