"Now that I'm here, I actually have the stability and the time to really think about stuff like that": Perspectives on medications for opioid use disorder in low-threshold harm reduction housing.
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| Titel: | "Now that I'm here, I actually have the stability and the time to really think about stuff like that": Perspectives on medications for opioid use disorder in low-threshold harm reduction housing. |
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| Autoren: | Chatterjee A; Boston Medical Center, Boston, MA, USA; Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA. Electronic address: avc031@mail.harvard.edu., Rapisarda SS; Brandeis University, Waltham, MA, USA; School of Criminology and Justice Studies, University of Massachusetts Lowell, USA., Silcox J; Brandeis University, Waltham, MA, USA., Zaragoza S; Brandeis University, Waltham, MA, USA., Summers C; Brandeis University, Waltham, MA, USA., Rolles A; Boston Medical Center, Boston, MA, USA., Kosakowski S; Boston Medical Center, Boston, MA, USA., Green TC; Brandeis University, Waltham, MA, USA; Department of Emergency Medicine, Brown School of Medicine, Providence, RI, USA; Department of Epidemiology, Brown School of Public Health, Providence, RI, USA. |
| Quelle: | Journal of substance use and addiction treatment [J Subst Use Addict Treat] 2025 Dec; Vol. 179, pp. 209810. Date of Electronic Publication: 2025 Sep 25. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 9918541186406676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2949-8759 (Electronic) Linking ISSN: 29498759 NLM ISO Abbreviation: J Subst Use Addict Treat Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [New York] : Elsevier Inc., [2023]- |
| MeSH-Schlagworte: | Opioid-Related Disorders*/drug therapy , Harm Reduction* , Ill-Housed Persons* , Housing* , Health Services Accessibility* , Narcotic Antagonists*/therapeutic use, Humans ; Male ; Female ; Adult ; Boston ; Middle Aged ; Opiate Substitution Treatment |
| Abstract: | Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Avik Chatterjee, Sabrina S. Rapisarda, Joseph Silcox, Sofia Zaragoza, Charlie Summers, Andrew Rolles, Sarah Kosakowski, Traci C. Green reports financial support was provided by National Institute on Drug Abuse. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Sweeping of encampments is one policy approach to the growing visibility of homelessness and substance use in U.S. cities but is associated with increased overdose deaths. In 2022, to mitigate the impacts of a sweep, the City of Boston created seven harm reduction housing (HRH) sites to accommodate displaced individuals. HRH sites offered on-site or off-site medications for opioid use disorder (MOUD). As part of a broader parent study, we recruited 28 residents from HRH sites previously enrolled in a survey for semi-structured interviews, exploring their experiences with housing, the current HRH site, substance use, service access, overdose, MOUD, and more. We engaged in an inductive thematic analysis of the MOUD interview data. Four themes emerged from thematic analysis: (1) HRH sites afforded participants on-site access and linkages that facilitated MOUD initiation and retention; (2) when off-site, location, transportation and accessibility issues limited MOUD access; (3) MOUD prescribing policies at HRH sites were uniquely low-threshold; and (4) HRH-related MOUD engagement shaped health-related outcomes. Participants reported that HRH facilitated ease of access and delivery of MOUD both on and off site, raised considerations about how MOUD is accessed through HRH, and described how MOUD through HRH changed their substance use behaviors, health, and quality of life. Government entities that opt to clear encampments as a policy approach to address homelessness and substance use should also implement HRH interventions that facilitate MOUD access in conjunction. Such an approach would mitigate known harms associated with sweeps. (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.) |
| References: | J Gen Intern Med. 2017 Jun;32(6):660-666. (PMID: 28194688) J Subst Abuse Treat. 2022 Jul;138:108752. (PMID: 35277306) Health Aff (Millwood). 2025 Sep;44(9):1164-1172. (PMID: 40893075) J Subst Abuse Treat. 2021 Oct;129:108483. (PMID: 34080541) Subst Use Addctn J. 2025 Oct;46(4):1058-1063. (PMID: 40552912) Addict Sci Clin Pract. 2023 Oct 26;18(1):66. (PMID: 37884986) J Subst Use Addict Treat. 2023 Sep;152:209059. (PMID: 37207834) Health Aff Sch. 2023 Jun 20;1(1):qxad018. (PMID: 38756842) Ann Intern Med. 2018 Aug 7;169(3):137-145. (PMID: 29913516) Am J Public Health. 2017 Jul;107(7):1092-1094. (PMID: 28520496) JAMA. 2023 May 2;329(17):1478-1486. (PMID: 37036716) N Engl J Med. 2023 Jan 12;388(2):185-186. (PMID: 36630629) Front Public Health. 2020 Sep 25;8:501. (PMID: 33102413) Harm Reduct J. 2024 Feb 19;21(1):44. (PMID: 38374063) Drug Alcohol Depend. 2018 Jul 1;188:161-168. (PMID: 29778009) Soc Sci Med. 2023 Dec;339:116408. (PMID: 37980786) Int J Drug Policy. 2019 Nov;73:199-207. (PMID: 31542327) Health Aff (Millwood). 2024 Feb;43(2):218-225. (PMID: 38315933) J Subst Use Addict Treat. 2024 Apr;159:209272. (PMID: 38128649) Front Public Health. 2024 Jun 18;12:1407522. (PMID: 38957203) Addict Sci Clin Pract. 2019 May 6;14(1):20. (PMID: 31060600) Harm Reduct J. 2025 Jan 23;22(1):11. (PMID: 39849487) Drug Alcohol Depend. 2018 May 1;186:182-186. (PMID: 29604525) Drug Alcohol Depend. 2022 Jul 1;236:109497. (PMID: 35607834) JAMA Netw Open. 2022 Jan 4;5(1):e2142676. (PMID: 34994792) Addiction. 2022 Oct;117(10):2635-2648. (PMID: 35315148) Lancet. 2018 Jan 27;391(10118):285-287. (PMID: 29150199) J Health Care Poor Underserved. 2021;32(3):1145-1154. (PMID: 34421018) Harm Reduct J. 2017 May 23;14(1):30. (PMID: 28535804) |
| Grant Information: | R21 DA058581 United States DA NIDA NIH HHS |
| Contributed Indexing: | Keywords: Buprenorphine; Harm reduction housing; Low-threshold housing; Medications for opioid use disorder; Methadone; People experiencing homelessness; People who use drugs |
| Substance Nomenclature: | 0 (Narcotic Antagonists) |
| Entry Date(s): | Date Created: 20250927 Date Completed: 20251031 Latest Revision: 20251203 |
| Update Code: | 20251203 |
| PubMed Central ID: | PMC12668795 |
| DOI: | 10.1016/j.josat.2025.209810 |
| PMID: | 41015388 |
| Datenbank: | MEDLINE |
Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Avik Chatterjee, Sabrina S. Rapisarda, Joseph Silcox, Sofia Zaragoza, Charlie Summers, Andrew Rolles, Sarah Kosakowski, Traci C. Green reports financial support was provided by National Institute on Drug Abuse. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br />Sweeping of encampments is one policy approach to the growing visibility of homelessness and substance use in U.S. cities but is associated with increased overdose deaths. In 2022, to mitigate the impacts of a sweep, the City of Boston created seven harm reduction housing (HRH) sites to accommodate displaced individuals. HRH sites offered on-site or off-site medications for opioid use disorder (MOUD). As part of a broader parent study, we recruited 28 residents from HRH sites previously enrolled in a survey for semi-structured interviews, exploring their experiences with housing, the current HRH site, substance use, service access, overdose, MOUD, and more. We engaged in an inductive thematic analysis of the MOUD interview data. Four themes emerged from thematic analysis: (1) HRH sites afforded participants on-site access and linkages that facilitated MOUD initiation and retention; (2) when off-site, location, transportation and accessibility issues limited MOUD access; (3) MOUD prescribing policies at HRH sites were uniquely low-threshold; and (4) HRH-related MOUD engagement shaped health-related outcomes. Participants reported that HRH facilitated ease of access and delivery of MOUD both on and off site, raised considerations about how MOUD is accessed through HRH, and described how MOUD through HRH changed their substance use behaviors, health, and quality of life. Government entities that opt to clear encampments as a policy approach to address homelessness and substance use should also implement HRH interventions that facilitate MOUD access in conjunction. Such an approach would mitigate known harms associated with sweeps.<br /> (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.) |
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| ISSN: | 2949-8759 |
| DOI: | 10.1016/j.josat.2025.209810 |