美国国家公共电台 NPR Knocking On Doors To Get Opioid Overdose Survivors Into Treatment（在线收听）

DAVID GREENE, HOST:

This month, we have been looking at life in rural America and sharing the results of a new poll from NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. It found 1 in 4 rural Americans view opioids and other drugs as the biggest problem facing their communities on par with economic issues. In Appalachia, the number is even higher - 41 percent. NPR's Sarah McCammon recently traveled to Huntington, W.Va., at the heart of the opioid epidemic to look at an innovative program trying to get people who overdose into treatment right away.

SARAH MCCAMMON, BYLINE: Larrecsa Cox is a paramedic, but instead of an ambulance, she drives around in an old sedan - no flashing lights, no sirens. Today's first call is to a small cottage in a quiet neighborhood.

LARRECSA COX: He overdosed yesterday, and I think we've been here before. I'm almost 100 percent sure we've been to this house before.

MCCAMMON: Cox works as the only full-time member of Huntington, W.Va.'s new quick response team. The project is a collaboration between the county's medical first responders, law enforcement and several drug treatment providers. The goal is simple - track down people who've recently survived drug overdoses, visit them at home, a hospital, even in jail and tell them how to get help.

(SOUNDBITE OF KNOCKING)

MCCAMMON: Flanked by a police officer in plain clothes and a local pastor who's volunteering with the team today, Cox knocks at the man's door and waits. When there's no response, she tries calling a family member whose phone number she has in her files.

COX: We can come back later, like, when he's definitely here if that's OK.

MCCAMMON: At the next stop, trash is piled high on a curb outside what looks like an old storefront, now a makeshift residence. Cox warns us that the place is filthy inside. She's visited a lot of different people here after they overdosed, she says.

COX: Only one of which actually went into treatment. She went into outpatient treatment, but a lot of people seem to hang out here. I really don't know what to say about it.

MCCAMMON: We walk down a narrow alleyway, which smells of urine. On the back porch, a man is slumped over in a chair asleep. Through an open door on the side of the building, we see a stained bare mattress piled with bedding. Cox calls out to another man inside.

COX: Is David here?

UNIDENTIFIED PERSON: Yeah, that's him.

COX: That's David. All right. Well, we'll leave this for him. Thank you.

MCCAMMON: These seemingly bleak interactions are part of the process, says Connie Priddy, a registered nurse with Cabell County Emergency Medical Services.

CONNIE PRIDDY: Overdosing and having to be revived may not be the bottom for someone.

MCCAMMON: Priddy coordinates the quick response teams, which got off the ground late last year with a little over a million dollars in funding from two federal grants. She says the teams keep going back with information about clean needle programs, emergency medication for reversing overdoses and the ultimate goal - information on enrolling in treatment programs. For some, that means inpatient treatment. Others enroll in outpatient medication-assisted programs where they can keep working or going to school.

PRIDDY: We'll leave them our information. We'll go back a couple of days later and talk to them again. You know, we'll call them. We'll text them, you know. So if they're not ready, they're not ready, but we keep going back (laughter).

MCCAMMON: That follow up after an overdose is a key step in helping people get treatment, says Dr. Alexander Walley. He directs an addiction medicine fellowship at Boston Medical Center. Walley says similar programs are beginning to pop up around the country. He sees quick response teams as a promising, if challenging, approach.

ALEXANDER WALLEY: If you've just overdosed and now you have a police officer knocking on your door, that first inclination among a marginalized, stigmatized population might not be so welcoming. And so how exactly to make that contact I think is really important.

MCCAMMON: In Huntington, police officers on quick response teams wear civilian clothing and are under instructions not to make arrests even if they see drug paraphernalia - unless there are children at risk. And there are success stories, like Anthony Dooley. He'd struggled with alcohol, cocaine and crystal meth and spent some time in jail before winding up in a hospital earlier this year.

ANTHONY DOOLEY: It was a point in my life to where I was lost. I felt helpless. I felt pretty much where I was in life was the best that I was ever going to get.

MCCAMMON: Dooley's 32 and recently graduated from an inpatient treatment program. He says Cox's team visited him in the hospital and walked him through his options.

DOOLEY: I mean, I was just so far gone. I was sleeping on the hospital bed that they had me on, and she sat there with me the whole time. She made sure all the paperwork was done and got me some help.

MCCAMMON: Overdose calls in the Huntington area are down by about a third since the teams started going out last year. The next challenge, officials say, is figuring out how to keep funding the teams and more treatment programs. Sarah McCammon, NPR News, Huntington, W.Va.

(SOUNDBITE OF CANYONS OF STATIC'S "NEVER ALONE AGAIN")