Substance Use Disorders Initiative
David F.M. Brown, MD
There is growing evidence that treating substance use disorders in the same way we treat patients with congestive heart failure or with diabetes—with disease management programs—can make a significant difference.
Mass General President
SUDs Initiative Background & Mission
The Mass General Substance Use Disorders (SUDs) Initiative was developed in response to Community Health Needs Assessments in Chelsea, Revere and Charlestown, in which residents identified substance use, particularly opioids, as the single greatest issue in their communities. The initiative represents a collaborative effort between the following departments:
- Social Work
- The Center for Community Health Improvement
- Mass General Community Health Centers
- Boston Health Care for the Homeless Program
To accomplish the SUDs mission of improving outcomes for addiction treatment while reducing cost of care, patients must have access to evidence-based treatment that is readily available and standardized across the system. The Mass General SUDs Initiative is focused on re-designing care at all levels to meet this goal.
Key Components of the SUDs Initiative
Inpatient Addiction Consult Team – A unique, multidisciplinary consult team including peers in recovery is now available for patients with SUDs on inpatient units across Mass General. The team provides comprehensive evaluation, treatment recommendations and connections to community resources. Validated SUDs screening tools are now a part of the hospital’s standardized initial admission assessment
Bridge Clinic – A transitional outpatient addiction clinic for discharged inpatients and patients leaving the emergency department who are not yet connected to outpatient care. The Bridge Clinic provides patients with continued necessary treatment for their SUDs until appropriate community connections can be made
Recovery Coaches – Peers in recovery, located in all of Mass General’s health centers and some primary care practices, assist patients by meeting them wherever they are on their journey to recovery. These recovery coaches help patients overcome barriers to treatment, providing motivational support, and serve as key members of patients’ care teams. Learn more about recovery coaches in this Boston Globe article
Enhanced Health Center Treatment – Collaborative, multidisciplinary teams provide increased access to evidence-based treatment, including pharmacotherapy and readiness services, at the Mass General Community Health Centers of Charlestown, Chelsea and Revere, Internal Medicine Associates, and Mass General Broadway Primary Care Revere as well as the Boston Health Care for the Homeless Program. The redesign also includes the creation of collaborative multidisciplinary SUDs care teams
Prevention – Community coalitions change lives and influence policy by providing continued patient support for prevention and harm reduction
Research & Evaluation – A series of research studies we initiated evaluated the impact of the SUDs Initiative on utilization of healthcare services such as the Emergency Department, addiction severity and engagement in treatment, as well as on providers’ attitudes and clinical practice
Education & Culture Change – The SUDs Initiative uses educational opportunities to strengthen understanding, identification and treatment of SUDs within the internal Mass General community, the larger medical and psychiatric community, as well as the broader public. By helping people understand that SUDs is a chronic and, more importantly, treatable disease, we've explored and implemented an array of opportunities to inspire hope and motivation in caring for the SUDs patient population.
Addiction Medicine Fellowship at Massachusetts General Hospital
Beginning in July 2018, Mass General will have a one-year Addiction Medicine Fellowship to complement the existing Addiction Psychiatry Fellowship, and applications are now being accepted for two fellowship spots. This clinical fellowship with advanced training in addiction medicine will prepare physicians for clinical and academic careers in addiction medicine across a variety of care settings. It particularly focuses on developing and enhancing evidence-based addiction prevention and treatment services for all patients, including those vulnerable to health disparity because of poverty, race, culture, age, gender, disability or stigma.
Addiction Consult Team (ACT)
The multidisciplinary Addiction Consult Team (ACT) offers expert consultation and support for patients with moderate to severe substance use disorders (SUDs) across Mass General’s inpatient units.
The ACT comprises multiple health care experts:
- Advance Practice Registered Nurses
- Clinical Pharmacists
- Social workers with special expertise in SUDs
- Resource Specialists
- Recovery Coaches
- Patient Services Coordinators
Through a framework of strong connections between inpatient, outpatient and community-based services, we provide:
- Improved access to treatment and smooth transitions between care levels
- Standardized medical treatment for SUDs, including withdrawal management and buprenorphine and methadone initiation
- Enhanced treatment plan on discharge
- Recovery coaches who bridge inpatient and outpatient care
The Bridge Clinic
The Mass General Bridge Clinic is a transitional addiction clinic that works to stabilize patients with substance use disorders and move them into long-term, community-based treatment. The clinic provides the following services, and for more information, please call 617-643-8281:
- Addiction pharmacotherapy
- Individual and group peer support services
- Individual and group medication education
- Assistance with social services and connections to longer-term care
The West End Clinic
The West End Clinic (WEC) of Mass General is an outpatient facility for those with alcohol and drug addictions, co-occurring mental health disorders and other types of addictive behaviors. The clinic offers a wide range of outpatient therapies and medication treatment along with other resources.
Addiction Recovery Management Service
The Addiction Recovery Management Service (ARMS) specializes in supporting teenagers and young adults between the ages of 14 and 26 and their parents as they deal with their substance use and related problems. For more information or to schedule an appointment, call 617-643-4699.
The HOPE Clinic (Harnessing support for Opioid and substance use disorders in Pregnancy and Early childhood) at Massachusetts General Hospital and MassGeneral Hospital for Children provides comprehensive care for pregnant women with substance use disorder, their partners and their infants from conception through early childhood. The HOPE Clinic sees patients from 9:00 am-4:00 pm on Wednesdays on the Mass General main campus. However, the team can be reached any time during the week by phone at 617-724-4643 or by email.
Our substance use disorder work is only possible thanks to the generosity of the following organizations:
- Bank of America Charitable Foundation
- Digital Federal Credit Union for Kids
Administrative Director, SUDs Initiative
For media inquiries, please contact McKenzie Ridings in the Massachusetts General Hospital Public Affairs Office at 617-726-0274 or firstname.lastname@example.org.
Join Us for Recovery Month
Every September Mass General, led by the Substance Use Disorders Initiative, marks National Recovery Month by hosting a slate of educational events to raise awareness of prevention, treatment and recovery support services.