An early evangelist for treating opioid addiction

Program director

Massachusetts State Technical Assistance Treatment Expansion of Office-based Opioid Treatment with Buprenorphine program

Boston Medical Center

Colleen LaBelle has been pushing the boundaries of how healthcare providers respond to substance-abuse disorders for many years, and as her work has expanded — along with efforts by colleagues across the country—more people now understand the science behind addiction.

LaBelle, 53, brings two decades of nursing experience to her job as program director of the Massachusetts State Technical Assistance Treatment Expansion of Office-based Opioid Treatment with Buprenorphine program. Her main goal today is giving more people addicted to opioids access to buprenorphine, an effective means of detoxification.

Massachusetts has opened 14 health centers with office-based opioid treatment programs offering patients buprenorphine along with a network of primary-care doctors, nurses and counselors. More than 9,000 people have received treatment since the current treatment model began in August 2007.

For her pioneering work meeting a critical need in the community, LaBelle has been named the winner of the inaugural Lillian Carter Exemplary Acts in Nursing Award, which will be given each year by Modern Healthcare in partnership with the Lillian Carter Center for Global Health & Social Responsibility at the Emory University School of Nursing in Atlanta.

When she worked with HIV/AIDS patients earlier in her career, LaBelle saw many people struggling with addiction who needed a path out of their dependency. After seeing the effectiveness of the new medication to treat addiction in 2003 and completing training, she seized every opportunity to spread her knowledge and ideas for treatment programs.

When she was in nursing school, addiction wasn't commonly treated as a healthcare issue. It was seen more through a lens of morality, and the treatment choices for people were limited. Treatment of addiction wasn't integrated into primary care.

“It wasn't something doctors were comfortable with,” LaBelle said.

Treatment of substance abuse can't be divorced from behavioral and physical healthcare, she said. Physical pain typically gets someone started on opioids. Mental illness can also play a role.

Opioid overuse causes chemical changes in the brain. “That's typically what drives people back to use,” she said. “They don't feel normal anymore.”

Michael Botticelli, who worked with LaBelle at his former job as director of the Bureau of Substance Abuse Services at the Massachusetts Public Health Department, said LaBelle embodies what is best about those working in the substance-abuse disorder field.

“She has been a strong advocate for expanding access to substance-use disorder treatment in primary-care settings and has backed up her advocacy with action by pioneering the Office-based Opioid Treatment program in Massachusetts,” said Botticelli, now director of the White House Office of National Drug Control Policy. “In the midst of the national opioid epidemic, Colleen has been one of our strongest and clearest voices for more action.”

In addition to significantly increasing the number of doctors in the state with waivers to prescribe buprenorphine, LaBelle said treatment sites have seen strong gains in the number of patients staying in care for 12 months or longer, rising to 67% in 2013 from 32% in 2010.

In the past few years, she has noticed more people understanding the true nature of addiction. She said politicians on both sides of the aisle now talk about treatment instead of incarceration, and fewer healthcare providers show a reluctance to take on patients suffering from addiction.

“It's been slow, but now I feel like the train has left the station,” she said.

Of course the stigma of mental illness and the lack of public understanding about substance abuse are still daunting issues, she said. But the number of recovering patients stepping forward to talk about their experiences is helping others learn and heal.

“I sometimes feel like I could talk about it until I'm blue in the face. But you hear them talk about it for five minutes and it makes a huge difference,” she said.

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