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Northeast Node to study Manchester’s Safe Station program


Photo courtesy the New Hampshire Union Leader.

New Hampshire is in the midst of an unprecedented opioid crisis. Recent CDC data from 2015 places the state second in the nation in opioid-related overdose fatalities and first in synthetic non-methadone opioid (fentanyl)-related overdose fatalities per capita. More New Hampshirites die every year from opioid overdoses than residents of every other state in the nation. The state also has one of the lowest treatment availability rates in the nation (for more on this and New Hampshire’s problem, see the Rapid HotSpot Phase I and Phase II studies the Node conducted). People who need help treating their opioid use disorders have limited resources available to them. To combat this problem in the state’s largest city, the Manchester Fire Department created Safe Station, a connection to recovery program that allows users to ask for help and get it immediately. No waiting lists, no multi-visit process, just access to treatment when people need and want it most.

The Northeast Node of the National Drug Abuse Treatment Clinical Trials Network, alongside the Dartmouth Center for Technology and Behavioral Health (CTBH), has been awarded funds to evaluate the Safe Station program’s function, impact, sustainability, and replicability (how it works, how it’s maintained, and how it can be replicated in other cities).

Safe Station is a community-based response focused on reducing barriers to accessing resources and providing a safe community for people with substance use problems. Anybody with a substance use problem can walk into one of the 10 Manchester fire stations at any time of day or night to seek assistance. Fire department personnel immediately assess each person’s vital signs. If it is determined that an individual needs immediate medical attention, such as for an overdose, they are provided with naloxone and/or transported to a local emergency department. Individuals interested in connecting with a substance use disorder treatment program are often transported to a program within minutes of entering the fire station. You can learn more about Safe Station by viewing our Science Series presentation by Christopher Hickey, the creator of the program.

From the program’s inception in May of 2016 to August of 2017, more than 2,000 people have sought help from Safe Station. This innovative program has generated significant national interest and is increasingly attracting individuals from across the nation, including Maine, Vermont, Massachusetts, Connecticut, Alabama, Nevada, Oregon, Florida, Kentucky, Pennsylvania, and Arizona.

Additionally, several fire departments in cities and states across the country (e.g. New York City, Los Angeles, Pennsylvania, Maryland) have contacted Manchester Safe Station to understand and implement this model of care in their own communities.

The goals of this study are to conduct a systematic evaluation of the novel Safe Station program, to characterize the multi-organizational partnership and workflow of the program, and to identify the active ingredients in this model that are engaging, effective, replicable, and sustainable. Researchers from the Node and CTBH will use a mixed-methods study design that incorporates observational methods, quantitative implementation metrics, and qualitative interviews with consumers of Safe Station, leadership and staff at Safe Station Sites, Serenity Place, and local emergency departments.

This is an unprecedented research opportunity to inform how a novel community-initiated response to the opioid crisis in New Hampshire could scale to respond to the national opioid crisis. Given that rates of opioid overdose continue to rapidly increase nationally and that drug overdose is now the leading cause of death of Americans under age 50, this research could inform novel, effective and disruptive solutions to tackling this urgent national crisis.