Structuring overdose responses

Oxford establishes protocol

By Kelsey Kimbler -

OXFORD — In the City of Oxford, when there is an overdose, there is a team of three different agencies available to follow up with the victim and encourage them to seek help. The Overdose Response Team consists of a police officer, fire and EMS personnel, and a drug counselor. The idea is to provide structured follow-up to an overdose and to encourage overdose victims to seek help.

This effort, formalized in October 2016, is a collaboration between Oxford Police Department, Oxford Fire and EMS, and Jennifer Mason of Fort Hamilton Hospital. Mason is an EMT Coordinator with the hospital, and Oxford Police Department Lieutenant Lara Fening’s main contact for the drug counselor aspect of the team.

The idea for the team was garnered from Colerain Township. According to Fening, they are “one of the major authors of this type of response.”

The decision for Oxford to form a team of its own came from an influx of overdose deaths in the city and what Fening perceived as a lack of follow up.

She said, “I had learned of the Colerain model, of the QRT (Quick Response Team,) which I found interesting. There became available training, ample training, on how to institute this model. Training was free and fairly local — there was no reason not to go to it. Many agencies grabbed onto this idea because none of us really knew what we should be doing. It was a new idea. It was worth giving it a try.

“At that time, also, we had a mother of an overdose victim, a victim who lived, but she was really pushing us to try to find new and inventive ways and be creative with how we were going to address this problem. At that time, especially for her, it was the perfect storm. She was wanting creativity and at that time there was opportunity that was presented to us on mixing our response up a little bit.”

The response the team offers does rely heavily on the situation.

If the overdose victim dies, there is no follow-up and no reason for the team to get involved. Oxford Police Department detectives will issue an investigative follow-up, but the Overdose Response Team has no role in that.

If the victim is sent to an out-of-town hospital, it is hard for the response team to follow up. According to Fening, she has no way to reach out to the victim as she is not aware of when they are released. Since they were transported, she does not have a phone number to use.

It would be easier for the team to follow up if the victim went to McCullough-Hyde Hospital in Oxford, however, most overdose victims do not go to the local hospital anymore.

If a victim gets Narcan, which reverses the effects of the opioids, typically he or she will not go to the hospital. Fening has found this is not the appropriate time to follow up with them, as they are not receptive.

Ideally, she says, somebody would follow up with the victim in three days.

Protocol states if there is an overdose which gets Narcan, Fening has to be contacted. She will initiate structured follow up. She may contact the victim and ask if they are interested in having a visit by “people who just want to help them and prevent this from ever happening again.”

She may also make a “cold call,” but she does not want to waste her resources and time if the victim is not home.

“We’ve had people deny help, they just do not want to meet with anybody. I would say since we have instituted that, for the people who have lived, they just decline assistance. They do not even want us to come over and meet,” she added.

The team has not had the opportunity to be fully utilized yet — both because of the issues following up and because of a significant decrease in overdoses the City of Oxford has recently experienced. The overdoses they have had have either died, been shipped to a different hospital, declined, or have already signed up for treatment.

“We have just had a different run of circumstances which has not made our use of the team very consistent,” she said.

Fening said the “most important” part of this structured follow-up is the drug counselor.

“They are the ones with the knowledge and the resources,” she said. “They have experience, they know how to assess the problem and figure out the severity of the problem — and what would be the best treatment protocol for that person.”

Ideally, the paramedic involved would be the one who responded on the scene of the overdose. According to Fening, that person would have the first-hand experience of witnessing the overdose and can recall details from the scene. The victim will not recall what shape they were in, but the responding paramedic will, and can shed light on just how dire the situation was.

“The police are there, for the most part, for security,” she said. “In our town, because we’re small and so many people know the police. We can have a persuading effect and make it personal. We are the ones who know these people. The paramedic and the drug counselor are not going to know these people. We know their kids, we know their families — we can use that history we have with them to persuade them.”

Oxford establishes protocol

By Kelsey Kimbler

Reach Kelsey Kimbler at 937-683-4061 or on Twitter @KKimbler_RH

Reach Kelsey Kimbler at 937-683-4061 or on Twitter @KKimbler_RH