Boston Medical Center has received an $89 million federal grant to participate in a nationwide research study addressing the opioid crisis, with an ambitious goal of curbing opioid deaths in a broad swath of Massachusetts by 40 percent in the next three years.
The grant from the National Institute on Drug Abuse, part of the National Institutes of Health, spans four states and totals more than $350 million. Other institutions receiving grants are Columbia University in New York, Ohio State University, and the University of Kentucky.
The funding, announced Thursday, will allow Boston Medical Center to better tailor treatment options to specific communities, said Dr. Jeffrey Samet, a principal investigator for the study and chief of general internal medicine at the center. The research will be carried out by BMC’s Grayken Center for Addiction.
“I’m excited, inspired, and daunted,” Samet said. “Mostly, I recognize that it’s a huge opportunity to work with a stellar group of investigators, a great community, and a really committed state public health department.”
Opioid-related overdoses in Massachusetts have declined the past two years, with decreases attributed to improved access to treatment and widespread use of the overdose-reversing drug naloxone, or Narcan.
But the death toll remains staggeringly high — with nearly 2,000 lives lost in 2018. The increased prevalence of synthetic fentanyl is raising alarm; the powerful painkiller was found in 90 percent of people who overdosed last year.
Samet said the opioid crisis is “about as bad” as any other public health crisis the nation has ever seen.
Boston Medical Center will work closely with 16 Massachusetts communities to determine what approaches best work for them, with the results closely monitored for effectiveness.
The communities are: Lowell, Lawrence, Brockton, North Adams, Gloucester, Holyoke, Pittsfield, Plymouth, Salem, Springfield, Weymouth, Barnstable County, Bristol County, Franklin County, Hampshire County, and Middlesex County. (Boston was not included because it already has numerous addiction programs underway.)
Half of the communities will solely implement addiction treatment that delivers medication for opioid-use disorder in a primary care setting. The other communities will receive the office-based treatment plus more holistic approaches to treatment that include community education; accelerated access to medication during hospitalization, jail, and detoxification; and prevention and intervention programs in communities and schools.
The communities will be able to pick and choose what strategies they think would be most effective for them. For example, a city with a prison might be more apt to choose programs dealing with medications for people getting out of jail.
“We are trying to see that, if you really do pull out all the stops, if you do put effort into the community therapeutic opportunities, can you take the treatment of this to a whole new level?” Samet said. “And that’s our hypothesis — that you can.”
Samet also stressed the importance of combatting the stigma associated with the addiction.
“We hope to get people to be very proud of their family, friends, or themselves that have gotten into recovery or are working to recovery,” he said.
For participating communities, the project could move them closer to a solution for the opioid-related deaths that have plagued them for years.
Franklin County, for example, has had a dedicated infrastructure for dealing with the crisis since 2013, according to Debra McLaughlin, coordinator of the Opioid Task Force for Franklin County and the North Quabbin Region. But it’s still not enough — opioid-related deaths increased 166 percent in the past year, she said.
McLaughlin said she is most excited about the grant’s potential to bring more medication-assisted treatment to the region.
“We have significant treatment deserts in our rural community,” she said. “Having the opportunity to have more access to medication-assisted treatment, including methadone, would be an incredible boost to our life-saving efforts.”
Boston Medical Center will partner with the state Department of Public Health, Boston Children’s Hospital, McLean Hospital, Massachusetts General, Baystate Medical Center, the University of Massachusetts Medical School, Tufts University, the Boston University School of Public Health, and Brandeis University.
Federal officials said they hope to use the results from the study as a blueprint for opioid addiction treatment and prevention nationwide.
“Those studies we have done before have been circumscribed in a particularly well-studied environment,” Dr. Francis Collins, director of the National Institutes of Health, said at the grant announcement in Washington, D.C.
“Reaching rural communities has been particularly challenging. This research attempts to change all that,” he said.