Philly residents with opioid addiction get medication from ‘bupe bus’ – creating a pathway to treatment

A mobile team providing drug treatment to people with opioid addiction has shown promising results getting patients in Philadelphia to return for follow-up visitsaccording to a peer-reviewed study I co-authored that will appear in the September 2024 issue of the Journal of Substance Abuse and Addiction Treatment.

The team, which includes a physician, case manager, and outreach workers with personal experiences with substance abuse, worked out of a van parked at six locations in neighborhoods with high rates of fatal and nonfatal overdoses. The goal was to provide patients with same-day prescriptions for buprenorphine, a life-saving medication who treats opioid use disorder. The bus is driven by Prevention Point Philadelphiaa non-profit organization that works to reduce harm and help people who are homeless and substance use disorder.

The important thing is that the “bupe busas patients and staff call it, reached a diverse group of patients. Nearly 60% were Black and 15% were Hispanic during the period we collected our data. Most did not have primary care physicians or mental health providers.

After their initial visit, 86% of patients completed at least one follow-up visit and 69% completed four or more visits on the bus.

When it came to connecting patients to more traditional brick-and-mortar programs, such as outpatient addiction treatment programs or buprenorphine prescribed in primary care, success was lower. Half of patients had at least one outside appointment for a buprenorphine prescription, and 30 percent had two or more visits to more traditional clinic locations.

Why it’s important

As a addiction doctor and researcherI think a lot about how we can provide effective treatment to the patients who need it most.

Philadelphia has the highest overdose death rate of any major U.S. city. The majority of people with opioid addiction—both in Philadelphia and nationwide—not receive treatmentThere are also persistent racial disparities in treatment, with black and Hispanic patients. less chance of drug treatment for opioid use disorder. Overdose deaths among black Philadelphians have exceeded that of white residents in recent years.

The most effective treatment for opioid addiction is a medication, specifically methadone and buprenorphine, often known by the brand name Suboxone. These medications prevent withdrawal symptoms, control opioid cravings, and reduce the risk of overdose if someone relapses. In essence, these medications break the disruptive cycle of addiction, allowing people to feel normal and focus on the rest of their lives.

What other research is being done?

A large number of studies describe barriers to addiction careExamples include barriers to obtaining health insurance, regulations that limit where treatment can be provided, and a lack of trained health care providers.

In addition, many patients do not know where to go for addiction treatment, feel mistreated once they get there, or are subjected to strict and cumbersome procedures. requirements to receive treatmentThese demands may include daily visits or regular counseling sessions, which can make it difficult to work, care for children, or pay attention to other life priorities.

How we do our work

The bupe bus is a so-called low-threshold or low-threshold model. Low-threshold models aim to bring treatment directly to the people who need it, without imposing additional bureaucracy. This approach is based on evidence that people more likely to continue taking medications for opioid addiction if they have quick access to them and that these medications are effective without intensive supervision or other requirements And whether or not people abstain from drugs.

This approach is consistent with the way health care providers treat other conditions, such as diabetes or high blood pressure. However, it is less common in substance abuse care.

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