Colerain Township fights the opioid epidemic with compassion
The Ohio town has developed a human-centered approach to addiction support services that has grown so successful it’s now used in at least eight states.
PodcastHealth & Human ServicesPublic WorksOpioid Surveillance
If, 25 years ago, you had told Will Mueller, Assistant Chief - Administrative Services in Colerain Township, OH, that he’d see a firefighter-paramedic driving around the community with a peer support specialist and law enforcement officer, he wouldn’t have believed you.
But as the opioid epidemic took hold in Colerain — as it has across the United States — Mueller, a Colerain native, knew something had to change. A major crisis was unfolding and the existing solutions weren’t doing enough to address the problem. It was time for a new approach.
In 2015, Colerain Township introduced its Quick Response Team (QRT) model, which uses a human-centered approach to address addiction. The QRT brings police, fire/EMS, and counselors together to seek out those suffering from addiction and deliver resources directly to them.
Now, the Colerain Township model has been adopted in communities across the country. It isn’t high tech. It’s not particularly fancy or expensive. But it’s incredibly successful, because it’s founded on building relationships, and being compassionate.
As Govlaunch works to build the global wiki for local government innovation, we’re highlighting a series of Innovators — cities, towns, and counties who are implementing transformative ideas and fostering a culture of innovation. We chatted with leaders in Colerain Township to understand how their innovative approach all comes down to building relationships.
The following year, after spending time to understand the main causes and impacts of the problem, Colerain launched its Quick Response Team model with the following goals:
--Bring recovery resources to the doorstep of someone who has overdosed and is suffering from addiction.
--Meet those suffering from addiction where they are.
--Remove barriers to treatment and recovery, including stigma, preexisting untreated medical conditions, transportation to/from treatment, and lack of id/medicaid services.
“We learned that people who were suffering from addiction or families who had loved ones suffering from addiction had a real hard time reaching out to recovery resources. It wasn’t as simple as calling an 800 number and getting help on the line and being able to get in that day. So we wanted to develop and implement a program that was addressing the issue at its root cause.”
Each Quick Response Team consists of three individuals: one from law enforcement, one fire fighter or paramedic, and a peer support specialist. The three-person team seeks out residents who have overdosed (identified based on 911 calls and the resulting police records) and bring recovery resources, such as linkage to care information, assessment tools to help place individuals onto the proper treatment path, and naloxone kits to their doorstep.
Mueller says the multidisciplinary framework is critical. All three members of the team play critical roles — it couldn’t just be a counseling-based approach or law enforcement:
“We knew that if public safety wasn’t key to this program, we wouldn’t find success. These individuals, both police and fire/EMS, were the ones who were responding to the 911 calls anyway. Those individuals knew the people who were overdosing. They knew them by name. They knew where they lived. They knew where they hung out. So using that team to infiltrate to break down some of these barriers made a lot of sense to us.”
The members of these teams develop ongoing relationships with those who need help. Sometimes, it takes multiple visits — addiction is a long battle, and steps backward are part of the process. But by creating personal connections built on trust and providing support, the QRT model soon started seeing results.
Colerain’s model is the first of its kind in the United States; there was no roadmap for success. So how did they know if the program worked? Mueller explains:
“We were really going into this blind. But addiction experts in our area told us that if we got 10 percent of the individuals that we reached into treatment, we’d be doing exceptionally well.”
So the team set the bar at 10 percent. They quickly blew past that number.
Since the program launched in 2015, Colerain has conducted 550 post-overdose follow ups. Of these, they have made face-to-face contact with 375 individuals. Out of these 375, 270 people have engaged in treatment. Says Mueller:
“That number is huge. That means that 72 percent of the individuals that we come face-to-face with, we’re successful in engaging them in treatment.”
These numbers, while impressive, don’t fully capture the program’s success.
The relationship-building by Quick Response Teams has led to a nearly 52-percent reduction in overdose responses by the town’s EMS agency, over the last year and a half.
This doesn’t just mean there were fewer 911 deployments. It’s a 52-percent reduction in the chance of death by overdose. A 52-percent reduction in exposure to Hepatitis C and HIV. And the collateral damage to families and community members is reduced significantly as a result of Colerain’s empathetic approach.
“That’s one of the things Chief Mueller and Dan Meloy, then Public Safety Director, and later, Township Administrator, brought to the forefront: We’re going to start a model that is based on caring about people. And look what happens when you care about people. You can really make a difference. And you don’t need great amounts of technology. All you need is a program that is based on caring and compassion.”
With opioid overdoses spiking around the country, word of Colerain Township’s model traveled quickly.
Now the program is being implemented in eight states outside Ohio: Kentucky, Indiana, West Virginia, Tennessee, North Carolina, South Carolina, Texas, and Delaware. Within Ohio, there are functioning QRTs in approximately 60 of 88 counties.
Colerain’s approach to innovation: fast, cheap, iterative
Even with the success of the QRT, Colerain’s model wasn’t perfect right from the start. Mueller notes that failure — and the learnings that come from it are a core part of the process:
“Those failures and those redos and those remakes of our program have only made us stronger.”
This mindset is indicative of how the town looks at innovation overall. According to Milz, in addition to the compassionate mindset embodied in the QRT, there are three components driving transformation in Colerain. All three came into play recently to address an issue that’s a thorn in the side of many communities: speeding.
It’s always possible to hone processes, to look for alternate workflows, and to retool how something is done, says Milz:
“The idea is to use these cheaper, faster, quicker tests, and then iterate on those until we get it right.”
To slow down drivers in neighborhoods, Colerain administrators weren't convinced speed bumps were the answer. Town leaders had seen communities like Seattle employ curved road features called chicanes. But Colerain Township is certainly not Seattle. Would a chicane work here? Milz wanted to find out:
“Instead of spending hundreds of thousands of dollars putting in a chicane somewhere and then realizing either A) it didn’t work or B) the neighbors just couldn’t stand it, we decided to do a test.”
The town purchased erosion control hay bales for about $250 and created three islands in the road. They put up signage, and effectively changed the way the road functioned — now drivers would have to carefully navigate around the islands, as opposed to speeding right through.
Like many communities, Colerain Township takes data into account when building a business case for a project, or determining if something is working or not.
Before adding the chicanes to the road, the town put out speed cameras and signs to gather traffic information, such as number of cars, and their speed.
After about three weeks of data gathering, they installed the test chicane, and kept measuring. It was supposed to slow people down, so the town checked the data. The chicane worked, says Milz:
“Sure enough, it slowed people down. And we had the data to prove it.”
3. Community input
All the testing and data-gathering in the world doesn’t matter if the community doesn’t like the solution.
For Colerain’s chicane, members of Milz’s team went and knocked on doors on the impacted street to ask whether residents liked it. Milz says:
“Responses were mixed, but ultimately the community group that represents the neighborhood stepped up and said ‘we really like this and we want it to go forward.’”
By iterating, collecting data, and getting community buy-in, Colerain was able to test new road infrastructure for about $250. Now the resulting more permanent chicane is in design, and Milz hopes it will be in construction next year.
Colerain Township’s community values
At the end of the day, whether it’s a makeshift speeding solution or a nationally embraced opioid response, relationships with the community are what drives the Colerain Township local government’s programs and services. Says Milz:
“We don’t have all the answers. That’s one of the critical things about our governing philosophy: we do this in partnership with our neighborhoods. We work for them. If they have a great idea about how to improve their neighborhood, let’s make that happen.”
“I joined the fire service 25 years ago not because I wanted to serve a community, but because I wanted to serve this community. My goal every day is to be able to give back to the community that supported me as I was growing up. It’s easy for me to be passionate about community, because of my connection to it.”