Two months into a six-month, city-funded pilot program to reduce Jacksonville’s opioid overdose deaths, only one of the participants receiving free comprehensive treatment has had a subsequent overdose, according to a report recently presented to City Council members.
Meanwhile, outside attorneys hired by the city General Counsel’s Office are expected soon to file a lawsuit against companies that make and distribute prescription painkillers.
The goal is a settlement that would reimburse the city for the costs of dealing with the recent spike in opioid overdoses and pay for treatment programs for people with addictions, said City Councilman Bill Gulliford, who proposed the lawsuit and heads the council’s Opioid Epidemic Special Committee.
In 2017 the Jacksonville Fire and Rescue Department handled 3,460 overdose calls, an average of 308 per month. From January to September there were 355 opioid-related deaths in Duval County, compared to 464 in 2016 and 201 in 2015. Also, 10 percent of 2017 overdose calls were repeat occurrences and 2 percent of those patients had repeat occurrences 10 or more times, according to department reports given to the committee.
The intent of the $1.5 million pilot program is to reduce overdoses, deaths and recidivism by getting victims directly from emergency rooms to treatment and providing wrap-around services. No other program in Florida is as comprehensive, said Raymond Pomm, medical director for River Region Human Services and Gateway Community Services, which partnered on the program with St. Vincent’s Medical Center Riverside.
Thirty people are participating and the person who had a subsequent overdose survived, he said. By the end of the program, as many as 200 people may have received treatment.
The preliminary results from the program, which began in November, are encouraging, he said.
“I am quite surprised at how effective it is,” Pomm said.
Huson Gilberstadt, chief clinical officer of St. Vincent’s HealthCare and president of St. Vincent’s Riverside, agreed.
“While it is still early in the opioid pilot program, we are pleased with its success so far,” he said. “Even one relapse is one too many, but we are cautiously optimistic by the overall numbers at this point.”
The overdoses of all 30 participants were caused by the use of fentanyl, a synthetic painkiller.
They were told about the program at St. Vincent’s Riverside emergency room after they had been stabilized after an overdose. Their options are residential inpatient treatment, outpatient services and contact at least three times a week by specially trained recovery peer specialists, who themselves are in recovery from substance abuse or mental health disorders.
Only 11 of the 30 who agreed to join the program chose residential treatment.
Soon they will begin receiving a drug called Buprenorphine, which blocks opioid effects and prevents harsh withdrawal symptoms, during their emergency room stays, Pomm said.
“Each encounter is personalized to the situation and the individual,” Gilberstadt said. “Eligible patients are initially approached by one of St. Vincent’s clinicians or by a recovery peer specialist. They learn about the program and decide whether they want to take part. Most patients do seem to be receptive at this point.”
That follow-up is a key part of the program, Pomm said.
“They know they are going to be checked up on, that people care,” he said.
Because of the peer specialists’ life experiences, their support can go “much deeper” than that of other counselors, he said.
Also, the program does not give up on patients who refuse treatment. A recovery specialist contacts them or their family later to encourage participation in the program.
“The best thing … is that we’re learning a lot,” said Gulliford, who has organized numerous Town Hall-style meetings to discuss Jacksonville’s opioid epidemic. “Things have taken place that we didn’t anticipate and expect.”
He said he was particularly surprised that there was less demand for residential services than predicted.
With outpatient treatment, “people are just living their lives” at the same time, Gulliford said. Residential treatment can be difficult because of the impact on families and employment, he said.
“We are constantly working together to make subtle adjustments as needed to increase program participation and effectiveness,” Gilberstadt said. “For example, based on what we’ve learned so far, we’ve made slight adjustments to our initial interactions with potential participants. We are also planning to expand the program to St. Vincent’s Southside and St. Vincent’s Clay County to increase the pilot’s sample size and hopefully make an even more significant impact on our community.”
He and Pomm said they hope the program will eventually be implemented at all area hospitals.
“Our hope is that the end of the pilot project will also mean the beginning of a successful program that is implemented throughout the city,” Gilberstadt said. “Regardless, once patients become pilot program participants, they gain access to a wealth of community resources that were here before the program began and will be here after it ends.”
Beth Reese Cravey: (904) 359-4109