New England continues to experience one of the worst drug abuse epidemics in the country. Millions of people in states like Massachusetts struggle with addictions to substances like prescription medications and opioids. To combat this growing problem, organizations throughout Massachusetts and elsewhere in New England continue to devise programs to help drug users and alcoholics. These programs are especially useful in metro areas like Boston where substance abuse continues to be one of the biggest public health risks.

Large-scale Response to Drug Use in Boston

Boston public health officials began to put together a large-scale response to the city’s substance abuse problem in October 2014. That month marked the beginning of a program that was designed to address every level of drug use as well as provide continued care and education to the general public.

The program labels all types of drug abuse as Substance Abuse Disorders or SUDs. The overall goal of the SUDs program aims to address SUDs at all level of the impact on health. It also is designed to offer primary continuity-based prevention of SUDs starting with early intervention and progressing to treatment of chronic disease management.

Levels of SUDs Program

Boston public health officials designed the SUDs program to encompass numerous levels in order to target the broadest scope of drug abusers in the area. The first level of the program is its inpatient component.

The inpatient component of the SUDs treatment and education program comprises of a multidisciplinary consultation team that provides patients with a variety of prompt and critical services. These services include:

Comprehensive evaluations

Treatment recommendations

Links to community and hospital-based resources

These services are rendered upon the admission of patients to a medical facility that participates in this community drug abuse treatment and education program.

The next level of the program is the SUDs bridge clinic. The bridge clinic is a transitional outpatient clinic designed to provide short term medical care for discharged patients and patients leaving the emergency room who do not yet have outpatient care services. It also will provide continued care for patients with SUDs until they can be linked to appropriate community outpatient services.

Recovery coaches are a key component to the community-based SUDs treatment and education program. Recovery coaches are actually peers who are in recovery themselves. They assist fellow patients who are in the process of working toward sobriety. They help patients overcome any barriers to substance abuse treatment, provide emotional support, and serve as key members of a patient’s care team.

This program additionally incorporates an enhanced health center treatment component. The health centers that participate in the program increase patients’ access to evidence-based treatment. The services in this component include:

Pharmacotherapy

Readiness services

Integrated mental health

Primary care around treatment of the patient’s substance abuse disorder

This component is closely linked to the program’s new opioid prescribing policies. These policies mandate more precise guidelines for safer prescription of opioids for chronic conditions. It includes taking inventory of inpatient opioid prescribing policies and has the ultimate goal of developing a standardized policy that can be utilized by all hospitals in Boston.

Implementing this policy ideally will be easier thanks to the discoveries made by the program’s research and evaluation component. Hospitals and medical researchers in conjunction with health officials continue to conduct clinical research and ongoing evaluation of comprehensive and integrated approaches to treating people with SUDs. The results they come up with ideally will influence treatment standards in Boston as well as in cities throughout New England.

The last component of the SUDs treatment and education program in Boston involves changing the culture of drug use. The culture change component utilizes all opportunities to not only inspire hope in patients but also motivate the overall caring for patients. It ideally will achieve this by shifting away from the historical component of SUDs and understanding that SUDs are chronic but highly treatable illnesses.

The SUDs treatment and education program in Boston is just one approach that public health officials now use to address the growing problem of drug use in New England. They appreciate that much of the problem that persists in Boston right now stems from the overprescribing of opiates.

While opiates have their rightful place in medicine, health officials hope to change the manner and frequency with which they are given to patients. This change could greatly reduce the number of people with SUDs in the region.