Quick Response Teams: Lessons Learned from a Review of Ohio’s Naloxone Plus Programs

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In response to the opioid crisis, many police and first responders implemented deflection programs, a unique collaboration between public health and public safety. These initiatives “deflect” individuals with substance use disorders away from the justice system and ERs by connecting them to behavioral health care or other needed community-based services.

In 2015, Colerain Township in Ohio created the first “Quick Response Team” (QRT), a multidisciplinary collaborative team trained to respond to those at risk of overdose or who have survived an overdose. The QRT is made of a police officer, a firefighter/ paramedic, and a peer recovery coach or treatment professional. The QRT is an example of a “naloxone plus” deflection program, meaning naloxone may be administered by police or first responders at the scene of an overdose plus QRTs conduct a rapid follow-up visit. Visits are typically made to the person’s home to offer a warm handoff to harm reduction, treatment, and other supportive services.

The Colerain QRT conducted more than 400 post-overdose visits from 2015 to 2019, and the model spread throughout Ohio. Today, Ohio has QRTs in a majority of its 88 counties, and the model has been adopted in other states.

What We Found

We examined Ohio QRT data through its statewide data system operated by Cordata, an Ohio-based company. Funded by the state, the records system is available to all Ohio QRTs, so we were able to analyze common measures from 22 QRTs. In addition, we examined survey and interview data of 50 QRT stakeholders in 35 Ohio counties. Together these data helped us learn about QRT operations and participants. Specifically, we learned:

  • There were some variations in the structures of QRTs in Ohio. Administrative data indicated most teams include law enforcement (4% did not); however, team composition varied —27% of QRTs had 3 team members (police officer, fire/EMS, and treatment); 25% had police and treatment; and 10% were comprised solely of police. Most QRTs operated part-time (i.e., 1 or 2 days a week).
  • QRT participants were mostly male, aged between 25 and 44, and half were White. Administrative data revealed 62% of participants were male, 50% were White, and 57% were aged 25 to 44.
  • Many QRTs expanded their program scope to help individuals who use drugs other than opioids, mainly methamphetamine. Some programs reported adoption of additional methods to reach potential participants including outreach activities or allowing persons to self-refer (e.g., persons go to the police station and ask for help accessing needed treatment and other services).
  • Some QRTs were not very “quick.” Some programs reported a goal of a timely overdose response (i.e., within 72 hours). There was a statistically significant difference in the average time between contacts following an overdose, which was 8 weeks, and those that did not involve an overdose, which was 6 weeks. Impediments to a quick response were limited access to real-time overdose information and limited staff capacity.

Moving forward – What is the impact of QRTs and what are the key components for success?

Our study found QRTs offer a model for public health and public safety partnerships that can be implemented across different communities in one state, including urban and rural areas. QRTs are generally understood to be overdose response programs, but many offer outreach or self-referrals to further reach those in need of treatment and services. Going forward, additional research is needed to better understand the process by which QRTs expand from post-overdose response to other pathways to the program. Further evaluation is needed to measure impact, as well as identify and define key components associated with successful QRTs.

About Police Treatment and Community Collaborative

PTACC is the voice of the field of deflection and pre-arrest diversion. PTACC’s mission is to strategically enhance the quantity and quality of community behavioral health and social service options through engagement in deflection and pre-arrest diversion. PTACC provides vision, leadership, advocacy, and education to facilitate the growth and practice of deflection and pre-arrest diversion in all its forms—including programs that incorporate co-responder and community responder models. For more information about PTACC’s research and evaluation work, contact Sophia Juarez.

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Kelly Firesheets is a member of PTACC’s Executive Leadership Committee and co-chair of PTACC’s Research and Evaluation workgroup. She is also VP, Strategy and Partnerships for Cordata Healthcare Innovations, where she provides consultation and guidance to communities implementing deflection initiatives. She holds a PsyD in Clinical Psychology from Xavier University.

Sophia Juarez is the Strategy Area Advisor for PTACC’s Research and Evaluation workgroup. She is also Research and Evaluation Coordinator for TASC’s Center for Health and Justice, where she supports CHJ’s JCOIN projects. Sophia holds a master’s degree in criminal justice/criminology from Loyola University Chicago.

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Albert Kopak is a founding member of PTACC’s Research and Evaluation workgroup. He is a Research Scientist at UNC Health Sciences at MAHEC in Asheville, NC and the founder of Research2Practice, an agency focused on supporting data-driven programs.

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Jon Ross is a member of PTACC’s Research and Evaluation workgroup. He is also Director of Research and Evaluation for TASC’s Center for Health and Justice, where he leads CHJ’s research and evaluation portfolio, including its federal work with NIDA/JCOIN and NIJ/RAND. He holds a PhD in public policy from the Union Institute and University.

 

Kimberly Sperber is a member of PTACC’s Research and Evaluation workgroup. She is also Director of the Center for Health and Human Services Research where she leads work that bridges research and practice, with a focus on improving outcomes for people with substance use disorder. Kimberly holds a PhD in criminal justice from the University of Cincinnati.

Jessica Reichert is a Senior Research Scientist and the Manager of the Center for Justice Research and Evaluation at the Illinois Criminal Justice Information Authority where she directs research and evaluation projects. She holds a master’s degree in criminal justice from the University of Wisconsin-Milwaukee.

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