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p h i l a m e d s o c  .o rg

OPINION...

The Case for Comprehensive
User Engagement Sites (CUES)
By: Jeffrey Hom, MD, MPH

The
Threat
and
Response

D

rug addiction and overdose, particularly from heroin and other opioids, is today
the greatest public health crisis facing Philadelphia, where an estimated 1,200
people died from overdoses in 2017.1 This is an increase from 907 deaths the
year before and four times the number of homicides in the city. With an overdose death
rate that far outpaces that of other major cities in the U.S., Philadelphia's life expectancy is
no longer increasing. No community or corner of the city has been spared.

Using the 18 recommendations put forth by the Mayor's Task Force to Combat the
Opioid Epidemic in Philadelphia as a blueprint, the city and its partners have taken - and
continue to take - many steps to address the crisis.2 To prevent more people from using,
misusing and becoming dependent on opioids, the city has launched media campaigns to
raise awareness among the public, and worked with prescribers to reduce overprescribing of
opioid painkillers and benzodiazepines. Insurers and health systems have both taken steps to
reduce the barriers to medication-assisted treatment and enable more people to receive care.
The Philadelphia Department of Prisons recently began initiating Medication Assisted
Treatment for inmates while they are incarcerated, a critical initiative for this high-risk
population. First responders and community organizations are using and distributing over
25,000 doses of naloxone, the lifesaving antidote to opioid overdoses. And the city is, after
extensive research and discussion with national leaders, moving forward to establish one
or more Comprehensive User Engagement Sites.
Continued on page 44

Spring 2018 : Philadelphia Medicine 43


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