Engaging Hard-to-Reach Clients at High Risk of Fatal Overdose

A post-overdose response team (PORT) pilot in Hawaii, an extension of an existing social work team and patient navigators, engages unintentional overdose survivors at the Queen’s Medical Center emergency department. One of the PORT team’s major challenges was reaching patients who might leave before a patient navigator contacts them, particularly those without contact information or addresses. The HI PHA identified Coordinated Overdose Response and Engagement (CORE) Program care pouches, a strategy tested in a previous ORS pilot project in South Carolina, as a possible solution and also advocated for funding of prepaid cell phones. The PHA contacted the hospital team and connected them with local HI providers, The Courage Center management team and the former South Carolina PHA, for insights on implementation. The PHA also assisted in creating a brochure for cellphone distribution at the hospital emergency department. To ensure that the document would be well received by people who use drugs, the PHA submitted the draft brochure to the Lived Experience Subject Matter Workgroup of the National Council for Mental Wellbeing. The PORT team obtained funding for phones and continued the pilot to identify those at the highest risk for overdose. Interest in PORT interventions continues to grow; following this pattern, the Hawaii HIDTA Director connected EMS leadership and harm reduction providers to collaborate on expanding linkages to care for patients at risk of overdose.