Maryland COAT Program Connects Patients to Opioid Treatment

More Americans die every year from drug overdoses than they do in car crashes – and most of those overdoses involve opioids. The escalating opioid epidemic is just one of many serious threats that are impacting communities all over the country, especially Maryland.

Wicomico County, MD, is located in the southeastern peninsula and had a population of just over 98,000 according to the 2010 census. The county began to see a rise in heroin use and heroin-related overdose cases in the emergency department (ED) as well as overdose deaths. In 2015, there were 100 overdoses in the ED. In 2016; there were 44 overdoses per month in March and April. The health officer and the state’s attorney began looking for a more comprehensive solution to intervene before anyone becomes a statistic for the health department or law enforcement.

The COAT Program (Community Outreach for Addictions Treatment) was developed as a one-year pilot to reduce overdoses with a budget of $125,000. The goal was to identify individuals who needed education and then provide “bridge” services to connect with access to treatment programs. In June 2016, law enforcement started an education campaign in the areas known for higher rates of drug use. Peer support specialists, with two years documented recovery, were hired to assist individuals as they entered a program. The COAT team receives calls from the hospital ED and law enforcement for all overdoses and respond in real time to meet with the individual and attempt to offer services immediately.

Through community outreach and partnerships with Peninsula Regional Medical Center, county and city councils, Life Crisis Center, law enforcement, churches, substance use treatment providers, and others, the outcomes through October 2017 include:

  • 404 individuals served with 214 engaged in treatment
  • 34% decrease in ED overdoses in 2017
  • 50% decrease in total opioid-related deaths
  • 50% decrease in total fentanyl-related deaths

While Maryland as a whole has experienced an 18% increase in opioid-related deaths and a 70% increase in fentanyl-related deaths, the COAT Program has been recognized as a “Promising Practice” by the National Association of City and County Health Officials. If you would like more information on starting your COAT Program, please email Lori Brewster, Health Officer, Wicomico County Health Department at


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