In the fight against drug addiction, the small waterfront city of Gloucester, MA, made a big splash this year. The police chief’s Angel program encourages residents living with an addiction to come to the police station with the promise of immediate treatment rather than arrest or jail. Nearly 300 people have been placed in treatment in the last six months.
What’s less well known is that the chief’s initiative is part of a multi-sector citywide response to drug and alcohol problems. At its core is collaboration among dozens of community agencies and a unifying strategy for prevention called SBIRT.
Last week, Community Catalyst brought state policymakers and advocates from five states to Gloucester to hear first-hand about the broad initiative. This “Learning Tour” also included a separate day-long immersion with experts on the effectiveness, financing and sustainability of SBIRT, or Screening, Brief Intervention and Referral to Treatment. Policymakers attending from Georgia, New Jersey, Ohio, Wisconsin and Massachusetts included state legislators, a Medicaid leader, and school staff. The Learning Tour goal was to help address the epidemic of drugs and alcohol ravaging our communities by fostering partnerships to increase adoption of SBIRT, particularly among youth. The Learning Tour was part of Community Catalyst’s True Talk: Power of Prevention program, funded by the Conrad N. Hilton Foundation.
Gloucester’s very own catalyst, Joan Whitney, who directs the Healthy Gloucester Collaborative, worked with Community Catalyst on a program featuring local elected officials, including state Representative Ann-Margaret Ferrante and Gloucester Mayor Sefatia Romeo Theken, other dynamic leaders and on-the-ground practitioners. Three key elements are fostering the growth of Gloucester’s initiative to address addiction: connection (linkage of resources); prevention (focusing on practice and policy change); and sustainability (adaptive and integrated programming).
In 2011, SBIRT became a critical element. The local hospital piloted SBIRT in the emergency department, using a health promotion advocate to identify people with addiction or at risk. They used a person-centered, validated set of questions (screening) and provided early intervention (brief counseling) and referrals to treatment and social services. The pilot’s success led the hospital system to implement SBIRT for all patients. Next, local community health centers added SBIRT to the health assessment at every visit, the public schools began screening all students in grades 7 and 10, and a community drop-in center incorporated SBIRT into the intake process. Clergy and staffers at community agencies are being trained in motivational interviewing, so they can intervene early with people who seek their help. Motivational interviewing is the cornerstone of SBIRT. It’s used to engage people living with, or at risk of, a substance use disorder in assessing their own lives and taking steps toward a better future.
The community also developed other interventions to address the opioid overdose crisis, including expanding access to an overdose reversal medicine, first responder and physician training, safe disposal of prescription medications, peer education and a family support organization. The Collaborative also convenes a High-Risk Task Force to coordinate services and strategies to save lives of those at high risk for opioid related deaths or other life threatening situations. The task force brings together first responders, medical and behavioral health professionals, local officials, and shelter and social service organizations.
Gloucester’s hospital and health center staff say institutionalizing SBIRT has yielded great results: It’s been a conversation starter for substance use problems that many still consider taboo, has helped people understand addiction as a disease, and has made the staff’s work more efficient by identifying issues underlying patients’ other illnesses and prompting new treatment and referral protocols.
Overall in Gloucester, there are fewer overdose deaths and more referrals to counseling and other treatments. Whitney estimates that there are nearly 4,500 new screenings a year using SBIRT. People across the city are now openly talking about preventing addiction, breaking down the stigma and building support for prevention.
The ability to save lives and promote healthier communities clearly resonated with Learning Tour attendees who traveled to Gloucester to gain strategies for addressing substance use in their states. They peppered implementers with questions, and received commitments to trade advice. They discussed partners to engage. They brainstormed about bringing similar results to their communities – through legislation to finance and promote SBIRT, school-based screening programs and more.
Fostering this kind of cross-community learning, and supporting on-the-ground action tailored to community and consumer needs is what Community Catalyst is all about. We will be available to support these efforts, and we look forward to sharing more outcomes. Our communities deserve no less as we work to fight addiction and help young people stay on a healthy and productive path.