Low-threshold access to buprenorphine that is co-located in a syringe service program for a predominantly urban, unstably housed population in Seattle, Washington
Buprenorphine (Bupe) Pathways, an initiative of Public Health — Seattle & King County that was begun in 2017, is a program in downtown Seattle that offers low-threshold medication treatment for opioid use disorder (OUD). It is co-located with a syringe service program (SSP) and shows promise for reaching people experiencing homelessness. Low-threshold care means immediate, patient-centered access to medication treatment with fewer rules and regulations than traditional clinics that treat OUD.
An innovative feature of the Bupe Pathways program, in addition to providing low-threshold treatment, is that the program uses a harm reduction lens and is co-located with a SSP and a pharmacy. This means that clients to the SSP can immediately engage in buprenorphine treatment, without the expectation that recovery is a goal of the client. The program is based on a set of practical strategies to reduce the negative consequences of substance use or injection drug use that can lead to overdose and other drug-related harms without requiring total abstinence. Clients are also connected to social services.
Initial findings from two different sources of data show that the Bupe Pathways program may reduce opioid use and improve the health and well-being of a vulnerable and marginalized population.
More information on Bupe Pathways can be found in the news article here and the qualitative study here. The program is highlighted in the presentation here.
A large proportion of enrolled patients, mostly experiencing unstable housing, demonstrated sustained retention and reductions in opioid use.