Philly’s opioid crisis

Philly’s new EMS overdose team is unlike any in the nation

Will the model work? Stakeholders are hopeful.

Max Marin / Billy Penn

Philadelphia has rolled out an emergency response team unlike any other in the nation. The new EMS unit, called AR-2, was announced Wednesday. It has a two-pronged goal: reverse overdoses and connect people to treatment services.

Currently deployed in the Kensington neighborhood, the team is a mix of paramedics, case workers and public health professionals — a model that puts the effort in uncharted territory.

Similar units have popped up across the country in recent years, though none quite like Philly’s. Various kinds of overdose response teams exist all over, from Boston to Ohio and Pittsburgh to Virginia.

The method adopted by Ohio’s Fairfield County does seem to be working. The county claimed an 80 percent success rate of referral to treatment services. Less effectiveness was found in Pittsburgh, though, where officials reported treating only a “handful” of patients — and declined to provide any actual number.

Compared to Philly’s approach, most of the others are focused less on responding to emergency overdose situations, and more on the follow-up. Paramedics respond to an overdose, then tip off the response teams, who will show up at a patient’s doorstep in the next few days to offer continued care.

So what’s different here, and how effective will the AR-2 unit be? Here’s what we know so far.

How it works here

The AR-2 unit — the name stands for “alternative response” — comprises six total staffers:

  • Two paramedics
  • Two case managers
  • One social worker
  • One epidemiologist

“In terms of case managers and paramedics traveling together,” Fire Department spokesperson Kathy Matheson told Billy Penn, “we are not aware of another model like this.” The Fire Department runs all emergency services in Philadelphia.

Teams will then operate following these steps:

  1. Someone reports an overdose in Kensington
  2. AR-2 will respond with two staffers riding in a Fire Department SUV. At the same time, a regular ambulance will also respond.
  3. Once they get there, they’ll reverse the overdose if necessary.
  4. Then, if they see fit, they can transport patients to the hospital or directly to a rehabilitation or treatment facility.

Each response can take hours, due to the complex coordination of services that might follow, Matheson said.

“It’s about meeting people where they are,” Mayor Jim Kenney told WHYY on Wednesday. “If a patient is not ready to enter a treatment facility, AR-2 will offer free naloxone and information on how to access care when they are ready.”

‘On the streets the next day’

This is Philly’s second foray into alternative EMS response. The first, AR-1, was deployed in the area around UPenn last September. It was meant to offset the high costs of regular ambulance rides so students are incentivized to call for help when they need it. So far, the team has performed more than 400 EMS transports.

It was April when the new AR-2 unit first hit Kensington streets. During a six-week pilot program. It has reached 25 people — six of whom accepted treatment services.

That number might seem low. After all, it doesn’t look like much stacked up to the 1,116 Philadelphians who died due to drug overdoses last year. Per Fire Dept. data, Philadelphia paramedics are called to an average of 37 overdoses every day. But those OD numbers are across the entire city — not just Kensington, Matheson pointed out.

Crystal Yates, the Fire Dept.’s assistant deputy commissioner, said the AR-2 concept will likely provide some relief for paramedics, who she said have long been frustrated with the cyclical nature of overdose response.

“They respond to overdoses, they take them to the hospital, they leave the hospital and then the EMS responder is seeing the same exact person on the streets the next day,” Yates said. “It causes frustration that you can’t do more to help that person.”

In Kensington, addiction outreach officials are cautiously optimistic. Prevention Point’s executive director Jose Benitez thinks that a dedicated team might relieve their workload a bit — and hopefully save some lives.

“It’ll take some of the pressure off,” Benitez told Billy Penn. “At this particular point, I’m just glad to see us trying some different and innovative approaches.”

For now, Matheson said the program is still in its “infancy.” Its actual effectiveness remains to be seen.

“It’s going to be pretty much a wait-and-see at this point,” Benitez added. “We’re hoping for a rhythm that will just add more resources to what we’re already doing out here. I do think it’ll save some people’s lives.”

Want some more? Explore other Philly’s opioid crisis stories.

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