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Low-threshold Buprenorphine Treatment in a Syringe Services Program: Program Description and Outcomes.

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Low-threshold buprenorphine treatment provided through syringe services programs (SSPs) shows promising results. This approach effectively connects high-risk individuals with opioid use disorder treatment, demonstrating good adherence and retention rates.

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Area of Science:

  • Addiction Medicine
  • Public Health
  • Harm Reduction

Background:

  • Opioid use disorder (OUD) presents significant public health challenges.
  • Low-threshold buprenorphine treatment models aim to reduce barriers to accessing evidence-based care.
  • Syringe services programs (SSPs) are uniquely positioned to reach high-risk populations.

Purpose of the Study:

  • To describe the treatment philosophy, practices, and outcomes of a buprenorphine program integrated within an SSP.
  • To evaluate the effectiveness of a low-threshold buprenorphine treatment model developed through an SSP-academic medical center partnership.
  • To assess patient retention and adherence in an SSP-based buprenorphine program.

Main Methods:

  • Retrospective analysis of 118 patients receiving buprenorphine prescriptions from February 2019 to October 2020.
  • Data collection included patient characteristics, substance use, prescription data, and urine drug tests (UDTs).
  • Treatment retention was measured by prescription fill rates at 30, 90, and 180 days, and days covered by prescriptions. Adherence was assessed via UDTs.

Main Results:

  • Retention rates at 30, 90, and 180 days were 62%, 43%, and 31%, respectively.
  • The median percentage of days covered by buprenorphine prescriptions through 180 days was 43%.
  • Among patients with multiple UDTs, the median buprenorphine-positive UDT rate was 71%, indicating high adherence.

Conclusions:

  • An SSP-based low-threshold buprenorphine program successfully engaged a high-risk population with OUD.
  • Approximately one-third of patients maintained buprenorphine treatment for 180 days or longer.
  • SSPs serve as a vital pathway for connecting individuals with OUD to essential buprenorphine treatment, reducing opioid-related harms.