A bridge to opportunity

IN 2014, THE OPIOID crisis passed two critical local milestones: Massachusetts’ fatal opioid overdose rate rose to more than double the national average; and the city of Boston lost an addiction recovery facility on Long Island, when the crumbling 63-year-old bridge to the island was condemned and closed. The island was evacuated, eliminating its 225 treatment beds and 742 beds for homeless people.

The loss of any recovery center hurts, but the loss of the Long Island treatment facility in the midst of an addiction crisis was particularly painful. The island is, for many reasons, the most promising potential site for recovery facilities of the size and scale needed to deal with the regional epidemic. It has the space to support a campus that is the centerpiece of a broad-based regional recovery effort, one that could provide comprehensive rehabilitation, counseling and practical life skills, and support.

Sufficiently secluded to provide privacy for residents and avoid objections from neighbors, it has working roads, buildings, and utilities, as well as 225 acres of mostly fields and forests and ocean views. That landscape is not just nice to look at; it’s therapeutic, as natural settings are shown to lower anxiety and depression and improve well-being, attributes that are particularly beneficial to people in recovery.

The island, coincidentally, has an almost century-and-a-half history as a refuge for the disenfranchised — single mothers, patients with tuberculosis, and the homeless. We now have an opportunity to continue its legacy of caregiving by creating a high-quality residential treatment center for the increased numbers of people with opioid disorders, a major public health challenge of the 21st century.

Massachusetts state and local officials have provided unprecedented national leadership in addressing the challenges of this epidemic. The governor has convened medical, dental, and allied health educators to develop educational programs for healthcare providers, and law enforcement has created new strategies, as well. Mayor Martin Walsh created an Office of Recovery Services, the nation’s first and only municipal recovery office, in 2015. The following year, he launched a 311 hotline to help people struggling with addiction.

Now he is proposing a recovery center that could be a cornerstone in reversing the epidemic of opioid overdoses, particularly if coupled with new innovative treatment programs. The city has committed $92 million to rebuild the bridge to Long Island over the next three years, and has allocated $1 million to study what kind of recovery facility would be most effective.

Our faculty and students at our affiliated hospital, Boston Medical Center (BMC), work on the front lines of the opioid crisis, caring for patients with use disorders and the associated medical complications. The Grayken Center for Addiction at BMC is working to empower and improve the lives of people with addiction with proven models of prevention and care. Our substantial expertise in caring for these patients makes us acutely aware of the urgent need for additional long-term specialty treatment options.

However, city officials in Quincy oppose rebuilding the bridge to Long Island, concerned that traffic to and from the island will put the town’s public safety at risk. Instead, they propose a ferry service to the island to serve any future treatment center.

Ferries are unreliable for transporting people in need of medical care. An effective recovery campus must have immediate access 24/7, year-round, to medical care. For that, a bridge is needed.

This dispute could set back the center’s development for years. The epidemic of opioid addiction has already affected too many people’s lives. While there are many details still to be determined, the Long Island Treatment Center presents far too great an opportunity. Its progress should not be delayed.

Karen H. Antman, MD, is the dean of the Boston University School of Medicine and provost of the Boston University Medical Campus.