Collaboration fights opioid epidemic

A collaborative approach involving local public health and public safety agencies may be what is needed to address the problem of opioid overuse in different communities. In Massachusetts, for example, such collaboration or partnership has given rise to four types of outreach and community support programmes aimed at connecting overdose survivors with support and treatment services.  

These new collaborative programmes being implemented in various counties of the state are described in a study published online in the International Journal of Drug Policy. The study is the first of its kind to attempt to systematically document this emerging approach to combatting the opioid epidemic. Researchers have identified four different approaches to conducting post-overdose outreach at the community level leveraging existing infrastructure, according to Alex Walley, MD, MSc, an addiction medicine specialist at Boston Medical Center's Grayken Center for Addiction and senior author of the study.

The four types of programmes in Massachusetts included multidisciplinary team visits, in which a public safety (police, fire, EMS) and one or more public health representatives travel together to the residence of the overdose survivor or site of an overdose shortly following the event. In addition, police visits with referrals were similarly structured, with officers providing information on support group schedules and addiction treatment options to individuals, and even direct referrals to partnering programmes, if the survivor was ready to accept services.

Clinicians were also embedded within a police department or employed at a collaborating social service or addiction treatment programme who received the contact information for overdose survivors or a member of their personal network. In the last group of programmes ("location-based outreach"), overdose survivors, people with an opioid use disorder, and family or associates were encouraged to visit a community-based site to obtain information, resources, and/or access to services.

The study was conducted between December 2015 and January 2016. Department of Public Health researchers reached out to all 351 communities in the state and surveyed public safety agencies (police, firefighters). They received responses from the police and fire personnel from 31 percent of the communities in Massachusetts. Of those respondents, 21 percent were actively engaged in implementing collaborative and outreach programmes in the community to help and treat overdose survivors.

Of the programmes that were interviewed, most were less than a year old at the time of the study, and roughly half were developed by an influential police or fire chief. Nine of Massachusetts' 14 counties had respondents who were interviewed for the study.

The researchers said the expansion of these collaborative programmes could save lives, noting their structures are capable of being scaled into other communities for a larger and broader impact.

"Our goal here was to advance the field by increasing awareness of these new innovative collaborations, raise issues that those seeking to adopt and implement these models should consider, and highlight the need for further research into their effectiveness and potential to save lives," explained Scott Formica, senior research scientist with Social Science Research and Evaluation, Inc. and the study's first author.

Public safety officials reported that stigma within their agencies and communities, lack of funding, and long-term sustainability were barriers to implementing programmes. If these public safety and public health partnerships are found to be effective, they have the potential to increase engagement across the country with social service and addiction treatment systems by those who are at elevated risk for experiencing a fatal opioid overdose.

Source: Boston Medical Center
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