Wilmington's opioid task force pilot works, but needs state money to continue
Launched in 2018, Wilmington Quick Response Team was initially conceived as a two-year, $500,000 pilot program designed to reach the victims of overdoses within 72 hours and get them into detox and treatment.
Two years later, program officials told Wilmington City Council the QRT has been successful. But despite recent stopgap funding, the QRT needs long-term support to keep working. That’s important, because the program’s success also indicates how many people are still in need --- numbers that are climbing during the Covid-19 pandemic, due to social isolation, economic disruption, and a host of other related stress factors.
Overall, QRT members guided 330 overdose victims to treatment. QRT leader and Coastal Horizons therapist Buffy Taylor told council this included 128 out of 159 people (80%) contacted in year one, 179 out of 197 people (90%) in year two, and stretching into a third year, 37 out of 42 people (88%). The process can be more complicated – and costly --- than some might expect, sometimes requiring the team to track down as many as nine people to reach a victim (and their support network) before getting them to treatment.
Unfortunately, no treatment is guaranteed to take hold for every patient; over the last two and half years there have been 14 subsequent overdoses, four of them fatal.
While reducing the human cost of the opioid epidemic has been sufficient justification for the program for many involved, QRT officials also point to the financial savings of the program. According to Coastal Horizons Clinical Director Kenny House, who has helped steer the program, the cost benefits are seven to one. As Taylor and House told council, the average cost to get a person to treatment is $1,515, compared to roughly $10,000 in costs to tax-payer funded services for an untreated person.
Despite the benefits, the program can’t continue long-term without help from the General Assembly.
According to Tony McEwen, who handles legislative affairs for the city manager’s office, the program has been able to extend beyond its original two-year plan thanks to additional local funding. The QRT was initially funded with $250,000 per year thanks to a bipartisan-backed bill spearheaded by Representative Ted Davis and co-sponsored by representatives Deb Butler and Holly Grange. The QRT was slated to receive a third year of $250,000 in state-level funding, but legislation was derailed by the budget fight in Raleigh.
McEwen noted that, in part because Wilmington’s QRT had expanded its scope to cover the entire county, New Hanover County and the United Way of the Cape Fear each matched $42,000 from the City of Wilmington; McEwen credited outgoing Commissioner Woody White as being very helpful in securing those contributions. An additional $40,000 will also be provided by the non-profit Cape Fear Memorial Foundation.
All of this buys the QRT about another 6 months, which could be stretched a little further but not indefinitely, McEwen said, adding that the local funding should be a stopgap but not a substitute for state level support.
In the meantime, House wrote in an email that “no wind down is planned at all; we will continue QRT… It is an effective intervention that we cannot afford as a community to lose!”
There are also some longer-term aspirations to make the QRT into a regional program. Expanding from Wilmington to New Hanover County was relatively easy, because the area is fairly dense. However, with larger more rural areas, the costs of time and distance start to stack up, McEwen said. Despite what is likely to be a more significant funding ask, officials still hope to pursue the idea.
Rep. Davis, recently re-elected to a new district, said he was working on making the QRT a permanent program.
“Funding for the Wilmington Opioid Pilot Project for the 2020-2021 fiscal year was included in the Budget that was vetoed by Governor Cooper. Unfortunately, there were no additional funds available for this appropriation. I am presently working with leadership of the House Appropriations Committee to hopefully find these funds. I also intend to pursue additional funding in the Budget for the 2021-2023 biennium that will be done during the Long Legislative Session beginning in January. It has been my goal to hopefully turn this successful temporary project into a permanent program,” Davis wrote in an email.
Regardless of whether the money comes from the state or locally, it’s still taxpayer dollars, and some, including Wilmington Mayor Bill Saffo, have expressed frustrations that those responsible for the epidemic aren’t shouldering the costs. Wilmington and New Hanover County, like cities and counties around the country, both have pending lawsuits against pharmaceutical companies. Despite recent concessions to the federal government by from Purdue Pharmaceutical, local lawsuits could carry on for years.
Beyond the finances, though, the long-term viability of the QRT is likely important outside New Hanover County as a successful model for other regions.
The program was based on a similar, although smaller-scale, project in Colerain Township, Ohio. The town has been one of the hardest hit by the opioid epidemic. It’s also served a grim bellwether for what would become the epidemic’s deadliest wave: drugs like fentanyl and carfentanyl, synthetic opioids that are dozens, even hundreds of times stronger than heroin. Colerain’s program also inspired a similar team in Guilford County.
Wilmington’s QRT has faced its own challenges, like operating on a larger scale --- covering about four times the population of Colerain --- and operating under Covid-19 conditions. According to House, Wilmington’s QRT has also made strides in improving its ability to connect with those in the Black community, a concern raised by Wilmington City Councilman Clifford Barnett, Jr. during a 2019 update from the program. And there is the ever shifting terrain of substances at play. House said around 60% of overdoses were related directly to opioids, but 40% were made up of cocaine and methamphetamines (often spiked with fentanyl) as well as newer drugs, like synthetic cannabanoids.
How Wilmington has approached --- and continues to approach --- these challenges is bound to be of interest to other towns, cities, and counties facing an epidemic that, unfortunately, has shown little sign of abating.