Groundbreaking Initiative Speeds Treatment for Addiction

Opiate-related deaths have nearly tripled in Massachusetts over the past five years. Boston Medical Center’s Emergency Department has seen this growing epidemic first-hand with 848 drug-related incidents coming through the hospital’s ambulance bay in 2015 alone, a staggering 33% increase from 2014.

To help confront this urgent public health crisis, Boston Medical Center has partnered with the Massachusetts Department of Public Health (DPH) and the Boston Public Health Commission’s PAATHS program to open an opioid urgent care center. Called Faster Paths to Treatment, the new center is led by dedicated addiction treatment specialists, and eases access to the hospital’s many specialized programs for addiction. The program is made possible by a four-year, $2.9 million grant from DPH’s Bureau of Substance Abuse Services.

Opioids include highly addictive drugs such as heroin, fentanyl and oxycodone. The increased use of potent fentanyl-laced drugs is fueling overdoses across the state. Studies show that the timeliness of intervention after a non-fatal overdose can be critical to a patient’s recovery and continued sobriety. Yet many patients confront barriers to receiving medications to reduce drug dependence, as well as mental health services and addiction counseling.

Because time is such a crucial factor in rehabilitation, Faster Paths provides low-barrier treatment for substance use disorders. The center’s doors officially opened on August 1, 2016, next to the hospital’s main urgent care center. Its location provides easy access to walk-in patients, as well as those being referred from the hospital and outside treatment centers. BMC’s Project ASSERT, a team of licensed alcohol and drug counselors, conduct assessment and follow-up for drug-related illnesses, as well as provide primary care appointments and naloxone (Narcan) rescue kits for overdoses.

“The center gives people rapid access to our services without high ER copays and long wait times. We work with people who are still using, as well as those seeking detox. In addition, because these patients face a number of serious health risks including HIV and Hepatitis C, the program integrates with primary care services streamlining access to lab tests and prescriptions,” says Faster Paths Director Edward Bernstein, M.D.

Faster Paths has its own dedicated medication treatment outpatient program, staffed by an addiction nurse, physician and a master’s level addiction counselor. When appropriate, patients receive buprenorphine/naloxone (suboxone) induction and stabilization, as well as vivitrol treatment. After these patients are stabilized, they are enrolled in maintenance programs at their local community health centers or at BMC.

“Looking at the bigger picture, we see Faster Paths becoming a medical home [a patient-centered model of care, focusing on comprehensive, team-based health care delivery] for patients with addiction. The model offers continuity of care and a safe place where patients are treated with respect. We have an open door policy, and they know they are always welcome to come back,” explains Bernstein.

Boston Medical Center is a longtime leader in the prevention, treatment and research of substance use with many treatment programs aimed at helping patients. There are many programs and departments collaborating on Faster Paths including: the Adolescent and HIV Clinics; Project RESPECT; the Pediatric Emergency Department Health Promotion Advocacy Program; the Office-Based Addiction Treatment program; the CATALYST Clinic; the Department of Family Medicine; Addiction Psychiatry; Case Management; and BMC’s network of community health centers.