In 2016, the Boston Health Care for the Homeless Program (BHCHP)—a health center that served over 11,000 patients last year—started a unique, on-site response to overdoses. Program staff recognized that the availability of on-site substance use disorder treatment and more traditional in-clinic engagement were not sufficiently impacting on-site overdoses, or overdoses in general. Staff and leadership then considered: Rather than being in constant crisis response mode, what if BHCHP proactively monitored people who were already sedated as a way of preventing overdose? Evidence showed that 91% of people who inject drugs said they’d be willing to use harm reduction programs, including those at highest risk of overdose. Since then, the Supportive Place for Observation and Treatment (SPOT), has become a central feature of the health center’s model of care.
Relevant Topics: Medications for opioid use disorder (MOUD), harm reduction.
