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Opioid treatment program expands linkage to lifesaving care

A person uses a vending machine to dispense narcan.

To obtain the free naloxone and test strips, an individual just punches in the code on the machine, then their birth year and zip code, and the items will be dispensed.

By ELLEN GOLDBAUM

Published January 22, 2024

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Joshua J. Lynch.
“People with opioid use disorder can be reluctant to walk into a pharmacy to obtain test strips or naloxone. So we wanted the vending machines to be in different types of places, outside and always accessible. ”
Joshua J. Lynch, founder of MATTERS and clinical associate professor
Department of Emergency Medicine

MATTERS, an innovative opioid treatment program that grew out of a UB physician’s frustration with the limitations of care for patients who had overdosed, is expanding its services throughout New York State, thanks to funding from the state’s Department of Health.

With the $8 million grant — part of the opioid settlement funds distributed throughout the state last year — MATTERS is hiring additional regional outreach coordinators to expand its geographic reach, supporting “no stigma” vending machines and working with neighboring municipalities that want to model programs after MATTERS.

Critical component

“The MATTERS program makes a difference and is a critical component of the department’s ongoing efforts to expand access to harm-reduction services and end bias and discrimination surrounding opioid use disorder,” says James V. McDonald, commissioner of the New York State Department of Health. “The department welcomes the collaboration with the University at Buffalo’s opioid-treatment program and the deployment of vending machines as an innovative tool to supplement existing harm-reduction programs throughout the state.”

Starting last fall, MATTERS has installed 13 “no stigma” vending machines throughout New York State, including here in Western New York. They provide free naloxone, the overdose antidote, and free test strips for fentanyl and xylazine. The first one in Erie County is located outside the Kenmore Volunteer Fire Department, which hosts the machine; it is owned and serviced by Save the Michaels of the World, which raises awareness about drug addiction and its risks.

Other local vending machines can be found at Alba de vida on Virginia Street in Buffalo, the Save the Michaels office on Main Street in Lockport, Evergreen Health in Jamestown and Dunkirk Express in Dunkirk.

“People with opioid use disorder can be reluctant to walk into a pharmacy to obtain test strips or naloxone,” says Joshua J. Lynch, founder of MATTERS, a physician with UBMD Emergency Medicine and a clinical associate professor of emergency medicine in the Jacobs School of Medicine and Biomedical Sciences. “So, we wanted the vending machines to be in different types of places, outside and always accessible.” 

To use the machines, an individual types in the code on the outside of the machine, their birth year and zip code, and selects the items they want, which are immediately dispensed for free.

Chinazo Cunningham, commissioner of the New York State Office of Addiction Services and Supports, says OASAS is proud to partner with MATTERS in their work dedicated to serving people with substance use disorders. “The new MATTERS harm-reduction vending machine builds on OASAS efforts to expand the availability of such life-saving materials,” Cunningham says. “This is important work, and we look forward to working with MATTERS on future projects.”

Allison Brashear, vice president for health sciences at UB, dean of the Jacobs School and president of UBMD Physicians’ Group, adds the Jacobs School “is proud to be part of a larger movement working to overcome stigma, increase awareness and build a future free from addiction’s grip.”

Lynch explains the MATTERS network is based on the premise that patients must be linked to treatment promptly and they must see that they have plenty of choices.

“We know that the window of opportunity when we can intervene with a patient may only be open for a very short time,” says Lynch. “Through the many partnerships we’ve established, we developed an electronic platform where we can link a patient to their first clinic appointment within 24-48 hours pretty much anywhere in New York State.”

Patients and families are often skeptical at first.

Green indicators on the map show the locations of all of MATTERS' "no stigma" vending machines in New York State. The purple indicator shows the future location of a vending machine.

Glimpse of hope

“But when I pull up the map on the app and tell them ‘I can get you into a treatment organization near where you live within a couple of days,’ their whole demeanor changes. That’s a glimpse of hope for them,” Lynch says.

To date, MATTERS partners with over 100 hospitals throughout New York State, and with over 200 treatment organizations. “Through these organizations, we are able to offer patients over 2,000 appointment slots per week. We also partner with 1,000 pharmacies statewide, and we cover the cost of the first prescription. If you don’t have transportation, we’ll pay for your ride to your first appointment.”

Eliminating all potential barriers to treatment has contributed to the success of MATTERS.

“We’ve helped over 3,000 patients so far by linking them to treatment as soon as possible,” says Lynch, “and then we took the lessons we learned in Western New York and spread them throughout the state and beyond.”

Beyond New York

Last summer, the New Jersey Department of Health announced it was launching a pilot program based on MATTERS.

“The New Jersey Department of Health is thrilled to partner with MATTERS on a pilot program that will further our reach into communities with high racial disparities in overdoses to strengthen first responder overdose response and linkage to care,” said Kaitlan Baston, acting New Jersey commissioner of health. “Medication and harm reduction save lives, and this platform creates a statewide, coordinated mechanism for rapid referrals to medications for addiction treatment and harm-reduction services from emergency departments, EMS and other first responders. This is just the beginning, and I can’t thank our New York partners enough for making this dissemination of best practices possible.”

Allegheny County, Pennsylvania, is also implementing a program based on MATTERS, and the team is in the early stages of collaborating with the Pinellas County Department of Health in Florida.

New regions can present new issues, Lynch notes.

“Once we started referring people who were patients at New York City clinics, we found that a lot of them live in New Jersey or Pennsylvania,” he says.

The MATTERS electronic platform was developed only for use in New York State, so Lynch and his team started working toward a more sophisticated platform, allowing for interstate referrals that will be available for use nationwide. It will be designed so that it can eventually integrate telemedicine services, patient follow-up and more.