“Warm Handoff” Program Aims to Get Overdose Survivors Directly Into Treatment

A new program in Pennsylvania called “warm handoff” directly transfers overdose survivors from the hospital emergency department to a drug treatment provider. The program, developed by the state’s Department of Drug and Alcohol Programs (DDAP), is designed to avoid merely giving survivors a phone number to call or setting up a subsequent appointment a day or two later.

“There is a very high risk of a repeat overdose in the period right after a person leaves the emergency room for a drug overdose,” says Gary Tennis, Secretary of the Pennsylvania DDAP.  “Our aim is to avoid that risk by getting the survivor directly to treatment without hitting the street at all.”

The program approaches overdose survivors in much the same way as the survivor of a massive heart attack, Tennis explains. “You wouldn’t just hand someone who had a massive heart attack a cardiologist’s card and say, ‘Here, go set up an appointment with this person.’ The hospital immediately starts the patient on the next level of care to get them better, or else they could die. The same should be true of overdose survivors.”

The idea for the program came about as police across Pennsylvania have reversed more than 1,600 opioid overdoses since November 2014 with the opioid overdose antidote naloxone. “Many people who would have died are now being saved in the ER, but the protocol there has been to release people once they are stabilized, or at most given a card with a referral for treatment,” says Tennis, who is also Chairman of the National Alliance for Model State Drug Laws.

His staff reviewed other programs around the country that bring people directly from the ER into treatment, and put together a list of five options for county drug and alcohol directors. DDAP has mandated that county drug and alcohol authorities develop, implement and maintain a plan for screening, assessment, treatment and tracking of overdoses survivors.

“We told them they have to reach out to every hospital ER in their county and set up some type of protocol for warm handoff,” Tennis says. “Who is involved can vary. It can be a certified recovery specialist from a treatment center, a hospital social worker or a government employee. In some cases, the warm handoff is handled by a person in recovery themselves, who can relate to what the patient is going through.”

Warm handoff case management teams immediately meet with survivors and their family in the emergency department. The team works to convince the survivor of the need for treatment, provide a clinical assessment and immediately facilitate transfer to a treatment program. Tennis notes that as with any hospital patient, overdose survivors have the legal right to refuse referral to treatment.

A key goal of the program is to ensure that healthcare professionals dealing with overdose survivors understand the intense shame and stigma that can accompany drug addiction. “We talk to them about treating these individuals with respect and caring, as people of value,” Tennis says.

While the warm handoff program is not yet up and running in every county in the state, some counties are already reporting success, Tennis says. In Berks County, Reading Hospital has been able to get between two-thirds to three-quarters of overdose survivors directly into treatment. Of the remaining patients, many have gone into treatment in the week or two after they have been discharged from the hospital.

In an area west of Pittsburgh, the Armstrong-Indiana-Clarion Drug and Alcohol Commission reports almost half of individuals referred to their warm handoff team have accessed treatment.

Funding for the Pennsylvania program comes from block grant funding. “Our block grant provides only a fraction of what is needed to treat everyone with this disease,” Tennis acknowledges. “We also don’t have enough detox beds and treatment beds,” he adds. “Our governor has moved us forward with Medicaid expansion, which has increased funding for addiction treatment. But right now we are in an all-out campaign to increase the treatment infrastructure in Pennsylvania. We must understand that if a drug overdose survivor is released onto the street, their lives are in great jeopardy.”

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    John Macarchick

    November 7, 2016 at 12:14 PM

    I would like to see how many people complete treatment along with how many get into treatment. This

    is also a component of sucess.

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    Kristie Lyonnais

    November 7, 2016 at 3:42 AM

    Warm handoff is exactly what is needed everywhere this will be a major shift and much more compassionate and understanding way so real healing can begin. I pray this idea is implemented everywhere.

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    Kathy

    November 5, 2016 at 12:31 PM

    Awesome! I’m so happy that Pennsylvania is stepping up and standing up to Addiction as a disease. Hopefully, we will see this start happening all across PA. WE NEED THIS.

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    Rick Esterly

    October 27, 2016 at 2:28 PM

    As a long time Pennsylvanian and member of the recovering community I can attest to the fine work being done to match the person’s needs to treatment. Most importantly, with few exceptions, the state Department of Drug and Alcohol Programs, the county alcohol and other drug authorities, the alcohol and other drug providers of Pennsylvania (DASPOP) are working together to develop and implement this “warm hands” program. As indicated in the Article, Berks County is already showing improvement and will impact on the problem and the number of deaths.

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    Norma Norris

    October 27, 2016 at 11:27 AM

    Warm hand off seems like a great idea! Hope it can be implemented soon. Also hope that PA DDAP will stop giving the ‘cold shoulder’ to prevention. Those addicted are in crisis and need services now, parents not educated about the elevated risks in the PA environment in which they are raising children are the most under-served population in our state. PA is doing nothing to prevent the ‘addict of the future’. DDAP actually works against a nonprofit that is providing research-based family prevention to 35,000+ self-referring parents/children. That is counter-productive to say the least. Question should be….why are so many people attending a parent/child program? Hoping DDAP’s ‘Warm Hand Off’ is successful and a warm hand will be extended to prevention for the masses. PA’s national lead in overdose deaths begs for an overhaul of current prevention outreach. Collaboration is key!

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