PORT – A Program Making a Difference in Rowan County

Nationally Growing Public Health Concern

Deaths, hospitalizations, and emergency department (ED) visits due to medication or drug overdose, have become a growing public health concern nationally and in North Carolina, according to the NC Department of Health and Human Services website. This has also been historically true in Rowan County. Concern over mental health and substance use disorders has been a topic of Community Needs Assessments and data gleaned from County Health Rankings for decades.

Historically, prescription opioids have been a major driver of this epidemic. However, illicit drugs are now contributing to this problem in increasing numbers. The majority of overdose deaths now involve illicit opioids like heroin or fentanyl, a synthetic narcotic. The number of overdose deaths involving stimulants is also on the rise, and the COVID 19 pandemic has seemed to worsen the trends.

The good news, however, is that some programs appear to be having a positive impact. While controversial, both the PORT program and the syringe exchange program are believed to be preventing deaths. While in a perfect world it would be great to prevent substance use disorders from ever developing, once they have developed, figuring out how and when to effectively intervene is quite a challenge. Preventing death is the goal. With each preventable death comes an opportunity for that person to recover and turn their life around. And that is the focus of PORT.

What is PORT?

PORT stands for Post Overdose Response Team and has been created in many communities as a means of intervening or breaking the cycle of substance use disorder. For Rowan County, PORT was initially established in 2019, and was funded by a $285,326 grant from Blue Cross and Blue Shield of North Carolina. When the grant ended at the end of 2020, the Rowan County Board of Commissioners agreed to use Medicaid Cost Settlement funding to support the program into the future.

The PORT Team

The team is made up of Ashley Creek, who is a certified Peer Support Specialist, community paramedic Jeff Brown, who responds to and records overdoses, and Natalie Arrington, who coordinates resources to help people who are using or have overdosed.

How PORT Works

When a person overdoses and is taken to the ED or 911 is called, the first responder (police, fire, etc.) notifies the community paramedic, Jeff Brown. Jeff can also go into call logs, etc. to find cases that may have slipped through the cracks. Jeff gets information about the person who has overdosed and relays that to Certified Peer Support Specialist, Ashley Creek. Within 24-72 hours, Ashley contacts the person who has overdosed to see if there is an opportunity for detoxification or treatment or anything else that might help prevent an occurrence of an overdose. A Certified Peer Support Specialist is a person who is themselves in recovery and has attained certification and training in intervention through a state-certified site at the NC Peer Support Specialist Certification Program (pss.unc.edu) The hallmark of the PORT program is that an overdose victim is more likely to respond to a person who has traveled their path, than to a healthcare provider who they may not be able to relate to as well. “It’s hard for somebody like a clinician to tell somebody how to get out of a situation that they have never been in before,” Creek said. “I’ve acquired a lot of knowledge I didn’t have in my recovery and that’s what helps me be able to help somebody get out of a hole.” Ashley has been in recovery for six years.

In addition to overdose intervention, another key part of the PORT program is education, coordinated by a Harm Reduction Coordinator, Natalie Arrington. Activities such as community outreach events, community Substance Use forums, community awareness walks, and conducting walks during which Arrington and Creek distribute bags of food, water, and Narcan, which can be used in an emergency to reserve or treat an opioid overdose are some of the activities. The PORT team added face masks, hand sanitizer and other personal protective equipment to the bags this year. Narcan distribution is also part of the harm reduction efforts. In addition to individuals receiving Narcan, the PORT team also distributes Narcan to first responders (police, fire, paramedics) to help prevent death when they respond to an overdose.

The PORT team does not force those who have overdosed to seek treatment. They’re there to connect people to whatever resources are needed. In January-February of 2022 Rowan County had 131 overdoses. This included 9 fatalities. Of the remaining, there were 5 people who entered treatment, ad 48 to whom Narcan was given. Narcan is a drug that can reverse an overdose quickly and is used to prevent death from overdose.

“It’s not about rushing folks to recovery. It’s about being a support to them when they feel comfortable as if they’ve had enough resources and support to get into a space where they can enter recovery in their own way,” Arrington said.

Arrington helped coordinate a mobile syringe program in Rowan County. Queen City Harm Reduction, based in Charlotte, now offers services in Salisbury. The program gives clean syringes and other resources to people who are using drugs. While the act of distributing syringes may seem counterintuitive, it can help prevent the spread of disease from used needles.

More Forms of Help are Needed in Our Community to Address Substance Use Disorders.

According to Judy Klusman, Rowan County Commissioner, the three main goals for our county stemming from the recent community needs assessment is to address 1) mental health issues, 2) substance use, and 3) improve healthy lifestyles. Judy is an executive team member for Healthy Rowan and has worked tirelessly in our community to drive initiatives for mental health and substance use. “Mental health and substance use must be priorities for our county to ensure a healthy workforce and to continue to have a climate for economic growth. We are pleased to receive the recent opioid settlement monies to help with this,” Judy shared.

In July 2021, NC Attorney General Josh Stein announced a historic $26 billion agreement that includes Cardinal, McKesson, and AmerisourceBergen – the nation’s three major pharmaceutical distributors – and Johnson & Johnson, which manufactured and marketed opioids. With this settlement, Rowan County will receive $15 million to be spent over 2022-2038 on programs to reduce and prevent opioid addiction. According to Alyssa Harris, Director of Rowan County Public Health, planning is already underway to set goals to reduce overdoses. The settlement provides two options that counties can use to spend the funds, and a task force is working towards concrete programs that would be most effective.

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