Planned SPOT Center at 780 Albany Street

Dr. Jessie Gaeta, chief medical officer of the Boston Health Care for the Homeless Program, stands in a conference room, where the SPOT Center will be at 780 Albany Street. (Jesse Costa/WBUR)

In response to the to the city’s increase in opioid overdoses, which are magnified among people experiencing homelessness, Boston Health Care for the Homeless Program (BHCHP) is implementing a program called Supportive Place for Observation and Treatment (SPOT). The SPOT will offer engagement, support, medical monitoring, and serve as an entry way to primary care and treatment on demand for 8-10 individuals at a time who are over-sedated from the use of substances and who would otherwise be outside on a street corner, alleyway, or alone in a public bathroom, at high risk of overdose.  BHCHP anticipates serving approximately 300 people through the SPOT over the course of a year. 

Currently, we are responding to 2-5 overdoses at our main site each week, and our lobby and clinic waiting room are already places where people rest safely in the midst of recent use of substances.  The street corners nearby are similarly filled with people who are also at high risk of overdose, and who may not be engaged with providers of health care or addiction services.

The SPOT will be located at our main site, 780 Albany Street on the corner of Massachusetts Avenue  and the program will be staffed by an addiction nurse , a public health advocate who specializes in community-based harm reduction services, and peers who are in recovery themselves.

The SPOT is not a safe injection facility –injection of substances will not be permitted on-site.

The Need

The increasing prevalence of opioid use disorder and drug overdose have touched every corner of our state, and our response has been escalating in recent years. Opioid overdose emergencies continue to rise in Boston. In Boston, suspected deaths due to opioid overdose in 2015 increased by more than 50% since 2014. Each day, BHCHP’s health care teams see the devastating impact that opioid use disorder has upon the lives and health of people within its grip, particularly in the immediate vicinity of our main site, which has become an epicenter of the overdose crisis.

Overdose is the leading cause of death among people served by BHCHP and alarmingly, opioids were implicated in 81% of overdose deaths in a study of mortality among homeless people served between 2003 and 2008.

While the immediate goal is to reduce the harm associated with use of opioids and other substances in a population who lacks stable housing and supports, our ultimate goal is to help medically-complex individuals access treatment for substance use disorders on demand, including medication-assisted therapies or detoxification.

BHCHP will continuously evaluate the positive effect of the SPOT on these individuals and the surrounding community.

Listen to a November 2015 WBUR interview with Dr. Jessie Gaeta about the planned SPOT

http://commonhealth.wbur.org/2015/11/heroin-safe-spaces

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