Magazine

Game Changers

Four innovative ideas for fixing the opioid crisis

Leonard Campanello, CeltiCare, MGH, and Jessie Gaeta are combatting the addiction problem with smarts and compassion.

Leonard Campanello, the police chief in Gloucester, Mass., Dec. 10, 2016. Believing addiction is a disease, the Gloucester Police Department has become the unusual law enforcement agency offering heroin users an alternative to prison. (Shiho Fukada/The New York Times)

SHIHO FUKADA/The New York Times/file

Gloucester Police Chief Leonard Campanello was recently honored as a “Champion of Change” at the White House.

The following article is part of our list of 2016 Game Changers. Look for full coverage of all 46 honorees on Friday.

The Massachusetts opioid crisis grew even more deadly in 2015, with 1,379 confirmed overdose deaths — up 41 percent in just two years. A community response requires help on multiple levels, from innovative law enforcement approaches to paying for treatment. These four people and programs are among those across the state answering the call.

REVOLUTIONIZING THE POLICE RESPONSE TO ADDICTION

After a string of heroin deaths in Gloucester early last year, Police Chief Leonard Campanello proposed a radical idea: Invite opioid addicts into the city’s police station for help. No one would be arrested, even if they had drugs or paraphernalia.

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Since June, more than 420 addicts have walked through the doors of the Gloucester station, where an officer alerts a volunteer “angel” familiar with addiction to offer moral support and starts calling treatment centers. The department has spent $23,000 largely from seized drug funds to help get addicts to dozens of treatment centers around the country. (When possible, treatment costs are covered by donated services and insurance.) The cost for arresting and housing those people would have been $94,000, according to police estimates.

Local businesses have started chipping in, too. The ambulance service offers a discount to take addicts to regional treatment centers, taxi companies give free rides to the airport for those entering out-of-state facilities, and pharmacies reduced the price of naloxone, used to treat overdoses.

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To spread the philosophy, Campanello teamed up with activist-businessman John Rosenthal to create the Police Assisted Addiction and Recovery Initiative, providing consulting and grants to police departments that want to help addicts. More than 100 nationwide have signed on so far, including 22 in Massachusetts.

Campanello’s groundbreaking work earned him an invitation to the White House last month, where he was honored as a “Champion of Change.”

In Gloucester, Campanello’s program seems to be making a difference. In 2014, there were 11 fatal heroin overdoses. Before the program began last year, there were five; afterward, only one. And in the first four months of this year, none.  — Katie Johnston

ASSURING GOOD TREATMENT

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Insurance companies aren’t known for embracing expensive health benefits. The less they pay in claims, the more money those insurers can keep. But at CeltiCare Health Plan of Waltham, the cost of not expanding benefits for people struggling with opioid addiction was even greater. Last year, nearly a quarter of all hospital admissions among its members were related to substance abuse.

“This is the most prevalent health issue in our population,” says Jay Gonzalez, chief executive of CeltiCare, which mostly manages care for people on Medicaid.

So, last year, CeltiCare initiated a series of steps to help members fight addiction. Significantly, the insurer removed restrictions for addiction treatment so that patients no longer needed approval before seeking detox, medication, or related services. At the same time, it introduced a new limit for doctors who prescribe opioid painkillers: They cannot give patients more than 15 days’ worth of pills without going through an extra approval process.

The goal is to spend more to treat addiction now and less on preventable hospital visits later. “The cost of the treatment is far less than if they keep ending up in the emergency room or keep ending up in inpatient treatment, because the root of the problem isn’t solved,” Gonzalez says. — Priyanka Dayal McCluskey

THE RECOVERY COACH WHO’S BEEN THERE

042832016 Chelsea Ma Recovery Coach Raina (cq) at MGH Chelsea Health Center with some in her group. As a Recovery Coach Raina facilitates a weekly support group . Boston Globe/Staff Photographer Jonathan Wiggs

Jonathan Wiggs/Globe Staff

Raina connects with patients fighting substance abuse.

There are plenty of doctors, therapists, and other health care workers at Massachusetts General Hospital ready to help people recover from drug addiction. But they probably can’t connect with patients quite like Raina can.

Raina, 35, started using heroin as a teenager and struggled with addiction for most of her life before entering treatment about three years ago. Now she draws on that experience in her new role as a recovery coach.

Raina is one of seven coaches at Mass. General helping guide patients from addiction into treatment and recovery. The coaches don’t treat medical problems but play a critical role as peer support. “I’m not here to judge them, I’m here to help them,” says Raina, who asked to withhold her last name to maintain privacy as she recovers. “I’ve been where they’ve been, so I understand what they’re going through.”

The concept is similar to that of sponsors in the Alcoholics Anonymous program, but it’s new for Mass. General, which expanded the recovery coach program last year. And the coaches don’t just meet patients in the hospital. They go to medical appointments, therapy, court — wherever the person needs support.

“The recovery coach is part of the care team,” says Martha Kane, a psychologist who is clinical director of the Center for Addiction Medicine at Mass. General. “They try to understand the patient’s perspective and report that to the doctor. The recovery coach really helps us get that patient point of view.”

So far, the coaches have worked with more than 450 patients, many of whom ended up at Mass. General after overdoses or other medical problems related to their drug addiction. The early results: Drug use, emergency room visits, and hospital stays are all decreasing for patients paired with coaches at the hospital.

But as coaches like Raina know, the path to recovery can be long and difficult. “When I meet with a patient and they tell me why they can’t get clean, I actually see myself in them. I recognize it instantly,” she says. “When I share my story with them, they think: ‘Wow.’ ” — Priyanka Dayal McCluskey

A SAFE PLACE TO SAVE LIVES

As chief medical officer at the Boston Health Care for the Homeless Program, Jessie Gaeta witnesses opioid overdoses — and deaths — so frequently that she came up with a radical idea: Why not create a safe space where drug users could ride out their highs under medical supervision? That concept became a reality in April, when SPOT, short for a Supportive Place for Observation and Treatment, opened at the Boston facility. SPOT sits at the corner of Massachusetts Avenue and Albany Street, an area infamously nicknamed “Methadone Mile.” The designated space, located in a former first-floor conference room, provides reclining chairs and is staffed by an addiction nurse and “harm reduction specialist.” The aim is to reduce the number of overdose deaths and build relationships with drug users in hopes they’ll seek treatment. People are accepted on a first-come, first-served basis and don’t have to give their names. Critics worry SPOT could enable drug use, and Gaeta is aware of that concern. But she notes that overdoses are now the leading cause of death among Boston’s homeless population. “We’re just watching deaths happen,” including on sidewalks and street corners, she says, “and our goal is to save lives.”  — Sacha Pfeiffer

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