Brigham Co-Leads Citywide Hospital Response to Opioid Crisis

From left: Christin Price and Samata Sharma, who care for patients with substance use disorder, meet in the Bridge Clinic.

The Brigham is one of 12 local hospitals that have committed to training their care providers about addiction as well as supporting faculty and staff faced with challenges related to their own or a loved one’s substance use disorder (SUD).

For the past several months, Brigham Health President Betsy Nabel, MD; Kate Walsh, president and chief executive officer of Boston Medical Center Health System; and RIZE Massachusetts, a nonprofit working to end the opioid epidemic in Massachusetts, have collaborated to develop a collective strategy that builds on the work each respective institution is doing to address the opioid crisis.

We pursue excellence logoThe participating hospitals, which also include Brigham and Women’s Faulkner Hospital and Massachusetts General Hospital, have agreed to take on a set of priorities as the first step to reduce stigma and enhance the uptake of treatment for SUD. They’ve also committed to conducting mandatory training for all hospital-based physicians and residents in key departments and creating support initiatives for faculty and staff and their loved ones.

In addition, addiction care will be further mainstreamed into all primary care encounters, and residents will be better prepared to treat addiction, including with medication, as a foundational part of their practice.

Scott Weiner, MD, MPH, an emergency physician and director of the Brigham Comprehensive Opioid Response and Education (B-CORE) Program, said he’s proud of the work the Brigham has done to address the opioid crisis thus far and sees great potential in this latest, multi-institutional effort to save more lives.

“This new consortium allows us to share our approach across the city, which greatly increases the impact,” Weiner said. “It also allows us to learn from our colleagues. If we’re going to solve this issue and ultimately reduce overdose deaths, we all need to work together.”

Making the Pledge

As part of the strategy, all hospital-based emergency physicians, hospitalists, obstetricians, psychiatrists, pediatricians, infectious disease specialists, primary care providers and internal medicine residents will undergo a mandatory SUD training. The course — which at the Brigham standardizes, centralizes and expands on existing, smaller-scale programs — will cover the fundamentals of addiction; modern treatment of opioid use disorder, including utilization of buprenorphine (widely considered one of the most effective medications available to treat opioid use disorder); and addressing stigma.

The Brigham and other participating institutions have also committed to increasing the number of providers who obtain buprenorphine training by offering additional in-person training sessions. Clinicians must undergo a specialized, eight-hour training to prescribe buprenorphine to patients with opioid use disorder.

In addition to being health care providers for the public, Boston and Cambridge hospitals employ thousands of people, many of whom may need their own support with substance use. The committed hospitals have pledged to doing at least three activities from a list of 10 that are meant to encourage campus-wide discussion around substance use and uptake of relevant health care services. 

Some of the activities include providing free, on-site training and subsidized access to naloxone, a fast-acting treatment for opioid overdoses; developing a training program for all managers on how to identify and support employees with substance use disorder; and sending a SUD-specific benefits guide to all employees.

 

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