Treating opioid use disorder among homeless families can reduce hepatitis C transmission, infant drug withdrawal, and overdose, which is the leading cause of death among people experiencing homelessness. Although office-based treatment is effective for homeless patients, homelessness (especially among families) creates barriers to office-based opioid treatment, such as stigma, child care needs, or distance from an office site. To reduce barriers to treatment, the Family Team at the Boston Health Care for the Homeless Program added a shelter-based opioid treatment program to its outreach clinic at a family homeless shelter and motel. The Family Team consists of a physician, a nurse, two case managers, and a behavioral health clinician.
This article describes a small, nonrandomized, noncontrolled, retrospective study to understand the characteristics of the team’s shelter-based opioid treatment patients and early outcomes. The study relied on patient charts for all adults treated by the clinic with an opioid agonist for at least three months from August 2015 to August 2016. Although 6 percent of the clinic’s adult patients (about 40 people) have an opioid use disorder diagnosis, 11 patients received at least one prescription for buprenorphine during the study period, and 10 met the inclusion criterion of three continuous months of treatment. Researchers recorded data on patient characteristics, urine drug test results in the first and third months of treatment, and patient outcomes after the conclusion of the study.
The authors note several limitations (e.g., sample size) that make it difficult to generalize the results. But the clinic has continued operation and expanded to a new site. The authors posit that opioid treatment in family homeless shelters is feasible, especially when delivered as part of an existing, interprofessional clinic.
[For more on this story by Avik Chatterjee, Aura Obando, Erica Strickland, Ariana Nestler, Rachel Harrington-Levey, Toni Williams, and Terri LaCoursiere-Zucchero, go to https://howhousingmatters.org/...nt-homeless-parents/]
For another story on a similar topic, see Housing Affordability and Strong Communities.
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