Massachusetts has an all-hands-on-deck approach to the opioid epidemic, and the most recent group to be involved is social workers. In October, the state unveiled a collaboration with the Massachusetts chapter of the National Association of Social Workers (NASW-MA) and nine schools of social work to upgrade the curriculum so that social work students are better prepared to prevent and treat substance misuse.
A working group, in a meeting with Gov. Charlie Baker, presented recommendations, which will expand a social work student’s competence when working with individuals with substance use disorders.
“Almost every front-line social worker will engage with a client struggling with substance use disorder or a family with a loved one struggling over the course of their career,” said Mary Lou Sudders, Health and Human Services Secretary (and a social worker), in announcing the plan Oct. 10. “They must be equipped with the best clinical tools to help clients navigate a path to treatment and recover.”
The Department of Health reported that the populations social workers often work with—the homeless, people with an incarceration history, and people with mental health diagnoses—are more likely to die from an opioid overdose than the rest of the population.
The core principles of social work training in addictions are broken into three categories (a more detailed description is included at the end of this article):
Primary prevention: preventing substance misuse;
Secondary prevention: caring for individuals at risk for substance use disorders; and
Tertiary prevention: managing substance use disorders as a chronic disease.
The nine participating schools of social work are Boston College, Boston University, Bridgewater State University, Salem State University, Simmons College, Smith College, Springfield College, Westfield State University and Wheelock College. Each school will fit the principles into their classes. In addition, continuing education programs will be available for current social workers.
Already working in the field
This is not to say that Massachusetts social workers aren’t already working with clients with addictions. There are 7,000 members of NASW-MA, says Jamie Klufts, association spokeswoman. “They have clients they see one-on-one, and the majority of them are working on behavioral health issues, with much of that related to addiction,” Klufts tells Addiction Professional.
The social work field is split into two main types of practice, Klufts explains. Micro-practice is clinical work involving counseling. Macro-practice is connecting people to resources, such as helping them navigate bureaucracy to get Social Security benefits. Social workers may be in private practice, or work in hospital settings or agencies such as foster care. In Massachusetts, the Department of Children and Families employs many social workers. “They work with youth who are homeless,” Klufts says.
Before the new social work principles, “There wasn’t a standardized way to talk about an approach for the field” in addressing the opioid epidemic, says Klufts. “Social workers are on the front lines—they are in the communities, they’re in agencies focusing on the opioid crisis.”
Currently, social workers do not have to have specialized training in order to treat clients with addiction, says Klufts. In fact, in many jurisdictions, neither do physicians. “That’s why the governor of Massachusetts has done a lot of work around training medical doctors,” says Klufts. “So now, it’s time to train social workers who are on the ground.” She adds, “Every social worker should be trained in addiction.”
Social workers have traits that make them well-suited to helping people with addiction, such as their mission to work with the underserved, and their focus on human relationships. Sometimes, people with addiction really need someone to talk to, not just a medication to take. Social workers don’t prescribe, or make recommendations or referrals for medications, says Klufts.
Social workers who are in private practice accept all types of insurance, and they get reimbursed for their services just like a psychiatrist or any other professional, says Klufts. Social workers on the prevention side do not get direct reimbursement, because they don’t see clients one-on-one, she says.
But social workers aren’t in the business for the money. “The social work population is traditionally underpaid for their services, with the average $35,000 [a year],” says Klufts. “This is abysmal for a master's-level clinician, but these are people who are in it for all the right reasons—they're social justice minded. They often serve the most vulnerable populations—people on Medicaid or Mass Health, which other providers might not accept.” And in Massachusetts, social workers are pleased that the governor values their work.
Alison Knopf is a freelance writer based in New York.
Core principles of social work training in addiction in Massachusetts
Primary Prevention Domain—Preventing Substance Misuse: Screening, Evaluation, and Prevention
1. Demonstrate an understanding of evidence-based prevention techniques and strategies, including community assessment, the use of data to inform prevention efforts, a focus on risk and protective factors for substance misuse, and other approaches consistent with the Strategic Prevention Framework and other evidence-based strategies.