Buprenorphine Shared Medical Appointments for the Treatment of Opioid Dependence in a Homeless Clinic

Opioid misuse and dependence are prevalent and rising problems in the United States. Treatment with buprenorphine is a successful treatment option for individuals with opioid dependence. We describe and preliminarily evaluate a unique delivery system that provides buprenorphine treatment via a shared medical appointment. Methods: We conducted a retrospective medical record review on all 77 opioid-dependent patients referred for a buprenorphine shared medical appointment in a homeless clinic from 2010–2012. We examined retention in treatment at 12 and 24 weeks. Results: Most patients were currently homeless (61%), unemployed (92%), had an Axis I psychiatric diagnosis (81%), and had recent polysubstance use (53%). Of the 77 patients, 95% attended at least one shared medical appointment. Treatment retention at 12 and 24 weeks was 86% and 70%, respectively. Conclusions:In a patient population with complex social and mental health histories, buprenorphine treatment via a shared medical appointment had high retention rates. Findings can help guide the development of unique delivery systems to serve real-world complex patients with opioid dependence.

Publication Date: 
In press
Journal Name: 
Substance Abuse Journal