| Course | PAC 410 Crisis Intervention and Prevention |
|---|---|
| Module | Module 7 |
| Paper type | Substance crisis paper |
| Length | About 1,034 words, 6 pages |
| Format | APA 7 student paper |
| School | Aspen University |
| Program | Psychology and Addiction Studies |
| Updated | October 2026 |
Free sample paper for PAC 410 Module 7
Ten Days Out: A Mobile Crisis Response to an Overdose After Jail and Turning a Near Death Into a Start
Student Name
Psychology and Addiction Studies Program, Aspen University
PAC 410: Crisis Intervention and Prevention
Instructor Name
Month Day, Year
Ten Days Out: A Mobile Crisis Response to an Overdose After Jail and Turning a Near Death Into a Start
At nine on a Thursday night, a mobile crisis team was dispatched to a row house in Poughkeepsie. Nate, thirty-one, had been released from the county jail ten days earlier after serving four months for a probation violation. That evening, his sister had found him on her bathroom floor, blue and barely breathing, and had given him two doses of nasal naloxone from a kit she kept since his last overdose. By the time the team arrived, alongside paramedics, Nate was awake, sweating, nauseated and angry. He refused to go to the hospital. "I'm fine," he said. "I'm not going back in there." This paper describes the crisis response by the mobile team, part of the course's invented crisis service. Nate and his sister are composites, and the research is real.
Why the Days After Release Are Dangerous
Binswanger et al. (2007) studied tens of thousands of people released from prisons in Washington State, linking their records with death certificates. Former prisoners died at more than three times the rate expected for people of the same age, sex and race. The risk was greatest in the first two weeks after release, when the death rate was many times higher than expected, and drug overdose was the leading cause of death in that period. The authors pointed to loss of tolerance during incarceration, the stress of reentry and a lack of treatment and support after release.
Nate's overdose fit this pattern exactly. Four months without opioids had lowered his tolerance, and when he used what he had used before, it nearly killed him. Fentanyl in the supply added to the danger.
Naloxone Saved Him
Coffin and Sullivan (2013) used a model to estimate the effects of distributing naloxone to people who use heroin, so that they and those around them could reverse overdoses. They estimated that distribution would prevent a meaningful share of overdose deaths and that it was highly cost-effective, costing little per year of life gained, even under conservative assumptions. Nate's sister's kit is an example of what the analysis describes: a low-cost intervention, in the hands of a family member, that prevented a death.
The Danger After Waking
Naloxone works quickly but can wear off in less than an hour to an hour and a half, while some opioids, especially in large or long-acting doses, last longer. A person who wakes after naloxone can slip back into overdose as it wears off. This is the main medical reason paramedics urge transport. Nate's refusal, which he had the right to make as an alert adult, meant that the team had to reduce this risk in other ways.
The Response
| Concern | What the team did | Why |
|---|---|---|
| Medical safety | Paramedics checked his breathing and oxygen; explained the risk of renewed overdose; he signed a refusal | He was alert and had the right to refuse |
| Renewed overdose risk | His sister agreed to stay with him for four hours; left two more naloxone kits; no further use tonight | Naloxone can wear off before the opioid |
| Withdrawal | Acknowledged he felt terrible because naloxone triggered withdrawal | Explains his anger; makes treatment more appealing |
| Anger and shame | Did not argue; reflected that he did not want to go back to any institution | Built enough trust to talk about next steps |
| Treatment | Offered a visit the next morning to a bridge clinic that starts buprenorphine the same day | Turns the crisis into an entry point |
| Harm reduction | Discussed never using alone and fentanyl test strips | Reduces risk if he uses again |
Treatment Started in the Crisis
D'Onofrio et al. (2015) tested starting buprenorphine in the emergency department for patients with opioid dependence. Patients were randomly assigned to referral to treatment, to a brief intervention with facilitated referral or to a brief intervention plus buprenorphine started in the emergency department and continued in primary care. Thirty days later, roughly three in four patients in the buprenorphine group were still in addiction treatment, about double the share in the referral group, and they reported fewer days of illicit opioid use. The study showed that a crisis contact can be the start of treatment rather than a referral that is often lost.
Nate's refusal of the hospital ruled out emergency department initiation, so the team applied the same principle another way, offering a bridge clinic visit the next morning, when he would be in withdrawal and buprenorphine could be started.
Respecting the Refusal
Nate's refusal frustrated the paramedics, and some crisis workers might have pressed harder or threatened an involuntary hold. The team did not, for two reasons. He was alert, oriented and able to understand the risks, so he had the legal right to refuse. And his refusal was rooted in experience: after four months in jail, he said, he could not stand the idea of another locked door. Forcing him would likely have ended any chance of engaging him the next day. The team chose to reduce risk within his decision, by keeping his sister with him and leaving naloxone, and to keep the door open, which is why he answered the phone in the morning.
The Next Days
The next morning, a team member called Nate as promised. He was still sick and agreed to go. His sister drove him to the bridge clinic, where he started buprenorphine and was given an appointment with an ongoing prescriber the following week. The team connected him with the county's reentry program, which helps with housing and work after release, and with a peer recovery coach. His probation officer would need to be informed of his treatment if Nate consented, which he did, so that treatment would be seen as compliance rather than a violation.
Conclusion
Nate's overdose came in the most dangerous period after release, as Binswanger and colleagues predict, and his sister's naloxone, the kind of distribution Coffin and Sullivan show is effective, saved his life. D'Onofrio and colleagues show that starting treatment immediately doubles engagement. By respecting his refusal while making the night safer and arranging treatment for the next morning, the crisis team turned a near death into a start.
References
Binswanger, I. A., Stern, M. F., Deyo, R. A., Heagerty, P. J., Cheadle, A., Elmore, J. G., & Koepsell, T. D. (2007). Release from prison: A high risk of death for former inmates. New England Journal of Medicine, 356(2), 157-165. https://doi.org/10.1056/NEJMsa064115
Coffin, P. O., & Sullivan, S. D. (2013). Cost-effectiveness of distributing naloxone to heroin users for lay overdose reversal. Annals of Internal Medicine, 158(1), 1-9. https://doi.org/10.7326/0003-4819-158-1-201301010-00003
D'Onofrio, G., O'Connor, P. G., Pantalon, M. V., Chawarski, M. C., Busch, S. H., Owens, P. H., Bernstein, S. L., & Fiellin, D. A. (2015). Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: A randomized clinical trial. JAMA, 313(16), 1636-1644. https://doi.org/10.1001/jama.2015.3474
Reading the PAC 410 Module 7 assignment instructions
Substance-related crises are the seventh module of PAC 410, and a typical assignment asks you to respond to an overdose, withdrawal or intoxication crisis and connect the person to ongoing care. The Module 7 instructions in your Aspen course govern; Nate is invented. Describe the immediate medical risks and how they are addressed. Explain the factors that made this crisis especially dangerous, such as loss of tolerance. Present evidence on naloxone and on starting treatment during a crisis. Respect the person's right to refuse while reducing risk. Plan the following days, citing every source in APA 7. Say what you will do if the person refuses transport, since that is common. Plan the follow-up call before you leave.
How this PAC 410 Module 7 example is built
Nate's sister found him blue on her bathroom floor and gave two doses of naloxone; he is awake, sick and angry, and he refuses the ambulance. Binswanger and colleagues' New England Journal of Medicine study explains why the days after release are so dangerous. Coffin and Sullivan's Annals of Internal Medicine analysis supports leaving naloxone with the household. D'Onofrio and colleagues' JAMA trial supports offering buprenorphine immediately rather than a referral. A six-row table follows the response. The plan includes watching for renewed overdose as naloxone wears off, a next-morning bridge clinic visit for buprenorphine, naloxone kits for the family, a reentry program and consent to inform probation.
Where the marks sit in the PAC 410 Module 7 rubric
Substance crisis papers earn credit for accurate medical risk, attention to the person's rights and a fast connection to treatment. This example explains why naloxone can wear off before the opioid does, a safety point instructors look for. Binswanger and colleagues' findings explain the danger of the post-release window. The plan respects Nate's refusal of transport while reducing risk, rather than either forcing him or leaving. D'Onofrio and colleagues' trial justifies offering treatment the same day rather than a referral list. Naloxone for the household follows Coffin and Sullivan, and the plan names who will call Nate the next morning. Probation is informed only with his consent.
PAC 410 Module 7 help from the desk
Overdose crisis papers often end when the person wakes up. Address the risk that naloxone wears off before the opioid, the period after release from jail or treatment when tolerance is low and the need for immediate treatment. Respect the right to refuse transport while reducing risk through monitoring and naloxone. Offer treatment the same day where possible, since referrals are often lost. Distribute naloxone to the household. Address shame and anger without arguing. Follow up within a day. Use nonstigmatizing language. Remember that many overdoses involve fentanyl in other drugs, and that test strips and never using alone are part of harm reduction. Connect people leaving jail to reentry services.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
More PAC 410 and Psychology and Addiction Studies sample papers
- PAC 410 Module 1: Crisis Theory and Intervention Models
- PAC 410 Module 2: Suicide Assessment and Intervention
- PAC 410 Module 3: Homicide Threats and Violence
- PAC 410 Module 4: Intimate Partner Violence
- PAC 410 Module 5: Sexual Assault and Abuse
- PAC 410 Module 6: Bereavement, Grief and Loss
- PAC 410 Module 8: Disasters, Mass Violence and Community Prevention
- PAC 110 Module 5: Social and Environmental Theories
- PAC 415 Module 8: Reflection on Practical Wisdom
- PAC 320 Module 4: Outpatient Treatment
- PAC 240 Module 5: Co-Occurring Disorders
PAC 410 Module 7 questions, answered
What does PAC 410 Module 7 usually ask for?
Aspen's PAC 410 covers substance-related crises in this module, so responding to an overdose or withdrawal crisis and connecting the person to care is typical. Check your Module 7 prompt.
Why is the period after jail so dangerous?
Binswanger and colleagues found former prisoners died at many times the expected rate in the first two weeks after release, mostly from overdose, as tolerance had fallen.
Is giving out naloxone worth the cost?
Coffin and Sullivan estimated that distributing naloxone to people who use heroin would prevent overdose deaths and was highly cost-effective.
Where can I find a free PAC 410 Module 7 sample paper?
Read the whole paper on this page: a mobile crisis response to an overdose ten days after release from jail, with a response table and plan.
Does starting buprenorphine in the emergency department help?
D'Onofrio and colleagues found it roughly doubled the share of patients engaged in addiction treatment a month later compared with referral alone.