University of New Mexico, Albuquerque, USA.
The Mountain Center, Santa Fe, USA.
Harm Reduct J. 2023 Apr 12;20(1):47. doi: 10.1186/s12954-023-00778-x.
People with Opioid Use Disorder (PWOUD) represent an underserved and marginalized population for whom treatment gaps exist. Low-barrier programs like mobile care units and street outreach programs have yielded increased access to buprenorphine and social services, however, OUD pertinent co-occurring behavioral health and medical conditions are frequently left unaddressed. A novel, tailored, comprehensive care delivery model may reduce disparities and improve access to care across a range of pathologies in this historically difficult to reach population and enhance efforts to provide universal treatment access in a harm reduction setting.
Descriptive data were collected and analyzed regarding patient demographics, retention in treatment and services rendered at a new, wrap-around, low-barrier buprenorphine clinic established at an existing harm reduction site in New Mexico between August 1, 2020, and August 31, 2021.
203 people used any service at the newly implemented program, 137 of whom specifically obtained medical and/or behavioral health care services including prescriptions for buprenorphine at least once from the physician onsite. Thirty-seven unique medical and psychiatric conditions were treated, representing a total of 565 separate encounters. The most common service utilized was buprenorphine treatment for opioid use disorder (81%), followed by treatment for post-traumatic stress disorder (62%), anxiety (44.5%) and depression (40.9%). Retention in buprenorphine treatment was 31.2% at 6 months.
An innovative, multidisciplinary, buprenorphine-centric care model, which targets a wide range of OUD pertinent pathologies while employing a harm reduction approach, can enhance utilization of these services among an underserved PWOUD population in a manner which moves our health system toward universal OUD treatment access thereby potentially reducing overdose and existing disparities.
阿片类药物使用障碍（PWOUD）患者是一个服务不足和边缘化的群体，他们存在治疗缺口。移动护理单元和街头外展计划等低门槛计划增加了丁丙诺啡和社会服务的可及性，然而，阿片类药物使用障碍相关的共病行为健康和医疗状况经常得不到解决。一种新颖的、量身定制的、全面的护理提供模式可以减少差异，并改善在这个历史上难以接触到的人群中一系列病理状况下的护理可及性，并加强在减少伤害环境中提供普遍治疗机会的努力。
收集并分析了 2020 年 8 月 1 日至 2021 年 8 月 31 日在新墨西哥州一个现有的减少伤害场所设立的一个新的、全面的、低门槛丁丙诺啡诊所的患者人口统计学、治疗保留率和服务提供情况的描述性数据。
共有 203 人使用了新实施项目的任何服务，其中 137 人专门从现场医生那里获得了至少一次的医疗和/或行为健康服务，包括丁丙诺啡处方。治疗了 37 种独特的医疗和精神疾病，共涉及 565 次单独就诊。使用最多的服务是治疗阿片类药物使用障碍的丁丙诺啡（81%），其次是治疗创伤后应激障碍（62%）、焦虑症（44.5%）和抑郁症（40.9%）。丁丙诺啡治疗的保留率为 6 个月时的 31.2%。
一种创新的、多学科的、以丁丙诺啡为中心的护理模式，针对广泛的阿片类药物使用障碍相关病理状况，同时采用减少伤害方法，可以提高服务不足的阿片类药物使用障碍患者对这些服务的利用，使我们的卫生系统朝着普遍获得阿片类药物使用障碍治疗的方向发展，从而有可能减少过量用药和现有的差异。
