Concord Fire Chief Daniel Andrus said when Manchester’s Safe Station began operations in 2016, the City Council asked him if he could do the same. Andus explained then that because of the increasing number of emergency calls, the city’s fire stations were unstaffed a significant portion of the time.
The city, though, has found another way. Concord Fire Department has implemented a comprehensive program that includes enrolling those struggling with opioid addiction into treatment programs, thanks to grants totaling $263,000 from the federal Substance Abuse and Mental Health Services Administration.
Jeffrey Stewart was hired in April as Concord’s Program Director of Project FIRST (First Responders Initiating Recovery, Support and Treatment) that began operating June 24.
The N.H. Project FIRST is a four-year $3.1 million federally funded program through the First Responders: Comprehensive Addiction and Recovery Act. It is now in its third year.
Paula Holigan of the New Hampshire Division of Fire Standards and Training is the state program manager. She said seven cities and towns are in the program and others are in the application process. Besides Concord, those in the program are Dunbarton police and fire; Epping police and fire; Hooksett Fire Department, Laconia Fire, Plymouth Fire and Salem police and fire.
The program trains and funds fire and law enforcement personnel who encounter someone who is overdosing to conduct a follow-up visit at that person’s home and provide resources for treatment or medication to the affected person and/or their family.
“It’s meeting people where they are at,” Holigan said.
Not every fire station can provide follow-up care due to staffing and resources, but they can leave a naloxone kit with the person or their family during the emergency, plus they can contact the nearest Doorway or contact 211 for information and referral, Holigan said.
First responders are trained to understand how someone becomes addicted and why relapse occurs. This program is called “OUD in the 603” (for Opioid use disorder). The training also contains information on suicide and who is at risk along with compassion fatigue training.
Stewart has more than 30 years of experience as a paramedic, was a combat medic, is a certified ARISE Level 2 interventionist and a recovery coach.
“What makes Concord fire unique is that we actually enroll a patient in our program and I case manage them,” he said. “So when they are ready to go into treatment I facilitate that.”
He meets with the patient, does a full assessment and works on barriers they may have, such as lack of insurance, homelessness, mental health issues or the need for medical treatment for an infection or some other illness.
“They may not be ready to go into treatment when I first interact with them,” he said. He keeps in contact with them, doing some motivational coaching to help them want to get treatment.
“Once they say yes and they’re ready to go, boom we get them into treatment,” he said.
He uses the Doorway and other treatment programs where he has contacts. The program collaborates among various departments, agencies and organizations, including the fire, police and public health departments, Riverbend Community Mental Health and its mobile crisis unit, Concord Hospital, the Homeless Provider Network and social services.
“There is no single solution,” Stewart said of the opioid epidemic. “There is no silver bullet. This is going to take a collaborative effort to make any dent in it. Complex problems require multi-tier solutions.”
As of Dec. 3, he’s had 40 referrals; nine people fully enrolled in the program; he is coaching several others and three people have successfully completed the program and are sober.
Soon, the program will be expanding to the Capital Area Mutual Aid Fire Compact, which is comprised of Concord and 22 surrounding towns. The compact has agreed to the education of first responders and the naloxone kits but the individual town will have to agree to Stewart providing the same service he does in the city. There is no cost to the town or city since the program is fully funded by the federal government.
Stewart believes he can handle the additional work.
“I would love to be able to say I have too many patients and we need help,” he said. If the third year of grant funding is approved, he has a plan to train people to do what he does.
Concord is also working on a sustainability model for the time when federal grants are no longer available.
“We have a tentative plan we are exploring,” he said.
(Susan Geier contributed to this report).