A new study conducted by researchers at the Geisel School of Medicine analyzes data collected on the Safe Station program in Manchester, a novel opioid addiction resource gaining national acclaim.
Created in May 2016, Safe Station is operated by the Manchester City Fire Department. The program allows people struggling with opioid addiction to seek help at one of Manchester’s fire stations, where they can receive immediate assistance any time of the day or night.
The study focuses on documenting how effectively Safe Station connects those seeking help with concrete assistance. The study also collected data on the program’s sustainability and replicability, said Geisel School of Medicine psychiatry professor and director of the Dartmouth Center for Technology and Behavioral Health Lisa Marsch, the lead researcher in the study. It was funded by the National Institute on Drug Abuse, which sought a comprehensive overview of the program and the creation of a possible “implementation road map” for use in other communities, according to Marsch.
“The whole point is that when people are ready and willing to get help it’s immediately available to them,” Marsch said.
Conducted by Marsch with a team of researchers at the Center of Technology and Behavioral Health, the study compiled both quantitative data and interviews with those involved in the program from September 2017 to April 2018. Among those interviewed for the study were firefighters, healthcare professionals involved in the program and participants.
Manchester fire chief Daniel Goonan, who cofounded the program in 2016, said Safe Station was started as a response to the area’s rapidly developing opioid crisis. During the year Safe Station was first implemented, Manchester had seen an unprecedented spike in opioid overdoses, according to Goonan.
“We knew we were in the middle of something unusual,” he said.
The Safe Station model is simple: a person seeking help may stop by any of Manchester’s 10 fire stations and be immediately greeted with personnel who perform a physical evaluation. If in need of medical attention, the person may then be transported to the hospital. The stations also keep the overdose-treatment drug naloxone on site. If not in immediate danger, the person will then be connected with assessment services at Granite Pathways , a local nonprofit organization that can then refer them to more specialized organizations.
The first program of its kind in the country, the Manchester Safe Station benefits from several logistical advantages over traditional outreach programs, according to the study’s findings. Being based in the city’s fire stations allows the service to be available 24/7 with no extra cost, and firefighters, already trained as first responders, easily learn to administer assessments of drop-in participants.
Safe Station’s outreach model also has a more psychological advantage. According to Manchester policy and strategic outreach director Lauren Smith, the program is successful because people tend to trust firefighters as nonjudgmental authority figures.
“You grow up and you learn that firefighters are here to help,” she said.
Despite its simple outreach model, the Safe Station program has experienced setbacks while trying to connect individuals with effective community resources. The Geisel study documents the dissolution of Serenity Place, Safe Station’s former primary referral organization, in October of 2017. City leaders and organizers of Safe Station were forced to quickly find an alternative solution after the addiction-treatment center stopped operating due to financial insolvency.
“It was really stressful working on this for a time,” Smith said. Ultimately, program planners decided to use a network of organizations to meet participants’ varied needs instead of relying on one provider.
Safe Station now works at an even higher efficiency than before, usually assessing individuals in an average of nine minutes and assigning them to personalized treatment within two days. The program has served over 4,000 people since its inception, according to Goonan.
Despite the program’s success within the Manchester community, the Safe Station program has recently been under threat from New Hampshire’s attempt to create a more unified strategy to combat opioid addiction. Last week the state’s Department of Health and Human Services received a federal State Opioid Response grant, which will infuse $45.8 million into the state’s opioid response efforts over two years.
The plan submitted for the grant called for the creation of eight regional “hubs” in New Hampshire to provide opioid addiction resources to individuals in each area. The new state-wide network is expected to be operational by November.
While seen by many as a step forward for New Hampshire’s perennially underfunded opioid addiction response, the new model’s plan does not clearly state how the Safe Station program will be affected, Marsch said.
Goonan sees the new plan as potentially disrupting a resource that has already been proven effective.
“It’s really maddening sometimes when you stepped up when no one else had, when everyone else was still sitting at a roundtable,” he said.
Goonan said he hopes the results of the Dartmouth study will help convince lawmakers to keep the Safe Station program running in Manchester. He also hopes to use the data and individual accounts published in the study to show other municipalities across the country how the program might be implemented elsewhere. Goonan has already given presentations in over 50 cities, and a Safe Station pilot program is already underway in Nashua, Massachusetts.
Marsch says that study’s findings point to Safe Station being a valuable resource, and that no effective resource to combat opioids should be discontinued.
“We shouldn’t close any of these doors, in my opinion,” she said.
