PP310 – Harm Reduction and the Changing Landscape of Case Management
Each day, 130 people die of opioid overdose in the United States, including six individuals daily in Massachusetts. No group has been more impacted by this crisis than homeless and vulnerably housed people, whose rates of drug overdose death are 20 times higher than those in the general population. A 2013 mortality study published in JAMA Internal Medicine identified overdose as the leading cause of death among the more than 11,000 people served by Boston Health Care for the Homeless Program (BHCHP) each year. Propelled by these findings, BHCHP swiftly implemented new strategies that incorporate harm reduction, increased outreach to a growing homeless population with substance use disorder, low-threshold engagement, and improved access to treatment. While opioid use disorders have come to the forefront as an urgent threat to the health and safety of the patients we serve, polysubstance use is also common, including alcohol and increasingly methamphetamine use.
Case management has played a critical role in extending traditional medical services during BHCHP’s response to this evolving crisis. Case managers are uniquely poised to provide care in a variety of settings, including the street, homeless shelters, primary care or emergency rooms – often specifically focusing on the increased risk for overdose during transitions from an institutional setting. Learn how the discipline at BHCHP has changed and expanded as a response to the opioid epidemic, incorporating a harm reduction framework into an existing workforce and standard of care.