A mobile team offering medication treatment to people with opioid use disorder showed promise in , according to a peer-reviewed study I co-authored that was released in the September 2024 issue of the.
Author
Margaret Lowenstein
Assistant Professor of Medicine, University of Pennsylvania
The team, which includes a physician, case manager and outreach workers who have personal experiences with substance use disorder, worked out of a van parked at six sites in neighborhoods that have high rates of fatal and nonfatal overdoses. The goal was to get patients same-day prescriptions for buprenorphine, a that treats opioid use disorder. The van is operated by , a nonprofit, harm-reduction group that serves people experiencing homelessness and .
Importantly, the “,” as patients and staff call it, reached a diverse group of patients. Nearly 60% were Black and 15% were Hispanic during the period we collected our data. Most did not have a primary care doctor or mental health providers.
After their initial visit, 86% of patients completed at least one follow-up visit, and 69% completed four or more visits on the van.
When it came to linking patients to more traditional brick-and-mortar programs, such as outpatient addiction treatment programs or buprenorphine prescribed in primary care settings, success was lower. Half of patients made it to at least one outside appointment for a buprenorphine prescription, and 30% made it to two or more visits at more traditional clinic sites.
Why it matters
As an , I think a lot about how to get effective treatment to the patients who need it most.
Philadelphia has the highest overdose death rate among large U.S. cities.
The majority of people with opioid use disorder – both in Philadelphia and nationally – . Also, there are persistent racial disparities in treatment, with Black and Hispanic patients for opioid use disorder. Overdose deaths among Black Philadelphians have in recent years.
The is medication, specifically methadone and buprenorphine, which is often known by its brand name Suboxone. These medications prevent withdrawal symptoms, manage cravings for opioids and lower the risk of overdose if someone relapses. Essentially, these medicines break the disruptive cycle of addiction, allowing people to feel normal and focus on the rest of their life.
What other research is being done
A large body of research describes . These include obstacles to obtaining health insurance coverage, regulations that limit where treatment can be provided and a lack of trained treatment providers.
Additionally, many patients don’t know where to go for addiction treatment, feel poorly treated when they do get there, or are subjected to rigid and cumbersome . These requirements might include daily visits or regular counseling sessions that can make it hard to work, take care of children or attend to other life priorities.
How we do our work
The bupe bus is what’s called a low-barrier or . Low-barrier models aim to bring treatment directly to people who need it without imposing extra red tape. This approach is based on evidence that people are for opioid use disorder if they can access them rapidly, and that these medicines are effective and .
This approach is consistent with the way health care providers treat other conditions such as diabetes or high blood pressure. However, it is .
The is a short take on interesting academic work.
