A New Approach To Opioid Treatment Comes To Cape Cod

ORLEANS – Can a new grant help close the gap in services that exist on the Cape for opioid use treatment? 

Outer Cape Health Services will use an anticipated $3.5 million in federal funding through the Substance Abuse and Mental Health Services Administration (SAMHSA) “to expand access to evidence-based treatment for opioid use disorder” in towns across the Lower and Outer Cape, the organization said in a press release.

OCHS has received initial funding of $677,045 for the first year of the five-year grant program. The organization must apply for the remaining funding each year.

Specifically, the funding kicks off the Outer Cape Recovery Access Initiative, which is designed to “integrate addiction medicine more fully into primary care while strengthening behavioral health, nursing, recovery support and community-based care coordination,” the release states.

“Basically it’s embedding addiction medicine into primary care, which is where it belongs,” Irene Hammer, OCHS’ director of development, who was instrumental in writing the SAMHSA grant, said in an interview Monday.

According to the grant, the initiative will service persons 18 years of age and older in towns from Yarmouth to Provincetown who are either diagnosed with or suspected to have opioid use disorder. The grant cites data showing that while overdoses declined by 35 percent and fatal overdoses by 25 percent on the Cape between 2023 and 2024, “the region continues to experience substantial overdose morbidity and treatment need,” according to the Massachusetts Department of Public Health.

Meanwhile, the stretch from Yarmouth to Provincetown remains underserved with respect to opioid treatment resources, OCHS says, especially in the Cape’s most rural parts.
“The 10-town service corridor extends approximately 65 miles, public transportation is limited, seasonal traffic is severe, and Provincetown is farther from a hospital than any other Massachusetts community,” the grant reads. “Patients may travel approximately 45 miles to reach an opioid treatment program.”

On Cape Cod, the profile of the addict bucks the traditional stereotypes. With an older population, Hammer said it is often senior residents on Cape who are struggling with opioid use disorder. In many cases, she said, addiction stems from people taking medicine for pain management. 

“If we can catch people early in the first indications that they’re facing pain, we’d be able to get in front of it a little bit,” she said.

OCHS expects to serve about 400 patients through the initiative in its first year, Hammer said, and 2,750 patients through the end of the initiative in year five. 

OCHS CEO Dr. Damian Archer said Monday that the grant funding will be used to set up the program, including setting up a system for program management and training staff as needed to deliver on the initiative.

“This helps pay what it costs to deliver that care and service,” he said. “Because we are not paid adequately by insurance companies. The way the system is set up, unless you’re putting bones back together after surgery, you’re not being paid well for your cognitive use and your preventative and primary care.”

Hammer said the initiative expands upon OCHS’ existing “consultive model,” where part-time clinicians are hired to treat emergent cases before passing them along to other clinicians once stabilized. OCHS, for example, has an endocrinologist who works five hours a week and a psychiatrist who works 20 hours a week to address the most severe cases in those areas of treatment.

“That same concept is going to apply here,” she said. “The program director is going to oversee everything. We’re going to have a clinician who is going to see the most challenging cases and then pass those individuals along after stabilization.”

As for insurance, Archer said that OCHS already bills for addiction treatment services within primary care, so patients won’t receive any additional out-of-pocket costs. 

  Towns on the Lower and Outer Cape have discussed the lack of resources available for opioid use disorder and other forms of addiction. More than $911,000 has been received by the towns of Orleans, Chatham, Harwich, Brewster and Dennis in opioid abatement funding since 2022, according to data presented to the Orleans select board in July. The funding comes from a successful class action lawsuit filed by then-Massachusetts Attorney General Maura Healey against opioid manufacturers and distributors.

When he first joined Outer Cape Health Services at the end of 2023, Archer said “very few clinicians” were open to treating people with opioid use disorder. Until recently, he added, clinicians needed a special license to prescribe Suboxone, which is used to treat people suffering from opioid withdrawal. Today, however, regulations have changed to allow any clinician to prescribe medicine to treat addiction.

Forecasting out five years, Archer said he’s optimistic that those in need of opioid treatment services will be taken care of more readily on the Cape.

“There’s no line, no wait,” he said. “High quality care being provided to you all the way out to Provincetown.”