A comprehensive program model, including harm reduction and treatment, that focuses on a chronically homeless population that is disproportionately affected by opioid use disorder
Homeless Health Care Los Angeles (HHLCA) is a comprehensive service center for the homeless in Los Angeles. It focuses on providing substance use disorder treatment that also addresses mental health issues, takes a harm reduction approach, and is in conjunction with stable housing.
The Center for Harm Reduction, a part of HHCLA, is a community-based organization providing injection drug users with a syringe service program, overdose prevention training, medical care with a disease prevention approach, case management, and linkage to treatment. Most of the clients live in and around Skid Row, a part of Los Angeles that has one of the largest stable populations of homeless people in the United States.
One of their programs, overdose prevention training, has been described and evaluated in a peer-reviewed article. The training included strategies to prevent an opioid overdose, how to recognize an opioid overdose, the mechanism of an opioid overdose, and recommended response techniques.
This organization has successfully adapted to the coronavirus pandemic through an innovative "telephone booth" model and "coordinated pharmacy" model to connect their syringe exchange clients to medications for opioid use disorder. Preliminary results show that these models have helped maintain patient enrollment and engagement during COVID-19.
97% of the program's clients still have housing 12 months after placement and 400 lives are saved from overdose.