“This started because Amber wasn’t afraid to start the conversation,” Paul Miller, Division Chief of EMS (Crawfordsville Fire Department) begins. And that initial conversation is making a big impact in this rural county of 38,000 people.
Crawfordsville is the seat of Montgomery County, ranked the ninth most at-risk in the state for opioid addiction. When Scott County’s HIV outbreak made national headlines, the state identified which counties needed the most focus and resources. And Montgomery County was high on the list.
So Amber Reed and her team decided to do something about it. A billboard went up in March 2016 highlighting the problem by showing a person with a needle in their arm. “The community was up in arms,” recalls Reed, department administrator at the Montgomery County Health Department. “There were calls to take it down. It was only intended to be up for 30 days, so we kept it up.”
That sparked a conversation about the county’s ranking. In fact, it was the first time many people had ever talked about the local problem. The Crawfordsville Quick Response Team was soon founded to discuss what could be done in the community. They brought everyone to the table: law enforcement, courts, paramedicine, coroner, schools, hospitals, probation, mental health, some 25 different stakeholders in all representing prevention, education, response, law enforcement/courts, and recovery.
Then things began to happen. There was no naloxone treatment in the community at the time. Grants were sought and received. Now all first responders are equipped with naloxone.
A community attitudes and awareness survey was conducted to gauge how people felt about addiction, policies, and treatment centers and to guide future decisions.
“We were very siloed. We do great work within silos, but didn’t have reference points within the others,” Miller said. “We didn’t want to duplicate efforts. We wanted to make better use of resources and become a community project, something we’re all working on at all levels and agencies.”
“Because we are a rural community, we didn’t have as much red tape to go through,” Reed adds. “We came together. No one is afraid to say no and everyone is willing to help.”
Last November they began working on an ED/MAT Bridge, utilizing firefighters and paramedics to work as physician extenders. They work with the emergency room and navigate patients from an overdose to treatment.
Quick Response Teams officially started going out on June 1 of this year. In that short time, they’ve made over 160 “touches,” have connected 11 people to mental health providers and three others to addiction treatment providers.
“We’ve had people walking up to us with controlled substances and saying they want help. We navigate them to treatment. We work with many primary care physicians to assist with bridging the gap,” Miller says. “We just want to fix the problem. It doesn’t matter who gets the credit. It’s all about being proactive rather than reactive.”
Not bad results for something that started with a conversation about a single billboard.
Montgomery County Substance Use Disorder Integration Health Initiative was a featured award winner in the 2019 Innovation Now project of the Addiction Policy Forum.