School of Medicine and Health Sciences Poster Presentations

Implementing Medication Assisted Treatment in Harm Reduction Organizations; A Review of Current Literature and Recommendations

Document Type

Poster

Abstract Category

Drug Abuse

Keywords

Opioid epidemic, substance use, medication assisted treatment, harm reduction

Publication Date

Spring 5-1-2019

Abstract

The opioid epidemic remains one of the most pressing public health issues in the United States, with 2.1 million Americans meeting the criteria for opioid use disorder (OUD). Medication assisted treatment (MAT) has been shown to be an effective long-term treatment for OUD and has demonstrated improvements on quality of life and reduction of health care utilization among people who use drugs. MAT can be successfully delivered to marginalized populations of low socioeconomic status through community-based, harm reduction agencies. Harm reduction agencies also have the benefit of being able to provide wrap-around services that can address socioeconomic factors that preclude access and adherence to treatment. However, despite the evidence, access to treatment remains difficult for marginalized communities, and barriers such as unstable housing or recent release from incarceration are associated with subsequent treatment failure. Expanding access to MAT through harm reduction agencies can provide non-judgemental, non-coercive care for marginalized individuals with OUD while addressing barriers to continued therapy. The objective of this narrative review was to investigate the current published literature on the feasibility and efficacy of offering MAT services at harm reduction organizations, particularly targeted at marginalized and vulnerable populations. We searched PubMed and MEDLINE for published literature on the feasibility and efficacy of offering MAT services at harm reduction organizations, particularly targeted at marginalized and vulnerable populations. The literature found in this review centered on three common themes. First, the literature shows that syringe exchange programs, a common service offered at harm reduction organizations, can be a means to improve access to medication assisted treatment for marginalized populations. A second theme found in the review is that familiarity with an organization can be a protective factor in retaining marginalized populations in long-term treatment, emphasizing the harm reduction principle of “meeting people where they’re at.” Finally, the literature demonstrates that harm reduction agencies and community based organizations can possibly improve retention for marginalized populations if they offer wrap-around services. With the findings of this review, we see promise in offering MAT services in harm reduction organizations. By developing treatment in familiar community environments that emphasize the principles of harm reduction, we can address treatment barriers, give patients agency in their treatment, and serve those unable or unwilling to receive care elsewhere by addressing and reducing stigma. Future studies should further examine long-term treatment outcomes of patients utilizing this integrative approach.

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Presented at Research Days 2019.

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Implementing Medication Assisted Treatment in Harm Reduction Organizations; A Review of Current Literature and Recommendations

The opioid epidemic remains one of the most pressing public health issues in the United States, with 2.1 million Americans meeting the criteria for opioid use disorder (OUD). Medication assisted treatment (MAT) has been shown to be an effective long-term treatment for OUD and has demonstrated improvements on quality of life and reduction of health care utilization among people who use drugs. MAT can be successfully delivered to marginalized populations of low socioeconomic status through community-based, harm reduction agencies. Harm reduction agencies also have the benefit of being able to provide wrap-around services that can address socioeconomic factors that preclude access and adherence to treatment. However, despite the evidence, access to treatment remains difficult for marginalized communities, and barriers such as unstable housing or recent release from incarceration are associated with subsequent treatment failure. Expanding access to MAT through harm reduction agencies can provide non-judgemental, non-coercive care for marginalized individuals with OUD while addressing barriers to continued therapy. The objective of this narrative review was to investigate the current published literature on the feasibility and efficacy of offering MAT services at harm reduction organizations, particularly targeted at marginalized and vulnerable populations. We searched PubMed and MEDLINE for published literature on the feasibility and efficacy of offering MAT services at harm reduction organizations, particularly targeted at marginalized and vulnerable populations. The literature found in this review centered on three common themes. First, the literature shows that syringe exchange programs, a common service offered at harm reduction organizations, can be a means to improve access to medication assisted treatment for marginalized populations. A second theme found in the review is that familiarity with an organization can be a protective factor in retaining marginalized populations in long-term treatment, emphasizing the harm reduction principle of “meeting people where they’re at.” Finally, the literature demonstrates that harm reduction agencies and community based organizations can possibly improve retention for marginalized populations if they offer wrap-around services. With the findings of this review, we see promise in offering MAT services in harm reduction organizations. By developing treatment in familiar community environments that emphasize the principles of harm reduction, we can address treatment barriers, give patients agency in their treatment, and serve those unable or unwilling to receive care elsewhere by addressing and reducing stigma. Future studies should further examine long-term treatment outcomes of patients utilizing this integrative approach.