The opioid epidemic continues to grow across America, along with an increasing incidence of polysubstance use, the use of multiple substances together. A review of 2,224 opioid-related overdose deaths in Boston between 2014-2015, conducted by researchers at Boston Medical Center’s Grayken Center for Addiction and published in Drug and Alcohol Dependence, found that 83% of those deaths involved an opioid and one or more additional substances. In addition, the study found that underserved populations such as the homeless and mentally ill are particularly vulnerable. These findings highlight the fact that communities, and community-based initiatives, play a major role in addressing the social barriers that impact individuals with substance use disorder and the incidence of polysubstance overdose.
One example of a community-based initiative is HEALing Communities, announced in April 2018. The National study is a joint effort between the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration (SAMHSA), with a goal of significantly decreasing deaths related to opioid overdoses.
To facilitate this goal, the test will look at the impact of an integrated set of evidence-based interventions and coordinated systems of care across multiple social service and community-based organizations. This will create a shared set of standards and best practices that will help inform professionals who work with populations more at-risk for polysubstance opioid overdose such as, “persons older than 24 years, non-rural residents, those with comorbid mental illness, non-Hispanic black residents, and persons with recent homelessness”.
One of the organizations selected to participate in the NIH’s HEALing Communities Study is The Boston Medical Center (BMC). In April 2019, BMC was awarded $89 million in funding from the National Institute on Drug Abuse (NIDA) to lead a research study with the goal of reducing opioid deaths by 40% in areas of Massachusetts critically affected by the opioid crisis.
BMC’s study aims to test the impact of Office-Based Addiction Treatment (OBAT) as well as the use of other interventional methods, by partnering with 16 high-risk communities throughout the state. Eight test sites will implement OBAT alone and the other eight programs will implement OBAT along with supplemental initiatives such as community education, accelerated access to medication, and intervention programs.
Specifically, the money will be used to see how coordinated systems of care can be used to:
- Reduce overdose fatalities and events
- Decrease the incidence of OUD
- Increase the number of individuals receiving medication to treat OUD, retained in treatment, and receiving recovery support services
- Increase the distribution of naloxone
As Nora D. Volkow, M.D., director of NIDA notes, “By testing and evaluating interventions where they are needed the most, we hope to show how researchers, providers, and communities can come together and finally bring an end to this devastating public health crisis.”
Boston Medical Center’s OBAT is unique in that it offers technical assistance to community health centers (CHC) in Massachusetts. Qualified training specialists can work with organizations such as hospitals and law enforcement directly, to provide the necessary education, support, and training needed to gather and understand complex data sets, make tough decisions, and improve the quality of life for patients as a whole.
The technical assistance provided by OBAT is free of charge and can be held in almost any location. Training programs that are currently available include Introduction to Addiction and Treatment (Addiction 101); Buprenorphine Waiver Training for Prescribers; Introduction to Addiction and Addiction Treatment for Social Service Organizations.
Without collaborative technology, communities all over America would be unable to improve outcomes and reduce the incidence of polysubstance abuse. By utilizing innovative tools that promote the spread of information and better coordinating care, communities can play a major role in reducing the incidence of polysubstance overdose.
