TY - JOUR
KW - buprenorphine
KW - Harm Reduction
KW - polysubstance use
KW - syringe services programs
KW - unstable housing
AU - J. E. Hood
AU - C. J. Banta-Green
AU - J. S. Duchin
AU - J. Breuner
AU - W. Dell
AU - B. Finegood
AU - S. N. Glick
AU - M. Hamblin
AU - S. Holcomb
AU - D. Mosse
AU - T. Oliphant-Wells
AU - M. M. Shim
A1 - 
AB - Background: Clinic-imposed barriers can impede access to medication for opioid use disorder (MOUD). We evaluated a low-barrier buprenorphine program that is co-located with a syringe services program (SSP) in Seattle, Washington, USA. Methods: We analyzed medical record data corresponding to patients who enrolled into the buprenorphine program in its first year of operation. We used descriptive statistics and tests of association to longitudinally evaluate retention, cumulative number of days buprenorphine was prescribed, and toxicology results. Results: Demand for buprenorphine among SSP clients initially surpassed programmatic capacity. Of the 146 enrolled patients, the majority (82%) were unstably housed. Patients were prescribed buprenorphine for a median of 47 days (interquartile range [IQR] = 8-147) in the 180 days following enrollment. Between the first and sixth visits, the percentage of toxicology tests that was positive for buprenorphine significantly increased (33% to 96%, P < .0001) and other opioids significantly decreased (90% to 41%, P < .0001) and plateaued thereafter. Toxicology test results for stimulants, benzodiazepines, and barbiturates did not significantly change. Conclusions: SSP served as an effective point of entry for a low-barrier MOUD program. A large proportion of enrolled patients demonstrated sustained retention and reductions in opioid use, despite housing instability and polysubstance use.
AD - Public Health-Seattle & King County, Seattle, Washington, USA.; School of Public Health, University of Washington, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; School of Public Health, University of Washington, Seattle, Washington, USA.; School of Medicine, University of Washington, Seattle, Washington, USA.; School of Medicine, University of Washington, Seattle, Washington, USA.; Swedish Family Medicine First Hill, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; King County Department of Community and Health Services, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; School of Medicine, University of Washington, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; Public Health-Seattle & King County, Seattle, Washington, USA.; School of Medicine, University of Washington, Seattle, Washington, USA.
BT - Substance abuse
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
CP - 3
CY - United States
DO - 10.1080/08897077.2019.1635557
IS - 3
JF - Substance abuse
LA - eng
M1 - Journal Article
N2 - Background: Clinic-imposed barriers can impede access to medication for opioid use disorder (MOUD). We evaluated a low-barrier buprenorphine program that is co-located with a syringe services program (SSP) in Seattle, Washington, USA. Methods: We analyzed medical record data corresponding to patients who enrolled into the buprenorphine program in its first year of operation. We used descriptive statistics and tests of association to longitudinally evaluate retention, cumulative number of days buprenorphine was prescribed, and toxicology results. Results: Demand for buprenorphine among SSP clients initially surpassed programmatic capacity. Of the 146 enrolled patients, the majority (82%) were unstably housed. Patients were prescribed buprenorphine for a median of 47 days (interquartile range [IQR] = 8-147) in the 180 days following enrollment. Between the first and sixth visits, the percentage of toxicology tests that was positive for buprenorphine significantly increased (33% to 96%, P < .0001) and other opioids significantly decreased (90% to 41%, P < .0001) and plateaued thereafter. Toxicology test results for stimulants, benzodiazepines, and barbiturates did not significantly change. Conclusions: SSP served as an effective point of entry for a low-barrier MOUD program. A large proportion of enrolled patients demonstrated sustained retention and reductions in opioid use, despite housing instability and polysubstance use.
PP - United States
PY - 2020
SN - 1547-0164; 0889-7077
SP - 356
EP - 364
EP - 
T1 - Engaging an unstably housed population with low-barrier buprenorphine treatment at a syringe services program: Lessons learned from Seattle, Washington
T2 - Substance abuse
TI - Engaging an unstably housed population with low-barrier buprenorphine treatment at a syringe services program: Lessons learned from Seattle, Washington
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 31403907
U3 - 10.1080/08897077.2019.1635557
VL - 41
VO - 1547-0164; 0889-7077
Y1 - 2020
ER -