Expanding buprenorphine treatment to people experiencing homelessness through a mobile, multidisciplinary program in an urban, underserved setting.

Autor: O'Gurek DT; Department of Family & Community Medicine, Lewis Katz School of Medicine at Temple University, 1316 W Ontario St, Philadelphia, PA 19140, United States of America; Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, 3200 N Broad St, Philadelphia, PA 19140, United States of America. Electronic address: David.ogurek@temple.edu., Jatres J; Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, 3200 N Broad St, Philadelphia, PA 19140, United States of America., Gibbs J; Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, 3200 N Broad St, Philadelphia, PA 19140, United States of America., Latham I; Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, 3200 N Broad St, Philadelphia, PA 19140, United States of America., Udegbe B; Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, 3200 N Broad St, Philadelphia, PA 19140, United States of America., Reeves K; Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, 3200 N Broad St, Philadelphia, PA 19140, United States of America.
Jazyk: angličtina
Zdroj: Journal of substance abuse treatment [J Subst Abuse Treat] 2021 Aug; Vol. 127, pp. 108342. Date of Electronic Publication: 2021 Feb 27.
DOI: 10.1016/j.jsat.2021.108342
Abstrakt: Background and Objectives: Inequities in access to buprenorphine treatment remain despite measures to increase access to treatment. "Begin the Turn," a low-barrier, multidisciplinary mobile care unit with access to outreach services, counseling, case management, and buprenorphine treatment addresses these disparities in an urban setting.
Methods: Retrospective medical record review of patients during the initial 6 months of operation abstracted patient demographics and clinical data, including 10 categories of adverse childhood experiences (ACEs) using a total number of ACEs (ACE score) and measuring scores greater than or equal to 4 given higher risk of chronic disease states at this level. The study collected data in electronic data capture tools. The study assessed retention rates at 1, 3, and 5 months.
Results: Among the 147 individuals who received care, the mean age was 39.6 years and median onset of opioid use was 21 years of age. Among study participants, 67.3% (n = 99) reported IV use, 91.9% (n = 135) reported previous experiences with addiction treatment, and 49.7% (n = 73) had previously suffered an overdose. Adverse Childhood Experiences surveys demonstrated a mean score of 4.6 (n = 141), with 63.1% (n = 89) having a score of 4 or greater. The percentages of patients retained in care at 1, 3, and 5 months were 61.2%, 36.6%, and 27.6%, respectively.
Conclusion and Scientific Significance: The program serves a population with high rates of trauma and overdose. The program can serve as a model for treatment for this population.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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