Drug abuse program for homeless veterans hopes to expand nationwide

WASHINGTON — Healthcare organizations based in Boston hope to expand their clinical partnership to engage more veterans with mental health and substance use diagnoses.

The groups unveiled the initiative Thursday at the annual conference of the National Coalition for Homeless Veterans in Washington.

In a nearly three-year partnership, the Boston Health Care for the Homeless Program has set up a full-service clinic onsite at the New England Center and Home for Veterans. The clinic is a “safe and welcoming environment” where caregivers can provide case management and counseling to veterans who are struggling with mental health issues and active substance use, said Lena Asmar, director of behavior health programs at the NECHV.

Other veteran care centers “are still resistant to work with folks who use drugs in the way that we do,” Asmar said. “If they’re intoxicated, we won’t kick them out.”

Asmar told dozens of veteran affairs managers at the Grand Hyatt Hotel that the clinic applies a “harm reduction approach,” which respects the rights of patients who use illegal substances and aims to reduce negative consequences associated with drug use. Clinicians and case managers are trained in “trauma-informed care” so they all recognize the signs and symptoms of trauma and understand what veterans have gone through.

BHCHP and NECHV started the Office Based Addiction Treatment partnership in 2015 amid a rising number of opioid-related deaths among homeless veterans in the Boston area, Geren Stone, medical director of the joint facility, said.

The collaborative model of treatment provides “a lower barrier of entry” for veteran patients “in the transitional housing that are really unstable or actively using other substances,” Stone said. “We meet each week to discuss not only what’s going on and around their addiction, but also their housing process because that impacts their care.”

Stone said 75 patients have been treated since the program began; four patients died after they had either been actively in treatment or refused to participate in follow-up treatments. Currently, 26 patients are in the program.

Stone hopes the program administrators from across the country who gathered at Thursday’s workshop will replicate the clinic’s success in their home facilities.

Adam DeCiccio, a regional manager at Veterans Inc. who attended the briefing, said he agreed with the panelists that the best time to intervene with veterans is when “they are in a safe place” and “a comfortable setting.”

DeCiccio, a veteran himself, joined the U.S. Army four days before the Sept. 11 terror attacks and left the service in 2007. He said he saw other veterans struggling with opioids who were kicked out of shelters without receiving the drug abuse treatment they needed. That old way of triage “just doesn’t really work anymore,” he said.

The success of this clinic partnership is due to the way organizers create an empathetic relationship between patients and the medical team, said Steven Ward, manager of the Veterans Employment Program at Volunteers of America in Michigan, who also attended the conference.

“A relationship can be maintained,” Ward said, leading to higher chances of success.

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