Photo Credit: City of Paterson

Paterson’s Targeted Solution to the Opioid Crisis

2021 Certification Level: Silver

By Jeremy Gantz

To break the deadly cycle of opioid addiction, people need to be aware of substance abuse treatment options available to them and trust they are effective. This insight led city officials in Paterson, New Jersey to launch a new innovative outreach program that meets struggling residents where they’re at and steers them toward the help they urgently need.

The city has been disproportionately impacted by the nationwide opioid epidemic. The most densely populated city in the country (after New York City, about 20 miles to the east), Paterson is considered a high-intensity drug trafficking area by the U.S. Department of Justice. A map of overdose victim locations shows red dots overrunning the city. With about 150,000 residents, Paterson comprises 29% of Passaic County’s population, but accounts for 55% of heroin and opioid treatment admissions countywide.

Photo Credit: City of Paterson

“The severity of the opioid crisis can feel overwhelming”, says Dr. Eric Piza, an associate professor at the John Jay School of Criminal Justice, whose research team has worked with the City and the Paterson Coalition for Opioid Assessment and Response (COAR) since 2019 to understand and address the problem. In a place like Paterson, a crucial first step involves data. “Data analysis helps focus the City’s intervention efforts by organizing this giant problem into more manageable pieces,” he says. One big benefit of this approach: finite intervention resources can be deployed in high-impact ways.

That’s the idea behind the Opioid Response Team (ORT), which launched last September. The outreach program targets a roughly square-mile overdose hotspot area in downtown Paterson, taking a data-driven approach to connect overdose victims with treatment resources. ORT members include social workers specializing in addiction treatment, police officers and EMTs. They offer information about medication-assisted treatment (MAT) and treatment referrals, as well as free meals, blankets and other aid.

Uncovering Hotspots

To settle on ORT’s target area and outreach strategy, COAR and Dr. Piza’s teams needed to answer an important question: Where and when were opioid overdoses — especially multiple overdose events involving the same individual — happening in Paterson?

The leadership of a dedicated Opioid Data Manager in working with a research institution proved critical to making change. The John Jay team helped Paterson set goals, metrics and targets, and TA partners from the What Works Cities team helped operationalize those goals and metrics by developing a digital tool to automate, clean, visualize, and analyze the data. The picture that emerged, supported by custom GIS-driven visualization tools, highlighted three important aspects of Paterson’s opioid crisis.

  1. About 22% of the thousands of overdose events over a two-year period occurred on just 2% of the city’s downtown street segments.
  2. Thirty percent of overdose victims Paterson police officers and EMTs responded to in that period were repeat overdosers.
  3. In the small downtown area where many overdose events were concentrated, about 20% of overdose victims responders encountered in the period analyzed refused transportation to the hospital, where they could receive treatment services.

Data visualization tools plotting overdose location, time of day, and day of week helped COAR and Dr. Piza’s team design ORT’s strategy and define success metrics. City leaders and other COAR stakeholders set a handful of specific performance goals for the effort by the end of 2022. They involve increasing the percentage of overdose victims in the target area that receive opioid abuse treatment services and reducing the number of victims in the area that refuse hospitalization. There’s a citywide goal as well: reduce the percentage of repeat overdose events by about one-third.

“A basic goal is to reach the people who are repeatedly overdosing and lift them up and out of the cycle of addiction,” says Andrea Ramahlo, a senior program manager in the Paterson Police Department who helped stand up the new program. “It’s a very tall order, but we’re optimistic — because the strategy is deeply data-driven.”

Photo Credit: City of Paterson

Outreach in Action

John Reagan, an addiction recovery specialist who has been part of an ORT outreach team since its start, calls the program a “game changer” for opioid addicts in Paterson. “I’ve never seen anything like it. You’re on the front line, gaining people’s trust,” says Reagan, director of the Recovery Center at the social services organization Eva’s Village in Paterson. Targeting the highest-need area and promoting MAT — which involves both a medication like suboxone and clinical counseling — is yielding results, he says.

“As an institution, we at Eva’s Village have seen people who have been using for 20 years and now they’re getting the support they need,” Reagan says. “You can see the difference week to week, you can see people getting better.” As of April, ORT teams have referred over 400 individuals in the target area to MAT services at a local hospital or other appropriate medical providers, a key component of treatment and recovery support.

It’s still early days for the program, but initial impact data is promising. The number of overdose events in ORT’s target area fell in 2021 compared to prior years, even as total overdoses across Paterson increased from 2019 to 2021. Dr. Piza cautions that correlation isn’t causation, while noting that COAR is refining the outreach target area as new data is analyzed: The City is committed to a dynamic process of rigorous analysis and course correction. Other program improvements in the works involve supplementing sidewalk tabling outreach in the target area with mobile van outreach that includes harm-reduction content; a new website making ORT-related data publicly accessible; hiring and placing social workers in strategic areas throughout the City to assure additional engagement; and software improvements to improve referral-making and data sharing relative to individuals receiving MAT referrals.

Big picture, says Paterson Chief Data Officer Harsha Mallajosyula, what the City is doing through the ORT effort is leveraging data analysis and tools to focus the City’s existing resources and reach people who need targeted engagement. “At its core, this program shows how insights derived from data can allow us to better deploy the services we already have to the people who urgently need them. We believe it’s a crucial part of turning the tide on the opioid crisis.”

And by strengthening the City of Paterson’s data infrastructure and analytical capacities, ORT’s ultimate value goes beyond addressing the addiction and overdose crisis. “We’re growing an array of skills that can help the City address a host of other problems from an evidence-based perspective, and then sustain solutions,” Mallajosyula says. “It’s all about building an internal culture and habit of data-driven decision-making.”

Jeremy Gantz is a communications consultant with What Works Cities who has more than 15 years of experience as a newspaper and magazine writer and editor.

As a member of the nationwide What Works Cities (WWC) network, the City of Paterson has received technical assistance from WWC’s expert partners to strengthen data-driven governance capacities.

Paterson is one of 55 cities to achieve What Works Cities Certification, the national standard of excellence for well-managed, data-driven local government. Read stories from other Certified cities here.

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What Works Cities

Helping leading cities across the U.S. use data and evidence to improve results for their residents. Launched by @BloombergDotOrg in April 2015.