Expanding Access to Opioid Use Disorder Treatment: Low-Threshold Buprenorphine Dispensing via an Interprofessional...

Less than 25% of individuals with opioid use disorder access medication treatment. Lower income and segregated Black and Hispanic communities often have little to no access to services. In 2021, the Drug Enforcement Administration authorized opioid treatment programs to add mobile units to their licensure, extending treatment to disproportionately affected communities. The objectives of this study were to describe the service outcomes and buprenorphine dispensing of a mobile medical unit that leverages an interprofessional team incorporating clinical pharmacists to provide low-threshold buprenorphine and primary care in Chicago neighborhoods with high opioid overdose rates.

This retrospective cohort study was conducted via chart review for all patients seen by the mobile medical unit between July 1, 2022 and June 30, 2024. Variables collected were demographics (i.e., age, race/ethnicity, gender, and substance use history), amount of buprenorphine dispensed, and reasons that buprenorphine was not dispensed (if applicable). Descriptive statistics were used for analysis.

During the study period, 737 patients were seen for buprenorphine across 2413 visits. The average patient was a 47-year-old Black male using five bags of opioids daily via insufflation for 20 years. Over 90% (n = 591) of patients reported polysubstance use. Two-thirds of patients (67.0%, n = 494) were dispensed buprenorphine across 1219 (70.5%) visits, including 697 (57.2%) 7-day, 291 (23.9%) 2-day, and 231 (18.9%) 3-day supplies. Reasons for not directly receiving buprenorphine when it was available to dispense included: longer duration indicated (25.9%, n = 132), shorter duration indicated (8.5%, n = 43), patient required different dosing from protocol (10.4%, n = 53), suspected diversion (6.7%, n = 34), patient taking or interested in methadone (2.8%, n = 14), or other (11.0%, n = 56).

Mobile medical services with an interprofessional low-threshold approach and direct buprenorphine dispensing offer a unique opportunity to involve clinical pharmacists in life-saving treatment and recovery support for communities with limited buprenorphine access.