Boston Medical Center’s Grayken Center for Addiction is a leading innovator for models of care that reduce overdose deaths and hospital admissions and support people toward long-term recovery. With Massachusetts’ overdose death rates at twice the national average, the hospital’s Addiction Consult Service is solving a particularly difficult problem of engaging people in treatment before an overdose occurs. Now, other hospital systems are taking note. In the fall of 2018, NYC Health + Hospitals, the largest public health care system in the nation, rolled out a program based on the BMC model.
In the midst of the nationwide opioid crisis, finding people who require medical intervention for substance use usually happens in the treatment bays of the Emergency Department (ED). BMC’s Addiction Consult Service identifies people who need help before they are brought to the ED for an overdose. The pioneering program reaches out to hospitalized patients on BMC’s inpatient floors. Here, physicians educate and connect with patients hospitalized for a variety of illnesses or injuries who may benefit from addiction treatment. The multidisciplinary team includes addiction specialists, a social worker and a peer wellness and recovery advocate. The service currently touches more than 1,000 patients a year who might not otherwise seek medical services until an overdose occurs.
“We know roughly 17 percent of our inpatient population has an active substance use disorder. The consult service provides a potentially life-saving entryway into treatment and recovery for these patients,” explains Zoe Weinstein, MD, director of the Addiction Consult Service. “We really strive to build relationships with patients while they are here at the hospital and post-discharge. We are having conversations, providing little activities to help them pass the time and meet them where they are on their journey. Building these relationships on a human level is a major key to our success.”
NYC Health + Hospitals is employing a program based on the BMC model in six of its major New York City-area hospitals. The new Consult for Addiction Treatment and Care in Hospitals (CATCH) program’s target is to reach and deliver treatment to more than 8,000 patients with opioid use disorder annually.
“This is an important shift for our public health system, which historically hasn’t had a mechanism through which to engage patients with substance use disorders unless they are seeking care specifically for that issue,” says Luke Bergmann, PhD, assistant vice president in the Office of Behavioral Health at NYC Health + Hospitals in a press release. “Reaching out to patients and engaging them when they are already here for our care creates a real opportunity for patients to say, ‘I’m ready for help.’”
For Weinstein and her team, it is an honor for the program to be chosen by NYC Health + Hospitals and an exciting opportunity to see how the BMC model can scale to reach more people in need.
“We are excited to lend our expertise to the new initiative and hopeful that the NYC Health + Hospitals’ program will have a far-reaching impact on reducing substance use disorder in the state,” concludes Weinstein. “We are working closely with our New York colleagues as the model rolls out in each of its six hospitals. Every hospital offers an opportunity to see our model in action under unique circumstances and will further guide us on developing best practices that can help address the opioid crisis at a national level.”
