Psychosocial barriers may hinder expanded buprenorphine access amongst opioid use disorder patients

1. In this study, counselors reported that patients would be more likely to access buprenorphine treatment if they had access to greater social resources, such as housing or internet.

2. Counselors also report that increased screening at intake about psychosocial factors would be helpful.

Evidence Rating Level: 3 (Average)

One of the current national public health priorities is expanding access to treatment for people with opioid use disorder (OUD), which includes buprenorphine treatment. Though some research has been performed on improving access to initial buprenorphine treatment in the emergency department setting, it remains difficult to retain such patients for long-term care. Barriers to retention and treatment adherence are still poorly understood.

This study was a survey of addiction counselors (n=27) at the Denver Health’s Outpatient Behavioral Health Services clinic, which served approximately 900 patients at the time of study. Only counselors involved in OUD treatment were included. All clinic counselors received an invitation to complete a survey, and 25 of the 27 eligible counselors responded. There was no missing data. Counselors were asked about various patient attributes associated with difficulty engaging with treatment (for example, housing assistance, access to phone, transportation access, etc.) as well as the most helpful services for these patients.

Results showed a large majority (84%) of counselors noted that housing assistance was necessary. Additionally, factors such as residential treatment placement, mental health care, and access to a phone were deemed important to the counselors. They also noted that having a dedicated case manager for each patient would be helpful. This study did have several limitations, especially its focus on one clinic in an urban setting, which may not be generalizable. Nonetheless, this study was significant in suggesting there are many perceived barriers that may be currently impeding access to buprenorphine treatment for those with OUD.

Click to read the study in Journal of Addiction Medicine

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