A primary care/multidisciplinary harm reduction clinic including opiate bridging.

Area of Science:

• Addiction Medicine
• Public Health
• Community Health Services

Background:

• Long wait times for methadone maintenance programs lead to high patient dropout rates.
• Dropout increases risks of continued illegal activities and high-risk behaviors for substance users.
• Community-based clinics face challenges in providing continuous care for patients with opioid use disorder.

Purpose of the Study:

• To describe a novel model of "bridging" patients to methadone maintenance treatment.
• To evaluate the feasibility of daily dispensing of alternative opiates for patients awaiting methadone.
• To assess the utility of a multidisciplinary team approach in managing substance-abusing patients.

Main Methods:

• A descriptive study utilizing chart reviews from 2001 to 2005.
• Inclusion of data from 104 non-injection drug users and 86 injection drug users.
• Specific focus on 43 injection drug users who received "bridging" therapy.

Main Results:

• The multidisciplinary team model, including opiate bridging, was implemented at a community clinic.
• Data from 2001-2005 charts were reviewed for patient outcomes.
• The bridging approach was applied to a cohort of injection drug users awaiting methadone treatment.

Conclusions:

• A daily dispensing model of opiates other than methadone can bridge patients to formal treatment.
• This team-based, community-based approach offers a viable option for substance abuse care.
• Further research is recommended to clarify impacts on health outcomes and service utilization.