A recent report issued by the Centers for Disease Control and Prevention and the Food and Drug Administration showed the rate of heroin overdose deaths skyrocketed 286 percent between 2002 and 2013. While pharmacological treatment exists for opioid use disorders, there are numerous barriers to access treatment, including the lack of physicians licensed to prescribe, providers who do not take insurance, waiting lists, and proximity to sites offering treatment.
To address barriers and improve patient access, providers at Boston Medical Center, in collaboration with the Massachusetts Department of Public Health, developed the Collaborative Care Model of Office Based Opioid Treatment with Buprenorphine in 2003, which brought treatment into primary care. While other opioid use disorder treatments typically take place outside of a doctor's office, Office based opioid treatment-Buprenorphine has patients receive their treatment under the direction of their primary care team, similar to other complex chronic …show more content…
Twenty-six patients were excluded from exploratory analysis because they left treatment due to preexisting legal issues leading to incarceration and medical conditions unrelated to their buprenorphine treatment such as chronic pain, advanced stage AIDS and various other unrelated complications, or transferred to another office based opioid treatment program due to relocation or consolidating their care, leaving 382 patients. This group, was predominantly male (sixty six percent) and white (sixty six percent). The mean age was thirty nine years; thirty five percent were employed at admission. Co-morbidities were common; sixty six percent reported psychiatric illness and fifty percent tested positive for the hepatitis C antibody. On admission, patients were using the following: sixty percent heroin (with or without prescription opioids); seventeen percent prescription opioids exclusively; thirteen percent methadone from a maintenance program; and nine percent buprenorphine from another office based opioid treatment program. Past year use of tobacco eighty percent and cocaine forty three percent was common. Eighty-five percent reported a history of inpatient detoxification, fifty eight percent past opioid agonist maintenance treatment, ten percent current use of illicit buprenorphine; forty six percent reported a history of opioid overdose. At twelve months, fifty