Darcie Miller, Orange County Commissioner of Social Services and Mental Health, reviewed the great strides Orange County, treatment providers and community organizations made in the fight against the opioid epidemic at a crowded forum on Jan. 18.
In Nov. 2017, 200 county stakeholders gathered together to map out the county’s current state regarding substance use disorder treatment and to identify gaps and barriers. The county and various stakeholders spent 2018 developing services and programs to address those gaps and barriers.
In 2014, there were 76 overdose deaths in Orange County, according to Orange County data. In 2017, that number had climbed to 112. In 2018, there were 102 overdose deaths January through November, which might be an increase or leveling off of overdose deaths, depending on data for December.
One of stakeholders’ priorities when tackling the epidemic is to get clients struggling with substance use disorders into treatment quickly, or to provide “treatment on demand.”
“Opioids are killing people much quicker than any other substance,” Miller said. “So, you need to see that person immediately, especially if there’re an intravenous drug user, because you are at risk for death.”
The county improved a 24/7 behavioral health call center, which provides a single point of access to treatment, by placing the center in the same building as the 911 call center. When 911 operators get calls that are better served by the behavioral health center, they’ll be able to transfer their calls to the center, and vice-versa.
“This is a big win for our community,” Miller said.
Although the two call centers are separate operations, Miller said being in the same room will allow the two operations to learn from each other and collaborate.
Behavioral health call operators can screen clients on the phone, deploy the mobile mental health team, connect clients with various treatment options with numerous health providers and peer supports, schedule appointments and contact peer groups to help clients get to their appointments.
Operators will also follow-up with callers to either try to coax them into treatment or ensure they accessed it.
“[The operators] will stay with that person until they are connected to treatment,” Miller said. “They will continue to do follow-up for the person who makes a call, asks some questions, are not quite ready; they will call them tomorrow.”
Operators will be kind and compassionate, treating callers with dignity and respect, Miller said.
While the behavioral health call center is currently operational, other county agencies who field calls will be able to roll their calls into the center on April 1.
The behavioral help call center can also use LOCADTR, a new tool from the New York State Office of Alcoholism and Substance Abuse Services (OASAS). The web-based system allows substance abuse treatment provers and other referral services to determine the most appropriate level of care for a client with a substance use disorder and identify a treatment setting that is as close to the client’s home as possible.
OASAS also launched a treatment availability dashboard, which allows referral services to search for available beds at substance use disorder treatment centers.
Another priority for stakeholders was to increase subscriptions for Medication Assisted Treatment (MAT).
Buprenorphine, naltrexone and methadone block the euphoric effects of opioids, reduce physiological cravings and normalize body functions.
When combined with counseling and behavioral therapies, MAT is more effective than traditional counseling and behavioral therapies.
“Medication assisted treatment, with psychological therapies, is the gold standard of care,” Miller said.
Physicians must obtain a special waiver to be able to prescribe most MAT prescriptions.
Many prescribing practitioners participated in Project ECHO, a hub-and-spoke model that allows community physicians—the “spoke”—to learn new practices and gain knowledge and support from a central location—the “hub”—through teleconferencing. The program with Montefiore Hudson Valley Collaborative focused on buprenorphine management and trainings for non-prescribing practitioners.
The Cornerstone Center for Recovery increased available prescribing providers for MAT. St. Luke’s Cornwall Hospital began administering MAT in its emergency room last year, and Bon Secours Community Hospital plans to do so within the next three months.
Various community partnerships have also been busy in 2018. The Tri-County Community Partnership, an anti-drug coalition based in three counties, launched a Hope Not Handcuffs chapter in the Wallkill, Maybrook and Montgomery police departments. The program offers a single point of access to treatment with the help of local police departments and volunteer angels.
Other community coalitions include Middletown Cares, Operation PJ Pride, Team Newburgh and Warwick Valley Prevention Coalition. The coalitions organized prevention and awareness campaigns, such as Narcan trainings, youth events, educational opportunities and pill pod and lock box disbursements.
To reach Orange County’s behavioral health hotline, call 1-800-832-1200.