Implementation of buprenorphine services in NYC syringe services programs: a qualitative process evaluation

Area of Science:

• Public Health
• Addiction Medicine
• Harm Reduction

Background:

• Syringe services programs (SSPs) offer a promising avenue for delivering buprenorphine treatment to individuals with opioid use disorder (OUD).
• New York City implemented a multipronged initiative in 2017 to reduce opioid overdose deaths, including funding SSPs for low-threshold buprenorphine services.

Purpose of the Study:

• To identify barriers and facilitators to implementing buprenorphine services within SSPs.
• To inform strategies for expanding access to OUD treatment in non-traditional settings.

Main Methods:

• Conducted 26 semi-structured qualitative interviews with leadership, staff, and providers across eight SSPs in NYC.
• Utilized thematic analysis to identify key themes related to program implementation.

Main Results:

• Barriers included staff knowledge gaps, hiring difficulties, philosophical tensions, and financial constraints.
• Facilitators comprised technical assistance, designated coordinators, supportive services, and telehealth.
• Challenges also stemmed from addressing participants' unmet psychosocial needs.

Conclusions:

• SSPs successfully implemented buprenorphine services beyond conventional treatment settings.
• Findings offer insights for health departments and organizations aiming to expand low-threshold buprenorphine services.
• Expanding these services is a vital strategy to combat the opioid overdose epidemic.