People who overdose on opioids in Tennessee could now be met in the emergency room by someone who has been there. The so-called "recovery navigators" were part of the state's sweeping response to the opioid epidemic, authorized by the legislature last year.
This idea is being tried in overdose hotspots around the country, often called a "warm handoff." The theory is that when someone has nearly died from an overdose, they're likely more open to finding a way out of active addiction.
Typically, emergency departments have given out a hotline for patients to call. Some even go so far as to line up a spot in rehab. But Debbie Hillin says about half the time — at least for her treatment center — they're a no-show.
"We may tell them we have a bed, tell them to come on in. Well, from the time they leave the EDs until they get to us, they probably have fallen through the crack," she says.
Hillin is president of Hohenwald-based Buffalo Valley, which won the state contract to oversee the program in Nashville. She's hired four navigators. They respond to calls at all hours of the night, preferably meeting the overdose patient face-to-face before they leave the hospital.
Kenneth Allison says he tries to stay within sight until the patient is discharged, even offering to drive them straight to a detox center if necessary.
"If they continually see my face, they're still thinking, 'ok, he's going to take me and I'm good. And I'm safe.' Sometimes you've got to save people from themselves," he says.
Allison, like most of the navigators, survived his own overdose. But even with the near death experience, he says recovery required a concerned pastor giving him a firm nudge into treatment.
"I couldn't see my way out, even though I wanted out. I couldn't see my way out of that," he says. "I think something drastic has to happen in order to change the way you think."
It will be a while before Tennessee can assess whether the $750,000 annual program is making a dent in overdose deaths, which have continued to climb. With 11 navigators stretched across the state's largest cities, they've collectively worked with more than 300 overdose survivors in the first few months.
Navigators in Knoxville and the Tri-Cities started work in mid-2018, but Nashville didn't come online until October. Buffalo Valley had trouble working out arrangements for their navigators, who are not licensed counselors, to provide consultations in major hospitals. The city's largest hospital, Vanderbilt Medical Center, still doesn't plan to participate. A spokesman says the role is handled in-house by a psychiatry department.