A Mobile Buprenorphine Treatment Program for Homeless Patients With Opioid Use Disorder

Opioid use disorder treatment for people experiencing homelessness: A scoping review

“…Apartment/independent housing retention for patients placed in supportive housing vs. comparison patients was 67.7 % vs. 3 % or 13 % (both P's < 0.01). Buzza et al (2019) Oakland, CA Descriptive report Homeless individuals with OUD 21 homeless patients with OUD had been prescribed buprenorphine through this mobile program. Clinicians regularly visited homeless encampments and maintained availability during follow up.…”

“…Eight articles described and/or assessed low-threshold OAT models seeking to expand access to PEH through flexible program requirements, intensive outreach, and increased accountability ( Buzza et al, 2019 ; Carter et al, 2019 ; Godersky et al, 2019 ; Hall et al, 2014 ; Hersh et al, 2011 ; Hood et al, 2020 ; Krawczyk et al, 2019 ; Tringale et al, 2015 ). One such model known as “mobile OAT,” which involves portable OAT induction clinics and street outreach teams, better engaged PEH in care compared to clients receiving fixed-site, outpatient methadone ( Hall et al, 2014 ).…”

“…Moreover, even though retention rates for mobile programs located in San Francisco (55 % at month 1, 26 % at month 12) ( Carter et al, 2019 ) and outside the Baltimore City Jail (32 % at month 1) ( Krawczyk et al, 2019 ) were lower than those typically observed in OBOT programs, the programs addressed gaps in care by recruiting difficult-to-reach people who were predominantly vulnerably housed. Buzza et al (2019) reported a similar mobile OAT model in California involving provider visitations to homeless encampments; however, the program has not been evaluated quantitatively.…”

“…PEH experience logistical barriers and competing priorities impeding appointment and medication adherence in standard, office-based MOUD programs. Models that lower access thresholds and remove obstacles to treatment, such as mobile and street-outreach MOUD clinics ( Buzza et al, 2019 ; Carter et al, 2019 ; Hall et al, 2014 ; Krawczyk et al, 2019 ) and shelter-based treatment programs ( Chatterjee et al, 2018 , 2017 ; Doorley et al, 2017 ; Lashley, 2019 ), more successfully reached and comparably retained marginalized populations such as PEH compared to similar office-based programs. These low-barrier, accessible options are extremely important now more than ever, as the COVID-19 pandemic has substantially disrupted the availability of in-person medical appointments and OUD treatment.…”

Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs

“…Information on receipt of other recommended vaccinations among PWUD is limited [31]. With increased attention on the public health consequences associated with opioid use, and limited understanding of opioid users' vaccination behaviors, this survey was launched to expand the thinking about how to address gaps in vaccine delivery within a harm reduction context [32,33]. Using a survey of PWUD recruited from needle exchange services in three US cities, we assessed self-reported vaccination coverage, vaccination patterns, and risk factors and correlates of non-vaccination among this vulnerable population.…”