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The Bellwether Collaborative
for Health Justice


Leadership Team
Lauren Brinkley-Rubinstein, PhD
Duke University
Emily Dauria, PhD
University of Pittsburgh
Alysse Wurcel, MD
Boston Medical Center
Kathryn Nowotny PhD
University of Miami
Duke Research Team
Margaret Roach, MPH
Clinical Research Coordinator
Jennie Riley, MA
Implementation Specialist
Amelia Ashkin-Baker
Clinical Research Specalist, Sr.
Background.
Overdose is one of the leading causes of death in the US. People who are exposed to or impacted by the criminal legal system (CLS) disproportionately report using substances and experience high rates of overdose. Community Paramedic or Post-Overdose Response Team (PORT) programs have grown across the country to address this crisis. These teams respond during and after overdoses to offer life-saving support—including naloxone, medications for opioid use disorder (MOUD), and connections to health and social services, to help people get care rather than face arrest or incarceration. However, these programs mostly focus on individual-level care. Research shows that broader issues—like lack of housing, difficulty accessing public benefits, and unmet legal needs—also drive overdose risk. These are sometimes called “health-harming legal needs” (HHLN). Medical-Legal Partnerships (MLPs) bring together legal and healthcare professionals to address these deeper challenges and reduce the chance of future overdose harm.
Overview.
With sites in North Carolina, Florida, Pennsylvania, and Maine, the CROSSROADS Study team aims to determine if an enhanced community paramedic services designed to address HHLNs improves health and well-being for members of the community, including reducing risks of overdose. In addition to testing the efficacy of the CROSSROADS intervention, our teams are interested in evaluating the acceptability, appropriateness, and sustainability of the intervention in real-world settings across the country.
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