Kimberly Holstein’s morning starts off by comparing charts turned in by first responders. Every day she arrives at the office, located in the Boone County Health Department, before anyone. She sips coffee, and compares two spreadsheets.
She looks for signs of a drug related call. She points to an EMS call dispatched for cardiac arrest, but then discovers that on the Narcan report, it shows Narcan was administered at that address shortly after the call.
She said this is common because people are too ashamed or afraid to admit that the call is for an overdose.
“I think it’s also just the stigma of being truthful with the situation in your home, especially for a parent,” Holstein said. “What parent wants to call 911 and say that their son is unconscious in the bathroom, and that they are using heroin in your home? That’s probably a really hard phone call for a mother to make.”
Credit: Briana Heaney/West Virginia Public Broadcasting
Holstein is the lead for the Quick Response Team (QRT) — an organization with Boone County Health — that follows up with people who are struggling with addiction in the community. For the cardiac arrest call, since Narcan was given, they will follow up within 48 hours to see if the individual will consider going to a substance use treatment center.
They also receive recommendations to check on people from police officers or community members who witness signs of drug use.
The Team
At 8 a.m., the peer support team comes in and circles up for a morning meeting. Holstein tells them where and who they need to go check in on. Many of them are in recovery themselves, and they are all from Boone County.
Barry Stowers, one of the peer support specialists, is an animated guy, with glasses and a beard.
“I feel like we’re kind of like a middleman, we exist to help connect people to the type of treatment that they need,” Stowers said. “We follow up on these overdoses and they don’t always take us up on the first time around. But that’s why we meet with them multiple times.”
Credit: Briana Heaney/West Virginia Public Broadcasting
He and the five-person team travel around the county handing out food, Narcan, hygiene supplies — and they talk to people about options for recovery.
“If they say that they’re fine with us coming back, we kind of put them in the driver’s seat. So we don’t force them to do anything that they don’t want to do. But we let them know there’s options,” Stowers said.
That day, they visit the man who overdosed the night before and received Narcan. Holstein knew him and calls to talk to him. The QRT had taken him to a treatment facility before. It wasn’t a good fit, he tells her, because it was a hospital and he had a lot of stress from being in the hospital before. But he said he was ready to try a new place, so she tells the QRT about their discussion in that morning’s meeting.
“Called him with no answer,” she explains to the team. “But it doesn’t mean he backed out because the last conversation I had with him on the phone was to go ahead and take a shower and start getting ready, because we’re gonna figure out a bed [for him] no matter what.”
The team heads out to talk to him, and possibly take him to a substance use facility. These things are tentative Holstein said, he could back out. Holstein opens his file and writes that, for future reference — he does not want to go to a hospital.
The team works with people’s preferences and takes them places they will feel comfortable. They never send someone to a place they have not checked out themselves.
“It’s really important we vet the facility before we take someone from our community there,” Holstein said.
Credit: Briana Heaney/West Virginia Public Broadcasting
The Courts
Holstein then goes to the county courthouse. She works closely with the courts, advocating for, and weighing in on, court decisions for people the QRT is trying to help.
“So this last year the magistrate court here in Boone County, between Magistrate [Danny] Moore and Magistrate [Niel] Burnside, has allowed us to send 59 people to treatment through their courtroom,” Hostien said.
This morning she has a meeting with Moore. He said working with QRT has given him more options for rehabilitation for some of the people he sees in his courts – and has helped the community in doing so.
“Allowing them to step in and offer help has made a tremendous turnaround,” Moore said. “That’s the reason why you see some of the numbers going down in this county.”
In this meeting, Moore and Holstein figure out a plan for one of the people in the court system, to have charges dropped if she graduates from her rehabilitation facility.
“He told her that if she graduated with no issues that he would consider wiping that out because it was trespassing. She’s estimated to be [graduated by] Dec. 27,” Holstein said.
The Police
Holstein leaves the magistrate court and heads to the sheriff’s office for a meeting with Sheriff Chad Barker. They discuss different families and people in the area.
Barker said the QRT has worked with the police force and helped change attitudes about drug use in the area. He said at first officers were hesitant about the QRT, and it was hard to get every officer to carry Narcan with them. Now, officers are happy to work with QRT and reach out to them often.
Credit: Briana Heaney/West Virginia Public Broadcasting
At the end of the meeting, Barker asks Holstein to check on a woman in the community he saw when responding to a call at a house down the street. Barker said the woman looks like she may be in crisis.
Holstein heads down there. The woman doesn’t answer, so they leave a note on her door handle. If she needs anything, she can call them.
The Money
The QRT team is entirely grant funded. Holstein found out earlier that day that the team received a grant to fund transportation for people coming out of recovery. Soon the QRT will be able to give rides to doctor’s appointments, prescription fills or jobs.
Holstein wants the QRT to be able to do more to help keep people off drugs and to help prevent drug use in the area through education. But they need more money to do it.
One option is the $1 billion opioid settlement money coming to the state. Boone County expects $2 million to $3 million, according to West Virginia First settlement documents.
Credit: Briana Heaney/West Virginia Public Broadcasting
“I hate how this money came about, and that so many people lost their lives for this money to be available,” Holstein said. “On the other hand, I have to look at how many lives can change because of that.”
Holstein said the next step for the QRT is to focus on more assistance for those coming out of rehab by strengthening programs that connect them to housing and jobs, and even access to mental health care.
“We’re gonna keep them in sobriety for X amount of time. But where are they gonna go past that? Once that court case is over? What options do we have?” She said, “Right now, our county has none.”
Many families in Boone County have been affected by the opioid epidemic. Holstein said it’s not uncommon for a child to be living in a home with a family member who is struggling with addiction.
“We also need to focus on just the mental health side. These kids, they have PTSD. They went through addiction with their family, sometimes multiple generations of addiction. They have experienced the worst of the worst,” Holstein said.
Credit: Briana Heaney/West Virginia Public Broadcasting
Between 2014 and 2020, Boone County was at the epicenter of the opioid epidemic, with one in four residents holding an opioid prescription.
The West Virginia First Foundation, which is responsible for distributing the money from the opioid settlement, had its first meeting Nov. 6.
The Winding Road Back
On the drive back to the office, a little red Volkswagen bug stops in the middle of the street. Holstein stops, too.
Out of the Volkswagen came a tall young man, with dark blond hair. He looks back at Holstein, his arms open in an embrace.
“I’m headed down to the courthouse,” the man said. “I got to head down to the courthouse and get my dismissal papers.” This is Hunter Gillispie — he’s someone the QRT helped into recovery.
“Okay good deal, see you soon!” Holstein said as they exchanged a hug and held up traffic for a few seconds.
Both Gillispie’s parents were addicted to opioids. As a teenager, he had been shot in the face by his uncle in a dispute over drugs.
After their embrace, they both get back in their vehicles.
“Him and his sister went through recovery at the same time,” Holstein said. “They are the first ones in three generations who’ve made it.”
Now, Gillispie is a year sober and works on a river boat. Holstein said he is one of QRT’s success stories. She said people like him are why she works so hard everyday to expand her program.