Opioid crisis response includes opening more pathways to treatment

Newsrooms across the commonwealth have spent years documenting the opioid crisis in their own communities. But now, in the special project State of Emergency: Searching for Solutions to Pennsylvania’s Opioids Crisis, we are marshalling resources to spotlight what Pennsylvanians are doing to try to reverse the soaring number of overdose deaths.

WITF is releasing more than 60 stories, videos and photos throughout July. This week, you will find stories about police intervention, courts and treatment.

Bobby Wahl’s access to the addiction treatment he sought required insurance he didn’t have. Together, he and his mother compiled the documents and filled out the paperwork for state-sponsored insurance that would cover his treatment.

Weeks passed. Wahl went missing, triggering a 10-day search that ended with the discovery of his decomposed body in some bushes by Temple University.

The card that would have allowed him to get treatment arrived in mail on the day of his funeral in 2013.

“But he never had a chance to use it,” his mother, Lynne Wahl, said.

Officials in Pennsylvania have been attempting to add resources and streamline services over the past few years to help those who are ready to enter treatment before their addiction once again takes hold.

Earlier this year, Gov. Tom Wolf declared the opioid epidemic a statewide emergency in Pennsylvania, and introduced programs that seek to make it easier to access treatment.

During that time, there’s also been a “significant increase” in people getting involved at the community level — from forming nonprofits and fundraising, to organizing events, said Diane Rosati, executive director of the Bucks County Drug and Alcohol Commission.

“We’re incredibly encouraged by everybody in the community,” said Rosati. “We know we can’t do it alone — government, medical, schools, business — we just can’t do it alone. We need everybody helping us out in a coordinated effort.”

The addition of hotlines in several states, including Pennsylvania, has been touted as one way to provide better, centralized access to treatment.

Pennsylvania’s hotline, established by Wolf in January 2016, fielded 5,078 calls in the first quarter of the year, up 1,700 calls from the prior year, the state announced this week. Of the callers, nearly 850 were directly connected to treatment.

The helpline connects people to at least one treatment resource, including detox, inpatient rehab, medication-assisted treatment, outpatient therapy or other services. Operators stay on the line with callers until an appointment is scheduled with whatever resource they choose or been approved.

“We know that getting people suffering from substance use disorder into treatment quickly is a key to establishing recovery and the helpline staff are the voice of expertise to direct callers to the help they or their loved one needs,” Wolf said in a statement.

Many advocates and addiction specialists emphasize getting someone into treatment as soon as they ask for help can be crucial. However, just getting through the intake and assessment process can be arduous.

The assessment captures the whole biopsychosocial background of the person — where they’ve been, what they’ve been using, how much, if they work, what their family and living situation is like. It has to be in-person and in most cases they need to have proof of residency.

There’s a urine screening, calls to the insurance company or funding provider to get approval for the level of care determined in the assessment, and then, if it’s detox or inpatient rehab, calls to treatment providers to find a bed, or to make a connection other services.

“It’s a long, tedious process because … there’s just so many working components to it,” said Linda Pharo, who runs a counseling practice in Philadelphia and Jenkintown, and who has worked with several area treatment providers.

“If you were one of those very lucky ones who just happened to walk in and get an assessment and there was a bed available, it was a Godsend.”

Certified recovery specialists, or CRSes, often have personal experience with addiction. They play an important role helping people get into treatment through a “warm hand-off” program that pairs Bucks County’s six hospitals with three treatment providers.

The goal of BCARES (Bucks County – Connect Assess Refer Engage Support) is for CRSes from the treatment providers to respond and talk with patients who end up in the emergency rooms after overdosing, or who are admitted to other departments and need help with addiction.

“Somebody has to be there, somebody has to connect, somebody has to talk, somebody has to support, somebody has to try to tell you that, ‘Hey, I’ve been through this, I’ve been able to do it, you can too,’ ” said Margie Rivera, associate director of the county Drug and Alcohol Commission, which provides funding and contracts for BCARES.

To eliminate some of the wait for treatment, Bucks County has agreed to pay for the first three days of treatment for every person who is connected with the warm hand-off program and a CRS, regardless of their insurance or funding stream for coverage, Rivera explained.

“Those three days will allow that receiving agency or treatment facility to work out the insurance and then call our office if there’s further assistance that’s needed,” she said. “We really don’t want to have any wait list, we don’t want to have any barriers to treatment.”