Reducing the stigma: 5 questions with Boston Medical Center CEO on the opioid crisis

Boston Medical Center is the largest safety-net hospital and busiest trauma and emergency services center in New England and provides essential care to Boston's most vulnerable patients. The strip just outside its doors has been dubbed the "Methadone Mile," indicating the burden of care placed upon this hospital's shoulders regarding the treatment of opioid addiction.

Opioid-related overdose deaths in the state of Massachusetts have been steadily rising since 2000. In 2015, an estimated 1,659 deaths were related to opioid abuse in the state.

BMC is a forerunner in establishing best practices for the care of drug addicted patients. The hospital has also taken substantial efforts to change the way clinicians prescribe pain medication. In 2014, BMC's Safe and Competent Opioid Prescribing Program received a National High Intensity Drug Trafficking Area award for Outstanding Prevention Effort from Michael Botticelli, director of the White House Office of National Drug Control Policy.

Kate Walsh has led BMC as CEO since 2010. Ms. Walsh is a graduate of Yale University in New Haven, Conn., and prior to her appointment at BMC, she served as executive vice president and COO of Brigham and Women's Hospital in Boston for five years. Recently Ms. Walsh spoke with Becker's about the opioid epidemic.

Note: Responses have been lightly edited for length and clarity.

Question: What are the biggest challenges your hospital faces in relation to the opioid epidemic?

Kate Walsh: Like all providers, we are challenged by providing care during one of the greatest public health crises of our time. We at Boston Medical Center are in a unique position to address this because of the programs we have built. We have created groundbreaking substance abuse programs for people literally from all walks of life. We have received more than $19 million in state and federal research grants in the last five years to study treatment for substance abuse disorders.

Q: What unique measures does Boston Medical Center take to treat opioid addicted patients?

KW: Among the many addiction programs at Boston Medical Center, we have project ASSERT, founded in 1994. It is the first program of its kind in the nation. The program provides screening for addiction as soon as patients walk into the facility. We want to provide them with support to quit, because any day could be that day. Project RESPECT provides pregnant women with opioid abuse disorders access to social workers, nurse practitioners and addiction specialists.

We aim to deliver integrated care to addicted patients. We work hard to train our physicians on all the challenges that come with caring for patients with substance abuse disorders. Integration is the key word. It's not a separate thing. Because we are a national leading research institution on root causes of addiction and efficacy of treatment models and interventions, we can both create and implement addiction treatment programs. As an academic medical center and the primary teaching affiliate of Boston University School of Medicine, we are educating the next generation of doctors in these innovative approaches.

Q: How helpful do you think recent actions taken by the federal government will be in curbing the rates of opioid abuse? What is the state of Massachusetts doing to fight opioid abuse? Is it enough?

KW: We applaud any effort made to end this epidemic. We received an award from the White House for treating pain in a manner that reduces addiction incidence. We feel we have been well supported by the federal and state government to give our patients the treatment they need. I think Gov. [Charlie] Baker and his team have been pushing healthcare to be more responsive to this health crisis. They've helped our industry broadly destigmatize this.

Q: Does Boston Medical Center have enough access to the antioverdose drug naloxone?

KW: Our clinics, pharmacy and security personnel are equipped and trained in overdose prevention and response with naloxone rescue kits. Overdose prevention training and naloxone rescue kits are available to all patients and staff at minimal or no cost through the retail pharmacy on campus. In Massachusetts, we've been okay in regards to the naloxone supply.

Q: What is the best way for the nation to combat the opioid epidemic?

KW: Reduce the stigma. These are our children, these are people's parents, these are our friends. This isn't happening to somebody else, this is happening to us. We must reduce the stigma and provide access to services. This is a chronic, potentially fatal disease that affects many people. This effort is going to take a lot of hard work from everyone to fully alleviate an enormous public health crisis.

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