The proposed FRONTLINES+ Project, First Responder Opioid overdose Naloxone Training and Linkage Into Needed Evidence-based Services PLUS, is a collaboration between the City of Houston Health Department (HHD), Houston Fire Department (HFD), Houston Recovery Center (HRC), Baylor College of Medicine (BCM) and the University of Texas San Antonio (UTSA) to address the opioid crisis in our community. Opioid overdose rates increased 186% in the Greater Houston area in 2020, the first pandemic year, with all-substance overdose fatalities rising nearly 40%, most involving multiple substances. HFD has responded to over 1,000 opioid related overdose calls in 2021. Additionally, high potency, synthetic opioids, including fentanyl, which have been linked to increased opioid overdose death rates in numerous communities across the country, have been increasingly detected in Houston area drug seizures, both in products marketed as opioids such as counterfeit prescription opioids and heroin as well as other substances including counterfeit benzodiazepines, stimulants, and club drugs. FRONTLINES+ will effectively address the opioid epidemic in the City of Houston by providing HFD first responder access to, and training in use of, both high and low dose naloxone for opioid overdose victims. Additionally, FRONTLINES+ will partner with the HRC’s robust peer recovery and case management services to link overdose victims and their family members to treatment services. To ensure every opioid overdose victim HFD responds to can access needed and desired care within the Houston community this proposed project will provide funding for peer Wellness Advocates who respond to overdose victims’ bedsides in local emergency centers 24 hour a day, seven day a week. For community lay first resonders, the proposed program delivery model builds in sustainability through the train-the-trainer model for naloxone opioid overdose training. Professional first responders at HFD will be trained via asynchronous online training, which will focus on recognition and treatment of opiate overdose, as well as the process to link patients encountered by HFD to HFC resources. The FRONTLINES+ Project builds on existing community resources and expertise to better equip the City of Houston to respond effectively and compassionately to the opioid overdose epidemic by achieving the following goals:
1. By the end of Year 1, all HFD response units will be equipped with high dose naloxone opioid overdose kits. Through Year 4, the project will continue to provide high dose naloxone overdose kits to all HFD response units;
2. By the end of Year 4, over 3,000 HFD first responders will be trained in recognition and pre-hospital management of a person with opioid overdose, including proper administration of naloxone using culturally sensitive and trauma-informed methods. Also, four classes of medical students at Baylor College of Medicine (N = 600) will be trained in recognition and pre-hospital management of a person experiencing opioid overdose, including proper administration of naloxone using culturally sensitive and trauma-informed methods;
3. All of the opioid overdose victims HFD treats will attempt to be contacted and offered linkages to opioid use treatment services in the community and ongoing case management through the Houston Recovery Center (HRC);
4. By the end of Year 4 implement a synchonous and asynchronous comprehensive, culturally sensitive and trauma-informed educational campaign on overdose education including fentanyl risks within the Greater Houston community, Texas that reaches at least 4000 people. The campaign will also include information on Good Samaritan laws and effective layperson response to opioid overdose, including the use of naloxone.