Faster Paths to Treatment

An opioid urgent care center located in Boston Medical Center to quickly initiate medications for opioid use disorder

In a response to increasing opioid-related events, Faster Paths to Treatment began in 2016 as a collaboration between Boston Medical Center (BMC), the Boston Public Health Commission (BPHC), and the Massachusetts Bureau of Substance Addiction Services (BSAS) to provide better access to treatment and other services for those with opioid use disorder (OUD).

Faster Paths can be termed an opioid urgent care center, located inside a hospital that serves many of Boston’s homeless population as well as people with OUD, although the program services patients with any type of substance use disorder (SUD).

With a mission to integrate, enhance, and fill the gaps in the existing continuum of SUD patient services, Faster Paths aims to rapidly evaluate a person with SUD, initiating buprenorphine, extended-release naltrexone, or linking to an appropriate methadone clinic as clinically indicated. Next, the program, leveraging BMC’s existing SUD infrastructure, links the patient to a comprehensive network of inpatient and outpatient services that can address SUD, mental health, and medical needs. In addition, the patient will receive opioid overdose education including a naloxone rescue kit, follow up from a licensed drug and alcohol counselor, and access to both case management and recovery support services which can help address many of the social determinants of health.

Faster Paths can also serve as a bridge clinic when buprenorphine is initiated after an opioid-related event in the emergency department. An academic paper has shown that providing patients with low threshold and timely access to addiction treatment will increase the likelihood that they will engage in treatment. 

Comprehensive...can address SUD, mental health, and medical needs as well as social determinants of health. 

Continuum of Care
Treatment
Harm Reduction
Type of Evidence
Peer-reviewed
Report with evaluation
Response Approach
Comprehensive services
Early Intervention
Medications for Opioid Use Disorder
Recovery coaching
Peer-reviewed Article

Evidence of Program Effectiveness

"From July 1, 2018 to June 30, 2019 Faster Paths to Treatment OUCC had 7,160 encounters; 2,199 resulted in placement in detox and 837 of these were transported by local taxi or Uber Health. Sixty-five were placed in clinical stabilization or transitional programs. Four hundred sixty five patients were initiated on buprenorphine and 61 on naltrexone. These encounters represented service to 2,199 unique patients: 72% male, 56% white, 24% Black, and 17% Hispanic. Among them, 70% reported high rates of homelessness, 10% manic depression, 10% PTSD, and 10% incarceration in past year." Reported statistics from Fall 2019 Global and Public Health BMC Newsletter

"Our analysis included 657 patients, of whom 410 (62%) arrived to their first appointment. Among the 657 patients, 47% (308) were scheduled the same day (0 days) and 82% (252) of them were seen, 23% (151) waited 1 day (next-day) and 53% (80) of them were seen, and 30% (198) waited 2+ days and 39% (78) of them were seen. Patients were more likely to be seen when they had a same-day or next-day appointment compared to waiting 2+ days...Patients seeking MAT through a clinic that schedules same-day and next-day appointments for treatment are more likely to attend addiction appointments compared to patients who wait longer. Clinics should strive to reduce wait-times for patients seeking MAT." (Roy et al., 2020)