Delaware Public Media

ChristianaCare takes opioid crisis response to the homefront

Oct 11, 2019

Over the past several months, ChristianaCare’s Community SOS program has sent outreach teams to visit the homes of overdose patients after the overdose event to try to get the patient to commit to long term addiction treatment.

Delaware Public Media’s Nick Ciolino examines how it works and it's progress thus far. 


The Community SOS program launched in April. Under the program, if an individual is discharged from any of ChristianaCare’s hospitals after being treated during an overdose event, the health system will later send a team to the patient’s home to try to get the patient to consider enrolling themselves into treatment for their opioid addiction. 

 

The program starts with EMS. When first responders arrive on a scene and treat an overdose patient with naloxone, they then drive the patient to a ChristianaCare facility and notify emergency department staff that the person is a candidate for Community SOS outreach.

“The county paramedics are on a daily basis identifying patients that are transported by EMS to a medical facility with the potential for substance abuse disorder so the Community SOS engagement teams can go meet and offer opportunities for treatment,” said New Castle County EMS Chief Larry Tan.   

Tan says Delaware’s opioid crisis has caused a rapid increase in the county’s EMS call volume in the past few years. He says his agency is working with ChristianaCare to try to address the underlying issue.

“Again, when you look at the volume of patients that Christiana Care receives on a daily basis, being able to rapidly identify the ones that may benefit and fast track that contact is of huge benefit to them. So we’re trying to help facilitate that,” Tan said.   

 

Community SOS is the brainchild of ChristianaCare’s Vice President of Community Health and Engagement Erin Booker. 

ChristianaCare was already working to get overdose patients into treatment through its emergency department program Project Engage. But Booker says there were still gaps in care. 

 

“So this program was specifically designed to be that next step for the patients who say no, because very often they’re just not in the place in the ED to say yes," said Booker. "They’ve just had an overdose. They’re certainly not feeling well and they leave.”   

Each morning Booker receives a list made by EMS of each patient admitted to a ChristianaCare Emergency Department for an overdose and she notes which ones have been discharged.

“Our team then takes that list and we identify who has been admitted," she said. "Anyone who has been discharged from the ED we are doing a proactive reach out to. They are calling them. They are going out into the community to try to locate them, and anything and everything we can do to try to find these patients and help them go into care.”   

But Booker adds it can sometimes be difficult to locate overdose patients who may not have a stable living situation.

“We’re looking into text platforms to be able to reach out in that way, because people don’t always want to answer their phones when they don’t know the phone number," she said. "Addresses are maybe a family member; they don’t live there. The family member might not be so happy with them anymore. So we’re definitely running into not being able to connect with a decent number of patients”   

If Booker’s team is able to locate the patient, then that’s where Alexandra Randolph comes in. She’s an intake assessor for the Community SOS program. 

Randolph makes calls to the patient and then plans a visit to the patient’s home. The home visit also includes a peer mentor, someone who themselves is in active recovery for opioid addiction. 

The two bring Narcan to the home to give to family members, and train them how to use the medicine to save a life during an overdose. They then sit down with the patient and try to make a connection. They show them the options for long-term addiction treatment, and address whatever else the patient might need to make a commitment to treatment.

“Really their basic needs," said Randolph. "I mean that’s food, shelter or even childcare and at times medical insurance issues. So we have a lot of resources from ChristianaCare in health guides, especially health guides located in Wilmington Hospital. So we give out additional information not just on substance abuse and that can get them even more engaged with us.”   

One patient Randolph visited was Richard Tortella Jr.

“Christiana Care took a couple days to get to me and I had made the decision I was going to beat this thing,” said Tortella.   

Tortella says he used heroin for decades and has experienced five overdoses. Following the most recent event he was visited by Randolf and a peer mentor and offered treatment options, but he decided he was going to quit cold turkey on his own.

“I told them, I said I’m going to do this and I need to do it my way. I need to embrace it this time no treatment, no nothing. I got to find some joy in this somehow. I have to beat this on my own. I’m going to earn this one. And I didn’t accept treatment. I went cold turkey,” said Tortella.   

Tortella is living with his sister and helps to take care of his brother-in-law. He attends AA meetings and has been sober now for almost two months. He says Randolf still calls to check in with him and adds he’s never going back to heroin.

Since its launch in April, the Community SOS program has had 149 interactions with patients like Tortella - either over the phone or during home visits. 27 patients have entered treatment as a result. 

Delaware reported an all-time high 400 overdose deaths last year. And more than 200 people have died of suspected drug overdoses in the First State so far this year.

Erin Booker says Community SOS is still in its early stages and ChristianaCare is looking for ways to increase patient interactions and get more people with substance abuse disorder into treatment.