For more than 30 years, Health Care for the Homeless (HCH) programs have been effectively delivering substance use disorder services as part of primary care. Right now, the country is in the grips of a true public health crisis–a drug overdose epidemic that in 2016 claimed the lives of 64,000 people, two-thirds due to opioids. The epidemic is in all parts of the country, the importance of integrated primary and behavioral care is more clear than ever, and the mainstream health system is trying to figure out how to do what we’ve been doing for decades.
HCH programs are far ahead of their peers in understanding how substance use disorders can be addressed through whole-person care. The Council’s preliminary analysis of 2016 UDS data shows that physicians in HCH programs are 6-10 times more likely to be certified to prescribe buprenorphine as part of Medication-Assisted Treatment compared to physicians in a regular community health center program.
I think it’s fitting that Senator Elizabeth Warren, who, along with Representative Elijah Cummings, has sponsored a bill to combat the opioid crisis, has held press conferences at three HCH facilities to highlight the needs and possibilities for effective treatment–in Boston, in Cincinnati, and most recently in Baltimore (see sidebar). Their bill, the Comprehensive Addiction Resources Emergency (CARE) Act, is based on the Ryan White AIDS program and has features that are worthy of serious consideration. The allocation of resources would direct funding to the geographic areas of greatest need and to programs that are most effective, allowing communities to determine how to best implement solutions.
As those on the front lines, we should have a prominent voice as Congress is considering various legislation. Be informed, be active on this issue, and raise your voice–loudly!
Advocate with your policymakers for needed solutions on the federal, state, and local levels using the Council’s Opioid Policy Agenda endorsed by over 40 local and national organizations.