A Novel Community-Based Buprenorphine Program

Abstract

The aims of this retrospective, descriptive study were to describe clients served by a buprenorphine program in a community-based recovery center and to present initial treatment outcomes. A record review was conducted for clients treated from July 2010 to August 2011. Client demographic, health, substance use, and treatment history data were abstracted from the records of the first 78 clients served. Buprenorphine and opiate use data were collected via urine toxicology reports, collected weekly among clients who remained enrolled in treatment. The average percentages of weeks spent opiate free and buprenorphine compliant were 83% (SD = 26%) and 95% (SD = 13%), respectively. When positive heroin toxicology and negative buprenorphine toxicology were replaced for the missing/unknown data, the average percentages of opiate-abstinent weeks and buprenorphine compliance were 60% (SD = 34%) and 74% (SD = 28%), respectively. Roughly half of all clients (49%) were successfully transitioned to continue treatment with buprenorphine in a primary care setting. Findings from this study demonstrate that buprenorphine treatment for opiate dependence can be incorporated into a community-based recovery center with high rates of opiate abstinence and treatment adherence.

Predictors of buprenorphine treatment success of opioid dependence in two Baltimore City grassroots recovery programs

“…The proximity of recovery centers to where clients live, in addition to ancillary services these centers offer, such as peer support, substance use counseling, and case management services, have potential to increase client engagement in the buprenorphine treatment program (Daniels, Salisbury-Afshar, Hoffberg, Agus, & Fingerhood, 2014). …”

“…The only eligibility requirements are being in withdrawal and expressing willingness to participate. (See Daniels et al (2014) for a more detailed description of the program).…”

“…Although there is no consensus regarding the treatment length that constitutes “success,” previous studies have defined treatment success as remaining in treatment at least 90 days (Dreifuss et al, 2013; Daniels et al, 2014; Schuman-Olivier, 2014; Drago, 2015). BHLI providers also reported observing greater treatment success for clients in program at least 90 days.…”

Challenges on the road to recovery: Exploring attitudes and experiences of clients in a community-based buprenorphine program in Baltimore City

“…In an effort to provide OUD treatment to hard-to-reach populations, the Behavioral Health Leadership Institute (BHLI), a Baltimore non-profit organization dedicated to increasing access to behavioral health services for disadvantaged populations, established the Project Connections Buprenorphine Program (PCBP) in 2010. The PCBP is a treatment program based on a low-threshold and harm reduction care model that is housed within a community-based, peer-led recovery center (Daniels, Salisbury-Afshar, Hoffberg, Agus, & Fingerhood, 2014; Krawczyk et al, 2018). Services consist of an experienced clinical team of peer advisors, nurse, doctor, and social worker as well as other recovery supports.…”

Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

“…Integrating primary medical care and medication assisted treatment using buprenorphine for opioid dependence can improve the health outcomes among people who use drugs because it provides an opportunity to address the health-related consequences of people living with HIV, particularly the health negative consequences of injection drug use [ 84 , 85 ]. Multiple models have been piloted for the integration of medication assisted treatment using buprenorphine within HIV primary care [ 86 , 87 ]. These include an on-site combination of addiction treatment/HIV specialist treatment; HIV primary care physicians prescribing buprenorphine; a nonphysician health care provider integrating medical care and substance abuse treatment services using buprenorphine; and community outreach model where buprenorphine is provided along with medical services in a mobile van or where buprenorphine is provided through a community-based recovery center.…”