Harm Reduction Agencies as a Potential Site for Buprenorphine Treatment

Abstract

Introduction Harm reduction agencies complement addiction treatment by providing diverse services that improve the health of people who use drugs. Buprenorphine maintenance treatment (BMT) is an effective opioid addiction treatment that may be provided from flexible settings, potentially including harm reduction agencies. This study investigated attitudes toward different potential sites for BMT (harm reduction agencies, general medical clinics, and drug treatment programs) among harm reduction clients. Methods Using computer-based interviews, participants indicated preferred potential site for BMT (harm reduction agency, drug treatment program, or general medical clinic), interest in BMT by potential site, motivation for treatment, and barriers to BMT. We used multivariable logistic regression to determine factors associated with harm reduction agency preference. Results Of 102 opioid users, the most preferred potential site for BMT was a harm reduction agency (51%), while fewer preferred general medical clinics (13%), drug treatment programs (12%) or were not interested in BMT (25%). In multivariable analysis, experiencing ≥ 1 barrier to BMT was strongly associated with preferring harm reduction agencies (aOR = 3.39, 95% CI: 1.00 – 11.43). Conclusion The potential to initiate BMT at harm reduction agencies is highly favorable among harm reduction clients, especially among those experiencing barriers to BMT. Offering BMT at harm reduction agencies could improve access to treatment, but studies are needed to determine safety and efficacy of this approach.

Injection and sexual risk among people who use or inject drugs in Kampala, Uganda: An exploratory qualitative study

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