Executive Summary
This collaborative effort is about saving lives! Bucks County, like much of the nation, continues to see the devastation that the “Opioid Epidemic” is causing individuals and their loved ones. Our goal is to stop the devastation, provide support, and make strides in reducing the stigma associated with behavioral health issues, in particular the disease of addiction.
According to the “Analysis of Overdose Deaths in Pennsylvania, 2016,” prepared by the DEA Philadelphia Division and the University of Pittsburgh Bucks County, more than 4,600 Pennsylvanians died as a result of drug abuse, which means we are losing 13 people every day from drug overdose in PA. In Bucks County, we saw an increase of 43 percent from 2015 to 2016 in overdose deaths.
In response to this epidemic, the “warm handoff’ protocol, mandated by Governor Wolf’s office, was developed in Bucks County. This initiative, BCARES (Bucks County - Connect. Assess. Refer. Engage. Support.), is a collaborative partnership between the nonprofit Bucks County Health Improvement Partnership (BCHIP), which includes the six hospitals in Bucks County, three drug and alcohol provider agencies (Gaudenzia, The Council of Southeast PA and Penn Foundation, Inc.), and the Bucks County Drug & Alcohol Commission, Inc. (BCDAC).
BCARES focuses on getting opioid overdose survivors directly into substance abuse treatment by bringing Certified Recovery Specialist (CRSs) into the hospital’s emergency departments (EDs). The CRS will work to connect individuals who have experienced an overdose directly to treatment, provide support for the families, and educate medical personnel on drug and alcohol resources.
As many of our lives are touched by this devastation, we continue to engage the families that will need an abundance of support, compassion, and acceptance just to survive the grief themselves…as well as to strengthen our own resolve to never give up on the effort!
The Driving Force
I'm sitting in the ninth row of pews with my wife, wiping tears from my eyes…dumbfounded by the reality that I'm at the funeral of 23-year-old Carlos, who played drums in the church band I sang in for many years. Funerals are tougher for me nowadays, since the passing of my son Michael five years ago, at the ripe old age of 21. Michael passed of his own choice, jumping into a quarry near the high school he graduated from just three years earlier. Since Michael's passing, I've attended three funerals of 20-somethings that overdosed on heroin. Each was devastating.
But not as devastating for me as for the families who lost their precious loved one. I know firsthand how difficult this loss is. There's still this enormous hole in my heart and my life. And to know that these families are just starting on their long journey of horrendous grief is what upsets me most. The compassion and pain I feel for them is overwhelming.
And then the thought enters my head…how many more funerals of 23-year-olds will I need to attend over the next five years? Since we're losing 13 people every day from drug overdose in Pennsylvania alone, and, as demonstrated by the chart below, we have seen a steady increase with drug-related deaths in Bucks County, I’m certain there will be many more funerals to attend…and many more tears to be shed.
A Response
As a community, there are things we can do to address this issue of substance abuse and misuse, and in Bucks County there are numerous organizations working together to make positive and lasting change. In response to Governor Wolf’s efforts to combat the opioid epidemic, in partnership with the Pennsylvania Department of Health and Drug & Alcohol Programs, and the PA College of Emergency Physicians, the “warm handoff” initiative was developed to support emergency departments and individuals suffering from an opioid overdose. This “warm handoff” protocol focuses on getting opioid overdose survivors directly into substance abuse treatment by hospitals bringing Certified Recovery Specialists (CRSs) into their emergency departments (EDs) to talk with individuals who have been revived about recovery services before the patient is discharged. This effort is saving lives!
The Collaboration
How does it work? The Bucks County Drug & Alcohol Commission, Inc., (BCDAC) the “Single County Authority” (SCA) for Bucks County, responded to Governor Wolf’s edict by developing and funding the BCARES Initiative (Bucks County – Connect. Assess. Refer. Engage. Support.). BCARES is a collaborative partnership between the nonprofit Bucks County Health Improvement Partnership (BCHIP), which includes the six hospitals in Bucks County, five presently involved in the initiative (Lower Bucks Hospital, St. Mary Medical Center, Aria - Jefferson Health Bucks County, Doylestown Health, and Grand View Health. The sixth hospital, St. Luke’s Quakertown Hospital, is expected to join the initiative soon), three lead agencies (Gaudenzia, The Council of Southeast PA, and Penn Foundation) and BCDAC. Besides the six hospital CEOs in Bucks County, the BCHIP Board of Directors includes the Director of the County's health department, a representative from the medical society, and six additional community volunteers. The Board was unanimous in approving the initiative and the hospital CEOs put the wheels in motion at each of their facilities.
Where the Rubber Meets the Road
At BCHIP, it is called the "Opioid Overdose Survivor Services" initiative. But where the real rubber meets the road is through the BCARES program, where connections are made and recovery begins. BCARES' primary goal is to provide a “warm handoff” into recovery services for opioid overdose survivors by having a CRS connect directly with the overdose survivor in the hospital’s emergency department; providing compassion, support, and encouragement. This is accomplished by identifying the survivor’s treatment needs and connecting them with an appropriate level of care assessment and placement, as well as providing the necessary community resources to assist them in their recovery. It is providing a second chance and hopefully guiding the individual along the path to recovery.
Often, the individuals accompanying the overdose survivors are not provided with information or support. BCARES recognizes this need and also offers support to these individuals as a secondary goal. A tertiary goal of BCARES is to provide education to healthcare professionals in order to break down the stigma and misunderstandings that are often associated with this dreadful healthcare crisis.
The CRSs involved in this initiative are individuals with their own lived experiences relative to substance abuse and can speak from experience with credibility and understanding.
Gaudenzia and Lower Bucks Hospital formed the first partnership to have BCARES fully operational. Since inception of their program in April, 59 overdose survivors have been referred through the BCARES initiative. Of those referrals, 28 agreed to participate with BCARES, 18 followed through with treatment referrals, and 17 families received support and information. This represents a 30 percent successful referral rate for the four-month period. All other partnerships have recently launched and our expectation is to see the program succeed throughout Bucks County as we struggle against this epidemic and provide support for individuals on their road to recovery.
How will we know this initiative is really working?
The simple answer is…by the number of lives saved, knowing that every person suffering from the disease of addiction is at great risk and their loved ones are greatly affected. But we also have a wonderful partnership with the Independence Blue Cross Foundation, which is investing $100,000 into an Effectiveness Study of the BCARES program and our Opioid Overdose Survivor Services initiative. This research study, being conducted by Public Health Management Corporation (PHMC), will tell us how effective the CRSs are in engaging revived patients, how long patients stay in recovery, how the attitudes of patients and their family members have changed due to the patient's recovery efforts, and whether this initiative can be replicated in other communities across the U.S.
Fighting the Stigma
BCHIP, through its Wellness Partnership group, is also making strides in reducing the stigma associated with mental and behavioral health issues, including the disease of addiction. This stigma is very real and affects millions of individuals and families who are dealing with these serious issues. Stigma is a real barrier to treatment, not to mention the barriers it creates for patients trying to enter the workforce, or just in everyday social engagement. We, as a society, need to change the language we use, the attitudes we have about patients dealing with these issues, and the social norms that currently prevail around the concept of addiction as a disease, not a choice. We must work together to achieve this positive change.
Saving Lives
Where will this epidemic be in five years? It’s possible we have not yet seen the worst, but there is hope and there is more we can do. We can participate in programs and collaborative efforts in our communities such as safe disposal of prescription medications that will slowly stem the tide. We can continue to support the families that will need an abundance of love, compassion, and acceptance just to survive the grief themselves…as well as to strengthen our own resolve to never give up the effort!
For further information on the BCARES program, and other programs that support prevention, intervention, treatment and recovery supports, please call 215-773-9313.
Works Cited
(U) Analysis of Drug-Related. (2017, July). Retrieved August 1, 2017, from link
(2017, January). Retrieved January, 2017, from link