This brief provides updates on the OPTIONS initiative based on data reported by OPTIONS liaisons. Liaisons are licensed behavioral health clinicians embedded within a law enforcement agency in each of the sixteen counties in Maine. At present, each county has one appointed liaison that works alongside law enforcement to provide short-term counseling interventions, conduct proactive outreach with communities at the highest risk of experiencing an overdose, de-escalate behavioral health crises, and engage in postoverdose follow up visits and referrals of persons in need, as well as affected others, to community- and state-based services

Soucier, Daniel S

English

University of Maine

The University of Maine DigitalCommons@UMaine Health & Public Safety Margaret Chase Smith Policy Center 10-26-2022 The Overdose Prevention Through Intensive Outreach Naloxone and Safety Initiative (OPTIONS): Project-to-Date Totals through September 30, 2022 Daniel S. Soucier Follow this and additional works at: https://digitalcommons.library.umaine.edu/mcspc_healthsafety This Article is brought to you for free and open access by DigitalCommons@UMaine. It has been accepted for inclusion in Health & Public Safety by an authorized administrator of DigitalCommons@UMaine. For more information, please contact um.library.technical.services@maine.edu. Knowyouroptions.me   1The Overdose Prevention Through Intensive Outreach  Naloxone and Safety Initiative (OPTIONS)Project-to-Date Totals through September 30, 2022Prepared by Daniel S. Soucier, Ph.D. Margaret Chase Smith Policy Center University of MaineThis brief provides updates on the OPTIONS initiative based on data reported by OPTIONS liaisons. Liaisons are licensed behavioral health clinicians who are embedded within a law enforcement agency in each of the sixteen counties in Maine. At present, each county has one appointed liaison who works alongside law enforcement to provide short-term counseling interventions, conduct proactive outreach with communities at the highest risk of experiencing an overdose, de-escalate behavioral health crises, and engage in postoverdose follow up visits and referrals of persons in need, as well as affected others, to community- and state-based services. This brief describes how referrals are generated for OPTIONS liaisons, who is referring clients to liaisons, referrals OPTIONS liaisons are making on behalf of their clients, the demographics of OPTIONS clients, overdose education and antistigma trainings, and linkages among other state programs from the project’s inception in October 2020 through September 2022. Additional resources, data, and visualizations are available at knowyouroptions.me and mainedrugdata.org.Key Metrics SnapshotDuring the most recent reporting period of September 2022 OPTIONS liaisons’ engagement included 75  co-response calls, conducted alongside law enforcement partners 108  postoverdose follow-ups, conducted frequently alongside law enforcement partners 111  individuals referred to community-based treatment programs, with 87% (97) attending their first treatment appointment 138  individuals referred to community-based recovery support programs 589  individuals trained in overdose and antistigma education 508  kits (1,016 doses) of naloxone (Narcan) distributed2  Knowyouroptions.meOPTIONS Monthly Report September 2022From October 2020 through September 2022 (project-to-date-totals), OPTIONS liaisons’ engagement included 1,102  co-response calls, conducted alongside law enforcement partners 1,455  postoverdose follow-ups. conducted frequently alongside law enforcement partners 1,241  clients referred to community-based treatment programs, with 84% (1,039) confirmed to have attended their first appointments 1,359  individuals referred to community-based recovery support programs 4,574  individuals trained in overdose and antistigma education 3,948  kits (7,896 doses) of naloxone distributedHow OPTIONS Liaisons Receive ClientsOPTIONS liaisons generate clients from operating alongside law enforcement officers as co-responders to nonfatal and fatal opioid overdoses as well as other substance-use-related public safety response calls. Co-response calls are those that OPTIONS liaisons respond to during the moment of crisis, whereas postoverdose follow-up visits are those they respond to in the days following a substance-use-related crisis. Oftentimes, law enforcement partners accompany liaisons during both co-response calls and postoverdose follow-up visits. OPTIONS liaisons also generate clients through self-referrals and proactive referrals. Self-referrals occur when individuals contact OPTIONS liaisons themselves. Proactive referrals are those made by public safety officials, clinicians, community-based substance use supports, and affected others. OPTIONS Response Calls and Self and Proactive Referrals,  Project-to-Date050100150200250300Jan-21Feb-21Mar-21Apr-21May-21Jun-21Jul-21Aug-21Sep-21Oct-21Nov-21Dec-21Jan-22Feb-22Mar-22Apr-22May-22Jun-22Jul-22Aug-22Sep-22Co-response calls, total to date: 1102 Post-OD visits, total to date: 1455Self-referrals, total to date: 516 Proactive referrals, total to date: 2440Knowyouroptions.me   3September 2022  OPTIONS Monthly ReportMonthly Client Interactions for OPTIONS LiaisonsOct–Dec 2020Jan-Mar 2021Apr–Jun 2021Jul-Oct 2021Oct-Dec 2021Jan 2022Feb 2022Mar 2022Apr 2022May 2022Jun 2022Jul 2022Aug 2022Sep 2022 TotalCo-response calls N/A 100 164 122 169 52 30 51 47 45 89 69 89 75 1102Post OD visits N/A 49 207 221 238 62 49 81 58 82 109 97 94 108 1455Self referral N/A 24 92 110 82 34 18 13 16 35 23 18 6 45 516Proactive referral N/A 81 159 152 371 127 130 167 189 168 222 207 217 250 2440The following chart and table show the number of law enforcement calls responded to and postoverdose follow-up visits conducted by liaisons along with the number of self and proactive referrals. Proactive and Self Referrals, Project-to-DateProactive Referrals, 2436, 83%Self Referrals, 514, 17%Proactive referrals to OPTIONS liaisons come from a variety of sources including law enforcement, treatment providers, affected others, other OPTIONS liaisons, recovery coaches, emergency department clinicians, and first responders. This data began being collected during the second year of the program in October 2021. The following two pie charts show the number and percentage of proactive referrals to OPTIONS liaisons as well as the number and percentage of self-referrals 17% (514) versus proactive referrals 83% (2,436). Law enforcement make up the preponderance of proactive referrals at 60% (1,250) followed by affected others 13% (259) and treatment providers 12% (240).4  Knowyouroptions.meOPTIONS Monthly Report September 2022Proactive Referrals by Type, Project to DateLaw Enforcement, 1250, 60%Treatment Provider, 240, 12%Affected Other, 259, 13%Liaisons, 53, 3%Recovery Coach, 64, 3%ED, 53, 3%EMS, 7, 0% Fire Fighter, 3, 0% Other, 129, 6%211, 10, 0%Note: Liaisons began reporting proactive referrals by type beginning in year 2 of the initiative (October 2021)Clients Served by OPTIONS LiaisonsOPTIONS liaisons serve not only individuals in need but also affected others. In many counties, liaisons are known members of the community who are able to reach at-risk individuals and those that might not engage with other State-based harm reduction, treatment, recovery, or prevention services. The following four charts show the demographic breakdown of clients served by OPTIONS liaisons. 65% (1,624) of clients are individuals in need connecting with OPTIONS for the first time, 21% (514) are individuals in need who had previously connected with OPTIONS, Individuals in Need and Affected Others,  Project to DateIndividuals in need, 1624, 65%Individuals in need from prior referral, 514, 21%Affected other, 282, 11%Affected other in need from a prior referral, 78, 3%Gender of Clients, Project to Date Male, 2070, 59%Female, 1432, 41%Transgender, 9, 0%Knowyouroptions.me   5September 2022  OPTIONS Monthly Report11% (282) are affected others connecting with OPTIONS for the first time, and 3% (78) are affected others who had previously connected with OPTIONS. 59% (2,070) of clients identify as male, 41% (1,432) identify as female, and <1% (9) identify as transgender. The ethnicity of clients is 9% (195) Hispanic/Latino and 91% (1,962) not Hispanic/Latino. The racial composition of clients is 87% (2,118) white, 11% (264) Black/African American, 1% (12) American Indian/Alaska Native, 1% (26) Two or more races, <1% Hawaiian/Pacific Islander (2), and <1% Asian (1).Race of Clients, Project to Date Ethnicity of Clients, Project to Date White, 2118, 87%Black/African American, 264, 11%American Indian, 12, 1%Two or more races, 26, 1%Hawaiian/Pacific Islander, 2, 0%Asian, 1, 0%Not Hispanic, 1962, 91%Hispanic, 195, 9%OPTIONS liaisons are effective at reaching individuals in need and affected others that are experiencing housing instability and experiencing homelessness. The following charts show that 61% (1,299) of clients referred to OPTIONS liaisons since October 2021 are reported to be housing insecure; 28% (591) are unstably housed and 33% (708) are homeless. Those who have stable housing constituted 39% (846) of liaison clients. Housing Status of Clients, Project to DateStably housed, 846, 39%Unstably housed, 591, 28%Homeless, 708, 33%Housing Security of Clients, Project to DateStably housed, 846, 39%Housing insecure, 1299, 61%6  Knowyouroptions.meOPTIONS Monthly Report September 2022Liaisons Connect Persons Struggling with Substance Use Disorder  to ServicesOPTIONS liaisons connect individuals with state- and community-based prevention, harm reduction, treatment, and recovery services. The first chart below shows client interactions and referrals to services. The second shows synergistic connections between OPTIONS liaisons and other state-supported programs across the four focus areas of the State of Maine Opioid Response Strategic Action Plan: prevention, harm reduction, treatment, and recovery. Client Interactions and Referrals by Type, Project to Date 020406080100120140160Oct-20Nov-20Dec-20Jan-21Feb-21Mar-21Apr-21May-21Jun-21Jul-21Aug-21Sep-21Oct-21Nov-21Dec-21Jan-22Feb-22Mar-22Apr-22May-22Jun-22Jul-22Aug-22Sep-22Treatment RecoveryInfectious Disease Testing ASAM Level of CareNote: Referrals to MARR, Community Coalitions, Patient Navigators, Rapid Induction, and Continuing Source of Naloxone were not reported by OPTIONS liaisons until October 2021Client Interactions and Referrals by Type, Project to DateOct–Dec 2020Jan-Mar 2021Apr–Jun 2021Jul–Sep 2021Oct-Dec 2021Jan 2022Feb 2022Mar 2022Apr 2022May 2022Jun 2022Jul 2022Aug 2022Sep 2022 TotalTreatment 0 43 102 118 229 55 55 91 82 59 91 100 105 111 1241Recovery 0 53 112 107 200 58 92 94 95 100 111 94 105 138 1359Infectious Disease Testing0 9 31 46 64 10 18 23 26 41 47 42 15 27 399ASAM Level of Care0 35 55 41 100 12 13 24 27 24 14 25 18 29 417Knowyouroptions.me   7September 2022  OPTIONS Monthly ReportClient Referrals to Other State-Supported Programs, Project to Date020406080100120140160Oct-20Nov-20Dec-20Jan-21Feb-21Mar-21Apr-21May-21Jun-21Jul-21Aug-21Sep-21Oct-21Nov-21Dec-21Jan-22Feb-22Mar-22Apr-22May-22Jun-22Jul-22Aug-22Sep-22Syringe Access MaineCare ApplicationMaineMOM MARRCommunity Coalition Patient NavigatorRapid Induction at ED Continuing Source of NaloxoneClient Referrals to Other State-Supported Programs, Project to DateOct–Dec 2020Jan-Mar 2021Apr–Jun 2021Jul–Sep 2021Oct–Dec 2021Jan 2022Feb 2022Mar 2022Apr 2022May 2022Jun 2022Jul 2022Aug 2022Sep 2022 TotalSyringe Access 0 20 53 45 68 16 0 43 10 32 31 22 24 57 421MaineCare Application0 41 38 23 47 1 3 6 6 6 4 10 4 8 197MaineMOM 0 0 1 8 16 2 1 2 2 1 0 1 2 3 39MARR N/A N/A N/A N/A 28 3 8 6 11 12 7 14 11 15 115Community CoalitionN/A N/A N/A N/A 61 4 7 9 12 2 20 25 18 15 173Patient Navigator N/A N/A N/A N/A 22 0 5 8 9 0 12 6 4 24 90Rapid Induction at EDN/A N/A N/A N/A 32 0 2 4 6 2 1 1 2 5 55Continuing Source of NaloxoneN/A N/A N/A N/A 127 37 44 46 87 108 104 73 68 138 832OPTIONS liaisons refer individuals for treatment programs in the moment when their clients are ready by meeting them where they are at. They use warm handoffs where they dial the phone number of the treatment provider for their clients. Some liaisons also drive individuals to their treatment appointment or MOUD (Medication for Opioid Use Disorder) inductions. For the project to date, 1,241  clients were referred for community-based treatment programs  84%  attended their first appointment with the provider (1,039) 16%  unknown if they attended their appointment or not (202)8  Knowyouroptions.meOPTIONS Monthly Report September 2022OPTIONS liaisons also serve as community educators conducting a variety of trainings including Overdose Education and Naloxone Distribution and antistigma trainings. The chart and table show the number and cumulative number of trainings conducted, individuals trained, and naloxone kits distributed by OPTIONS liaisons. OPTIONS liaisons have conducted 387 trainings, trained 4,574 individuals, and distributed 3,948 kits (7,896 doses) of naloxone from October 2020 to September 2022.Number of Trainings Conducted, Individuals Trained, and  Naloxone Kits Distributed by OPTIONS LiaisonsTrainings Conducted, Individuals Trained, and Naloxone Kits Distributed by OPTIONS Liaisons0100200300400500600700Oct-20Nov-20Dec-20Jan-21Feb-21Mar-21Apr-21May-21Jun-21Jul-21Aug-21Sep-21Oct-21Nov-21Dec-21Jan-22Feb-22Mar-22Apr-22May-22Jun-22Jul-22Aug-22Sep-22Trainings, total to date: 387Individuals trained, total to date: 4574Naloxone distributed, total to date: 3948Oct-Dec 2020Jan-Mar 2021Apr–Jun 2021Jul–Sep 2021Oct–Dec 2021Jan 2022Feb 2022Mar 2022Apr 2022May 2022Jun 2022Jul 2022Aug 2022Sep 2022 TotalMonthly Trainings 0 27 48 69 71 12 15 18 22 10 17 18 31 29 387Monthly Trained 0 245 390 547 466 81 115 325 505 351 157 250 553 589 4574Monthly Naloxone 0 90 195 624 378 217 223 215 350 280 245 282 341 508 3948

The Overdose Prevention Through Intensive Outreach Naloxone and Safety Initiative (OPTIONS): Project-to-Date Totals through September 30, 2022

https://digitalcommons.library.umaine.edu/cgi/viewcontent.cgi?article=1046&context=mcspc_healthsafety

The Overdose Prevention Through Intensive Outreach Naloxone and Safety Initiative (OPTIONS): Project-to-Date Totals through September 30, 2022

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