PHILADELPHIA — City officials on Wednesday announced an innovative response to the opioid crisis in which paramedics and social service case managers travel together to provide care and support to overdose survivors, with the ultimate goal of getting them into treatment.
The new EMS alternative response unit known as AR-2 first hit the streets in April as a pilot program and engaged 25 people in the first six weeks. Six people accepted treatment; many others accepted free naloxone and/or literature on treatment options and resources.
“This unique combination of responders will help us increase warm hand-offs and save more lives,” said Mayor Jim Kenney. “It’s a great example of what’s been possible through the increased interagency coordination stemming from the Philadelphia Resilience Project.”
The AR-2 initiative combines the skills, knowledge and resources of the Philadelphia Fire Department, Philadelphia Department of Public Health and the Department of Behavioral Health and Intellectual disAbility Services.
A paramedic and case manager ride together in AR-2, which is a marked Fire Department SUV. They respond when an individual revived from an opioid overdose declines ambulance transport to a hospital but is interested in seeking help for substance use disorder.
AR-2 staff can refer people to a variety of rehabilitation services, including residential treatment when space is available. The paramedic’s ability to determine on the spot if the individual is medically able to begin treatment allows the person to be placed more quickly at a facility.
“This is why partnerships are so important,” said Fire Commissioner Adam K. Thiel. “Working together makes the response to this epidemic that much stronger.”
AR-2 is part of the Philadelphia Resilience Project, a citywide effort to combat the opioid crisis. The program, which includes a dedicated epidemiologist and social worker to track client interactions, is funded by the Fire Department and a four-year grant from the federal Substance Abuse and Mental Health Services Administration.
“This alternative response unit significantly increases our capacity to reach individuals with substance use disorder, engage them on the street, and connect them to treatment with timely and efficient warm hand-offs,” said Behavioral Health Commissioner David T. Jones.
AR-2 builds on the success of AR-1, an alternative response unit that responds to low-acuity, non-traumatic EMS incidents at the University of Pennsylvania. AR-2 operates daily in the Kensington area.
The Philadelphia Fire Department responded to 271,450 EMS incidents in Fiscal Year 2018, or nearly 744 per day. About 5 percent of EMS incidents are classified as overdoses, a category that includes all types of overdoses – not just opioids.