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Low barrier addiction clinics increase access to medications to treat substance use disorders, while emphasizing harm reduction. The Harm Reduction and BRidges to Care (HRBR) Clinic is an on demand, low barrier addiction clinic that opened in October 2019. In the first three months of operation (November through January 2020), HRBR saw steadily increasing numbers of patients. Oregon saw its first case of novel coronavirus in February, and declared a state of emergency and enacted a formal “Stay at Home” order in March. That same month, the DEA announced that patients could be initiated on buprenorphine through telemedicine visits without an in-person exam. Within a week of being granted the ability to see patients virtually, HRBR had transitioned to over 90% virtual visits, while still allowing patients without technology to access in-person care. Within four weeks, the clinic expanded hours significantly, established workflows with community harm reduction partners, and was caring for patients in rural areas of the state. In response to the COVID-19 crisis, the HRBR clinic was able to quickly transition from in-person to almost completely virtual visits within a week. This rapid pivot to telemedicine significantly increased access to care for individuals seeking low-threshold treatment in multiple contexts. Overarching institutional support, grant funding and a small flexible team were critical. HRBR’s increased access and capacity were only possible with the Drug Enforcement Agency loosening restrictions around the use of telehealth for new patients. Keeping these altered regulations in place will be key to improving health and health care equity for people who use drugs, even after the pandemic subsides. Further research is needed in to whether addiction telemedicine impacts medication diversion rates, continued substance use, or provider practices.

Persons with substance use disorders face major barriers to hepatitis C virus (HCV) treatment. learn more Co-location of addiction and HCV treatment is appealing, yet there are limited data on outcomes using this model. This study evaluated HCV outcomes of patients treated with direct-acting antivirals (DAAs) by primary care providers in two sites of co-located addiction/HCV care.

The study conducted a retrospective chart review for all patients receiving DAA treatment from 2016 to 2018 at 1) a hospital-based primary care clinic with an office-based buprenorphine program, and 2) a primary care clinic within an opioid treatment program (i.e. methadone clinic). The study classified patients into 3 groups according to treatment status buprenorphine maintenance, methadone maintenance, or neither. Descriptive analyses compared patient demographics, clinical characteristics, adherence to monitoring and treatment, and the primary outcome of sustained virologic response at 12weeks (SVR12), defined as an undetectable HCV viricant comorbidities and barriers. DAA treatment should be expanded to co-located HCV and addiction settings.

Persons with substance use disorders treated with DAAs in co-located primary care and addiction treatment settings can achieve high rates of cure despite significant comorbidities and barriers. DAA treatment should be expanded to co-located HCV and addiction settings.Substance use during pregnancy is a critical public health issue that affects both the mother and the fetus. While research has assessed racial differences in treatment completion among women who are pregnant for specific types of substances, few studies have evaluated treatment completion for a variety of substances. As such, the purpose of this study was to examine racial differences in substance use treatment completion among women who are pregnant. The study derived data from the 2017 Treatment Episode Data-Discharges (TEDS-D) of the Substance Abuse and Mental Health Services Administration (SAMHSA). TEDS-D documents annual discharges from publicly funded substance use treatment programs in the United States, collected by each state and aggregated by SAMHSA. The study used Chi square tests for bivariate analyses and used logistic regression models to predict treatment completion by race and ethnicity. After accounting for other explanatory factors, Black and Hispanic women who were pregnant were significantly less likely to complete treatment compared to Whites. These differences were evident even after examining the interaction between race and substance of use. The study found no differences between Indigenous and Other race women who were pregnant and Whites. Results indicate the need to examine cultural, historical, and systemic factors that could affect lower treatment completion among Black and Hispanic women who are pregnant. Interventions should, therefore, move beyond the impact of socioeconomic factors and focus on the role of social support, external responsibilities, and the criminalizing of substance use during pregnancy.

Few studies and no theory-based scales have addressed specific barriers to substance use disorder (SUD) treatment retention. The current study, building on the Theory of Planned Behavior (TPB), sought to (a) identify those barriers that are most strongly associated with treatment retention, and most common, and (b) develop and validate a new scale of retention barriers, focusing on TPB attitude and perceived control components.

The study administered surveys to 200 participants initiating SUD treatment at a public, outpatient program in Northern California; the analytic sample (N=156) included only those not strongly coerced into treatment. Surveys included TPB-based measures of treatment barriers; other motivational readiness measures; treatment coercion and social desirability measures; and clinical severity variables and demographics. Discharge status was collected from program records.

Item and scale analyses identified three dimensions of attitudinal barriers (i.e., Low Perceived Treatment Need/Valentially useful as a screener and in future research. Results suggest that interventions to improve retention should focus strongly on concerns about the negative impacts of abstaining from alcohol and drugs on craving and quality of life.