Certified recovery specialists Pat Dooley and Eric Jackson know that not everyone they come into contact with in their work will be ready to seek help for their addictions. Regardless, their objective is to make people aware of treatment options that exist.

“I’m not saying I’m a superhero or anything like that,” said Jackson, whose goal is to “just touch one” person and “plant the seed” of hope. After all, somebody planted the seed for him.

Dooley and Jackson are certified recovery specialists with PRO-ACT’s Recovery Overdose Survivor Engagement (ROSE) warm handoff project at Temple/Episcopal Hospital. In their role there, they are trained to connect at-risk patients and those who have survived an overdose to resources, like treatment centers and counseling services.

Since the ROSE program launched last December – the first of its kind in Philadelphia – it’s seen some success. According to the Department of Behavioral Health and Intellectual Disability Services (DBHIDS), in January, the initiative engaged 125 people and coordinated 78 referrals to treatment.

“Recovery support services, and the whole [overdose awareness] program has really taken off,” said Dooley, who has been a certified recovery specialist for about a year now. “The way that the epidemic is out of control is making us move a million times faster.”

In 2016, Pennsylvania had the fourth-highest rate of fatal overdoses in the country, just behind New Hampshire, Ohio and West Virginia. More than 4,600 people died of overdoses – 4,627 to be exact – and those numbers are expected to rise in 2017.  

Philadelphia accounted for nearly 20 percent of those deaths in 2016 — 907 people died of an overdose in the city, according to the Philadelphia Department of Public Health. In 2017, the number of fatal overdoses increased by more than 34 percent to 1,217.

Getting the proper care after an overdose can lead people to go into recovery and prevent future overdoses. However, people often don’t get the treatment they need because a variety of barriers prevent them from getting to the hospital in the first place and into treatment after they’re discharged.

When someone overdoses, friends, family, and bystanders often call for emergency services. If the person is overdosing when first responders arrive, they give them naloxone, an overdose reversal medication commonly known by its brand name Narcan. But getting them to the hospital after their overdose has been reversed is a different story.

According to Chas Carlson, an EMT with Narberth Ambulance in Montgomery County, people don’t always agree to go to the hospital after an overdose. The most common reason people refuse care in any emergency, whether it’s an overdose or a broken bone, he said, is finances.

According to Healthcare.gov, the average cost of a three-day stay at the hospital is approximately $30,000. And the average cost of an ambulance trip can range from $224 to $2,204 depending on the level of support needed, according to the United States Government Accountability Office. Some people with insurance might not be able to afford the copay, and those without health insurance are less likely to get the care they need.

“Medicare and Medicaid pay only a certain amount of what we bill,” said Joe Sobol, an EMT with Narberth Ambulance. “We hear all the time that someone doesn’t want to go because of the concern for money. It’s not that they don’t want the care; they don’t want the bill.”

In the search for a solution to help combat the financial burden of receiving medical care, some ambulance companies, like Narberth Ambulance, are willing to work with patients by reducing or waiving the fee to get them the care they need, Carlson said.

“Our response is pretty standard,” Carlson said. “If someone says, ‘I don’t want to go because of my insurance,’ I understand, but let’s just get you to the hospital. Health insurance doesn’t matter if you’re dead.”

But finances are certainly not the only barrier to treatment. Even if patients do get to the hospital and receive medical care there, they aren’t always guaranteed access to a treatment program due to space limitations and lack of identification. That’s where Dooley, Jackson, and the rest of their team come in.

As a certified recovery specialist, there’s only a small window of time to connect people to treatment after they get to the hospital, Dooley said. While patients receive medical attention, Dooley and Jackson start simple conversations with them about their lived experiences, as well as about treatment. Then, if a patient decides to pursue further care, they’re connected with a detox, where they can be treated for the physical effects of withdrawal from substance use.

Certified recovery specialists with the ROSE program are there to help with other barriers, too. For example, there are state and federal regulations that require identification to access treatment for opioid addiction, and even though Philadelphia can waive these requirements, some treatment programs in the city still require an ID. ROSE also provides funding to help people cover the cost of an ID, which costs just over $30 in Pennsylvania. That way, patients can actually get into treatment and not be turned away.

And if someone doesn’t get into treatment, they’re not left without options either. Dooley and Jackson supply them with a packet of resources in case they want to find treatment in the future.The packet includes their business cards, and information about housing, food, and emergency services. That way when they’re ready, they know where to go.

The warm handoff process doesn’t end there. Dooley, Jackson, and their colleagues’ work continues once people get out of treatment by connecting them to other resources around the city.

“I’ll talk to them about what kind of plans they have when they come out of the treatment facility,” Jackson said. “You should want to have a plan. Treatment is a start, but it would be to that person’s advantage to have a plan after that.”

Dooley often refers people who can’t get into treatment to the Last Stop, a recovery center located in Kensington that offers people food and a place to sleep.

“If they can’t get any kind of services, if people can’t get in, I’ll walk them right over there,” Dooley said.

And those who Dooley takes there will likely meet Rob Elliss, who runs the kitchen.  

“This place right here is my own,” said Elliss. “You won’t find another like it anywhere.”

The building has a wall celebrating all the people at Last Stop who’ve reached one year in recovery with their names written on the bricks in white ink. Opposite, on another wall, is a memorial for those who’ve died.

“Two years ago I was sleeping on this floor,” Elliss said as he prepared a meal for the night. “Now, I basically run the place.”

Even with continued barriers for people to get into treatment, helping just one person in the field can go a long way, and is a victory for a certified recovery specialist, Dooley said.

“You have good times, and you have bad times, and unfortunately you see some people pass away,” Jackson said. “We’re just trying to be a part of something productive and positive and trying to help in whatever way we can.”