A study co-led by investigators at Mass General Brigham reveals that mobile addiction services can be implemented across multiple organizations and communities to bring addiction treatment, harm reduction services and basic healthcare directly to people who use drugs, especially those disconnected from traditional care. The findings are published in the International Journal of Environmental Research and Public Health .
"Our model proved highly adaptable across different regions, and the successful deployment of new mobile teams demonstrated that street-based mobile addiction services can be effectively operated by differing entities, ranging from academic medical systems to community health centers," said senior author Elsie M. Taveras, MD, MPH, Chief Community Health and Health Equity Officer at Mass General Brigham and Executive Director of the Kraft Center for Community Health.
First launched as a single clinic in Boston in 2018, the Kraft Center's Community Care in Reach® uses mobile clinics to provide care to people at high risk of drug-related morbidity and mortality who are unhoused or at risk of losing housing. The model has grown to include six programs across Massachusetts with support from the Massachusetts Department of Public Health and the Kraft Center.
When Taveras and colleagues assessed the impact of this growth, they found that from January 1, 2022 to June 30, 2024, there were 17,887 harm reduction encounters which minimized the negative health, social and legal consequences associated with drug use. There were also 16,117 clinical encounters providing care to 4,645 individuals. Buprenorphine (a key medication for opioid use disorder) was initiated among 1,227 individuals, of whom 15% remained in buprenorphine-based treatment after 180 days. The researchers identified various challenges among the programs across the state, but all programs were able to engage hard-to-reach individuals.
"Our findings reveal that the model can be expanded to reach and serve adults with very complex needs, and that the physical presence of mobile units can offer a popular, low-barrier access point for care," said Cynthia A. Tschampl, PhD, a Senior Research Scientist at The Schneider Institutes for Health Policy and Research, Heller School for Social Policy and Management at Brandeis University.
Authorship: In addition to Taveras and Tschampl, other Mass General Brigham authors include Craig Regis, Jadyn Baptista, Madeline E. Davies and Priya Sarin Gupta. Additional authors include Jennifer J. Wicks, Dominic Hodgkin, Brittany P. Chapman, Kimberly De La Cruz, Karen Peugh, Allyson Pinkhover, Ben Plant, Sarah Mackin, Catherine E. Urquhart, Samantha Walsh, Jessie M. Gaeta and Constance Horgan.
Disclosures: Regis, Baptista, Davies, Gupta and Taveras were employed by non-profit organization Kraft Center for Community Health at Mass General Brigham. De La Cruz was employed by non-profit organization Tapestry Health. Peugh was employed by non-profit organization Lowell Community Health Center. Pinkhover was employed by non-profit organization Brockton Neighborhood Health Center. Walsh and Gaeta were employed by non-profit organization Boston Health Care for the Homeless Program. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Funding: This work was funded by the Massachusetts Department of Public Health, Bureau of Substance Addiction Services through state funding and SAMHSA, grant number (1B08TI084586-01). The Robert K. Kraft Family generously donated five of the vehicles for the mobile programs.
Paper cited: Tschampl, C., et al. "Multisite Mobile Addiction Services: Four-Year Outcomes." International Journal of Environmental Research and Public Health. DOI: 10.3390/ijerph23060756
