A groundbreaking program review from researchers at the University of Washington and Seattle King County Public Health found that people connected to opioid treatment through their local needle exchange were more likely to continue accessing that treatment.
The results show that literally meeting people where they are at is an effective way of engaging people in life-saving medical treatment, said Brad Finegood, strategic advisor, Public Health – Seattle & King County.
“We started to co-locate buprenorphine at the needle exchange and, lo and behold, it was a wild success,” Finegood said. “It has created a model that has really taken off.”
The review worked with 146 people who accessed the program through the needle exchange in downtown Seattle. The vast majority — 82 percent — were unstably housed. Over the course of six visits to the clinic, the percentage of toxicology tests that were positive for buprenorphine, a drug used to curb cravings for opiates, increased from 33 percent to 96 percent, and the percentage of people testing positive for other opiates dropped from 90 percent to 41 percent.
Bringing services to places where potential patients already are and helping them access treatment in the moment was key to success, Finegood said.
“Someone seizing on that moment when they are ready is really important,” Finegood said. “We know people are in different places of willingness.”
Overall, the study drove home that retention in the program was related to the number of barriers to entry. People with fewer resources have more difficulty accessing care to begin with. By taking those barriers away, people who are either homeless or unstably housed are better able to stay on a given path.
Bupe Pathways, the program involved, is itself “low barrier.” Patients were not disqualified if they tested positive for other drugs, something that made the handoff to other opioid treatment clinics less successful.
“If folks didn’t stop using, we weren’t going to stop giving them medicine,” Finegood said. “It’s like cancer. If the cancer doesn’t go away, do we stop giving them chemotherapy? If their diabetes is uncontrolled, do we stop giving them insulin? Of course we don’t.
“Not everybody has the same philosophy,” he continued.
The review is the proof of concept that the team needed to convince other treatment facilities to take up a Bupe Pathways-style model. They’ve seen interest in Washington and nationwide, Finegood said.
The results come at a time that the United States is being rocked by an opioid abuse epidemic.
Ashley Archibald is a Staff Reporter covering local government, policy and equity. Have a story idea? She can be can reached at ashleya (at) realchangenews (dot) org. Follow Ashley on Twitter @AshleyA_RC
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