A Continuum of Care: Detroit’s Opioid Quick Response Team

Hope. It’s a word that’s heard often these days in Detroit. Just 10 years out of bankruptcy, the city is experiencing an economic resurgence, and many Detroiters are thriving. However, some of the city’s most vulnerable residents didn’t feel that same hope until the city invested in them by bringing in the Opioid Quick Response Team, or Detroit QRT. The initiative is off to a great start.

Peer recovery coaching

On a brisk, Friday morning in January on the way to Sinai-Grace Hospital, Thomas Hunter, who is the program director of the Detroit QRT, says, “It’s not about the metrics; it’s about the people.”

A few minutes later, Hunter is talking with Daniel, who is a 39-year-old veteran and father of two who found himself homeless after becoming addicted to opioids.

Daniel now feels that hope. He is in recovery and getting not only the medical care that he needs for a serious back issue that he says was caused by his addiction but also wraparound services and peer recovery coaching.

The most important factor to the Detroit QRT’s wraparound services is meeting those who are in need where they are, rather than requiring those people to go to the members of the team. This improves the likelihood that the people will share their thoughts, which is key to the team’s capability to determine what it needs to provide, which can include
connecting the people with an organization(s) that can fill any gaps.

As for peer recovery coaching, it has proved vital the coaches have lived the same experiences as those they are helping.

For the first time in quite a long time, Daniel is making plans for his future.

When Daniel’s mother died at the age of 63, he says that he “gave up on everything and was numb.” He says that the help that he gets from peer recovery coach DeJuan Williams is life changing, and he finally feels as though he’s got space to take care of himself.

Daniel says that the support that he gets from Williams and Hunter is so different than what he got from his family. “With family,” he explains, “you know they love you, but they won’t call you out on your choices. I know I can’t get anything over on these guys.”

Daniel texts updates regularly to Williams and is looking forward to entering a recovery house when his hospital stay is complete. He hopes to have his criminal record expunged and earn a Commercial Driver’s License. When asked where he sees himself five years from now, Daniel says, “As a normal, functioning, taxpaying, bill-paying member of society—and reconnected to my family.”

‘A continuum of care’

The opioid overdose epidemic is an urgent public health crisis that has affected Detroit disproportionately, killing 430 people in 2023 alone. The Detroit QRT was launched through the Detroit Fire Department (DFD) in September 2024 as part of the city’s response to this health crisis and is funded by opioid settlement dollars. The latter derives from legal settlements with manufacturers and distributors of opioids, which deliver annual payments to state and local governments over the next 18 years.

The DFD staff members are on the front lines. In 2024, they used naloxone (Narcan) 2,400 times on medical calls. Many of those who are saved by the DFD decline transportation to a hospital, and many who are transported often still struggle to get connected to ongoing treatment.

“The Detroit QRT is proving to be a game-changer for our residents,” Detroit Fire Commissioner Chuck Simms says. “The men and women of DFD are saving the lives of overdose patients every day, but their role ends when emergency care is complete. Now, there’s a continuum of care in place to support these members of our community who long felt forgotten.”

When the decision was made to bring in a QRT, the city sought a trusted community partner and signed a two-year, $1.7 million contract with Face Addiction Now (FAN). FAN is a nonprofit agency that was founded in 2007 originally as Families Against Narcotics. It operates 17 QRTs across the state of Michigan, but the Detroit team is the first that’s operating 24/7.

Follow-up visits

With the Detroit QRT now on board, when DFD responds to a suspected opioid overdose and completes its treatment, it informs the patient that an outreach team of people who specialize in recovery from a substance use disorder will follow up to discuss safety and available resources.

During follow-up visits, the Detroit QRT assesses each resident’s needs and interests and helps to place each person in substance use disorder treatment if the person is willing.

The team works to remove barriers to other services to reduce risk of overdose mortality. It has a growing collection of clothing, blankets and other supplies. Although the team’s contract with FAN doesn’t include funds for these sorts of items, it has built relationships with members of the community and has asked family and friends to donate.

Further, the team can connect residents to harm-reduction services, housing services and employment assistance and even helps with food security. Regarding the latter, the Detroit QRT forged a relationship with a food bank, which gives it a direct line to provide help to those who are experiencing food insecurity.

The Detroit QRT also helps to fill a gap for patients who end up getting admitted to the hospital. Often, once someone is admitted, there aren’t as many resources as are available in the emergency department. The team meets regularly with the various hospital-based providers to build cooperative partnerships to fill these gaps. When the Detroit QRT meets patients while they still are in the hospital, it is connecting with them at a time when they already accepted some level of help, even if only medical at that point. This improves the team’s chances of establishing a continuum of assistance.

The big wins

Although it’s clear that the people are the driving factor behind this work, thus far, the metrics of the program are outstanding. Since its inception, the Detroit QRT has received 328 referrals from the DFD’s EMS division. Between these referrals and street outreach, which also is funded by the contract, the team has connected with 934 residents who are experiencing substance use disorder. Of those, a staggering 822 accepted some services, from harm-reduction supplies to connection to social services to treatment. It often is recurring connections with these residents that result in the big wins, which the team considers to be the 41 people who either are in treatment for recovery or completed treatment for recovery.

Years of ‘couch surfing’

Providing harm-reduction items is a way to connect with residents and meet them where they are. Tracie, who is 34 years old, has been homeless since 2017. After years of “couch surfing,” she found herself alone on the streets, having lost guardianship of her now 11-year-old son.

Tracie is accepting help from the Detroit QRT. After years of her own unsuccessful attempts, she was offered a bed in a shelter, and she plans to start her path to recovery.

“I feel understood, supported and not judged by this team,” Tracie says, a key to this, once again, being that so many of the Detroit QRT members have lived the experience of substance use disorder and they can see through the addiction to the person underneath.

“I feel my life finally coming to a calm,” Tracie adds. “The clouds are breaking, and I see a little light shining through.”

Tracie hopes to one day own her own home and get her nursing certificate.

“I like helping people,” Tracie says. “I want to put out into the universe what I hope to receive.” As Tracie left the Detroit QRT van after receiving some harm-reduction items, she exclaimed to the team, “Keep shining. Don’t let anyone dim your light!”

Visions of hope

The Detroit QRT members are passionate about their work and the clients who they serve. Most members of the team are in recovery themselves and are a true witness to how one life saved can be a beacon of hope for so many others. 

Hunter, 57, who is a husband, father and grandfather, is a Detroit native who battled addiction and thanks God for every day that he now spends serving those who need the help he was blessed to get. For him, as well as for so many others, this work is a calling. He believes that he was spared from active addiction to help people like him and to be some sort of vision of hope. In addition to his work on the Detroit QRT, Hunter owns a recovery house of his own and plans to open two more later this year.