Orlando Health Credit: Image via Google Maps

Orlando Health, one of the region’s largest health systems, announced the expansion of its “opioid navigator” program in certain local hospitals, which helps connect people who end up in the ER for overdose with follow-up resources and treatment options.

The expansion is being funded by money that Orange County received through national settlements reached with opioid manufacturers and distributors.

According to data from the Florida Department of Health, hundreds of people end up in Orange County emergency rooms for nonfatal overdose each year — and for some, it’s not the first time.

Jaime Bridges, a former Orlando police officer with lived experience of addiction who now works for Orlando Health as a licensed clinical social worker, said sometimes people just aren’t ready to get help for a drug problem — but that doesn’t mean that offering resources to  them is a waste.

“The difference between a program like this and what already exists in hospitals is this navigator may provide a number to that patient — say, that patient’s not ready to talk right then, or just not in a good place — but the navigators provide a good contact number for their team so that patient can reach out, even if they’re not in the hospital,” Bridges explained, in an interview with Orlando Weekly last year.

Addiction is complicated — especially when it comes to opioids, a class of sedatives that can legally be prescribed in some cases for the treatment of acute and chronic pain conditions.

Opioid use can, for some, become a way to cope with life troubles: a messy relationship, depression or post-traumatic stress. It may offer a sense of relief, and may feel like a lifeline — despite the legal risks, the dangers to physical health, and the effects that chronic drug misuse can have on a person’s relationships or their ability to hold down a job.

In time, drug use becomes a familiar routine, and with chemical dependence — a physical addiction to the drug — the continued use of opioids may feel uncontrollable and necessary, if only to stave off withdrawal symptoms such as anxiety, insomnia, nausea and vomiting. Illicit opioids such as heroin and illegally manufactured fentanyl, which are unregulated by the federal government, may pose additional safety risks.

Sometimes, Bridges said, she hears from patients months after they’ve left a local ER, when they’ve reached a place where they’ve decided they’re ready to seek further help for their drug use.

“The idea is to meet a patient where they’re at, whatever that may be,” said Bridges, who is in recovery from an addiction to opioids herself. “If they’re not ready for help, we will provide them with Narcan and provide them with our phone number so they can call when they’re ready.”

Narcan, a brand name for the generic medication naloxone, can help reverse an opioid overdose by blocking its life-threatening effects. If administered correctly, and quickly, it can quite literally save lives.

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Orlando Health’s opioid navigator program staffs specially trained behavioral health clinicians and certified peer recovery specialists. It first launched at the Orlando Health Orlando Regional Medical Center in 2019, thanks to grant funding.

Later, the hospital system was able to extend the program to Orlando Health Winnie Palmer Hospital for Women & Babies, Orlando Health Arnold Palmer Hospital for Children and Orlando Health South Seminole Hospital.

An Orlando Health spokesperson said that, over the last fiscal year, navigators at these sites made about 600 referrals to various community resources, including inpatient/outpatient facilities and recommended harm-reduction practices. 

The most recent expansion of the program, announced Tuesday, is occurring in partnership with the Orange County government, as part of the county’s effort to prevent fatal drug overdose. According to Orlando Health, the county funds will allow the program to expand to Orlando Health’s hospital in the Dr. Phillips area and the Health Central Hospital in Ocoee.

The program itself is just a stepping stone on the path towards recovery — a process that can be a years-long journey for those with chronic struggles. But Bridges, the social worker, said just having someone familiar with the ins and outs of substance use disorders to help walk you through your options can be incredibly helpful.

“There’s really nothing scientifically crazy about the program,” she said. “It’s just a matter of meeting patients where they are and when they’re ready, we guide them to whatever treatment fits their personal life best.”

That could include medication-assisted treatment (the most effective treatment for opioid use disorder), an abstinence-based treatment program (less effective but preferred by some), or at the very least, options for harm reduction.

“I think with harm reduction, with Narcan, and understanding that if we can get a patient to maybe only use once a week, as opposed to using, you know, 10 times a week, that’s a little bit of a success, right? Like, that’s somebody moving towards successful recovery.”

It’s a different approach than treatment providers might have taken a couple of decades ago, when medication-assisted treatment (using certain opioid-based medications to help treat addiction) was more stigmatized and less understood, and the abstinence was often deemed the only clinically-appropriate approach.

But  the number of overdose deaths recorded in recent years — driven in large part by the highly-potent opioid fentanyl — has reached crisis levels, drawing greater focus to identifying effective treatment and preventative strategies.

Nearly 108,000 people in the U.S. died of drug overdose in 2022 — more  than double the number of overdose deaths recorded a decade prior. Roughly 75 percent of overdose deaths in 2022 involved an opioid.

“It’s really important for our media outlets to remind people that death is final — so we don’t take any death lightly”

Although overdose deaths have started to decline locally and nationally since, according to Dr. Thomas Hall — a treatment provider who is working with the county to guide overdose prevention initiatives — hundreds of people still die due to overdose each year.

To treatment providers like himself, and to local families, that matters.

“It’s really important for our media outlets to remind people that death is final — so we don’t take any death lightly,” Hall told Orlando Weekly. “We’re happy that there’s the decreases, but that doesn’t mean the fight’s over.”

Orlando Health’s program, as a stipulation of receiving government funds, prioritizes low-income populations that have a higher risk of overdose: people with chronic or severe addiction who have overdosed multiple times, people who were recently incarcerated in the county jail, and pregnant and postpartum women without health insurance who misuse opioids.

Navigators with the program guide individuals and families through their options, which could include connecting them with mental health, substance use or grief counseling, as well as other crisis intervention and health services.

Orlando Health’s team is required to track the number of people they help and the referrals they offer for the county, in order to ensure the hospital system is being efficient with its funds, and to help better understand what’s working and what’s not.

The county has also earmarked opioid settlement funds for initiatives such as naloxone distribution, the distribution of fentanyl test strips — to help prevent accidental overdose — and a mobile treatment clinic for opioid use disorder.

People with OUD often face barriers to treatment. They may lack consistent access to the resources necessary to recovery, such as treatment costs or reliable transportation. They may fear stigma in their immediate circles.

Dr. Hall said the county is also looking into purchasing specialized vending machines that would distribute naloxone in parts of the county where the highest concentrations of overdoses occur, according to EMS data. The goal is to make the overdose reversal drug as accessible as possible.

The total payout of settlements reached in national lawsuits filed against opioid manufacturers and distributors is expected to exceed $50 billion. Over the next 15 or so years, Orange County is expected to receive more than $50 million from those settlements, with the bulk of that coming within the next 10.

Orlando Health — a private, not-for-profit healthcare system with $12 billion of assets under management — secured $365,800 in settlement funds from the county last year for its navigator program. That funding was for a one-year term, to last through Feb. 28, 2025.

Neither the county nor Orlando Health readily confirmed to Orlando Weekly how much funding the latter has been approved for the program’s continuation and expansion, but we will update this story when and if they do.

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This article appears in Jan 15-21, 2025.

General news reporter for Orlando Weekly, with a focus on state and local government and workers' rights. You can find her bylines in Creative Loafing Tampa Bay, In These Times, and Facing South.