With rising rates of opioid addiction, inadequate opioid addiction treatment is increasingly problematic. Buprenorphine treatment can address this problem by reducing opioid use and HIV risk behaviors. Marginalized populations at high risk of acquiring and transmitting HIV, like injection drug users (IDUs), have limited access to buprenorphine treatment. Because of minimal regulations, buprenorphine treatment can be integrated into community-based settings where IDUs congregate. There is great potential for strategies that emphasize community-based buprenorphine treatment to reach marginalized populations, like IDUs. Building on our previous work in which we developed community-based strategies to improve access to HIV treatment and developed a buprenorphine induction strategy to overcome induction challenges, we believe that developing a buprenorphine treatment intervention in community-based settings is critical to improving accessible and successful opioid addiction treatment for IDUs. Thus, we propose to develop a buprenorphine treatment intervention in non-medical community-based settings to improve access to opioid addiction treatment, improve health outcomes, and reduce high-risk behaviors among IDUs. We will collaborate with two community-based organizations (CBOs) to develop, test the feasibility of, and preliminarily examine a community-based buprenorphine treatment (CBBT) intervention. We anticipate that the CBBT intervention will consist of: buprenorphine education, facilitated access to physicians, support during buprenorphine induction, and support during buprenorphine maintenance. Additionally, we anticipate that the CBBT intervention will target clients of the CBOs'syringe exchange programs, be implemented by CBOs'outreach workers, and occur in the CBOs'settings.
The specific aims are: 1) To develop a community-based buprenorphine treatment intervention. We will conduct focus groups and open-ended individual interviews with two CBOs'staff and clients to guide development of CBBT intervention components, materials, and processes. 2) To test the feasibility of implementing a community-based buprenorphine treatment intervention. We will examine feasibility by: 1) monitoring outreach workers'ability to adhere to the intervention manual;2) measuring outreach worker and client satisfaction, and 3) tracking clients who engage in the CBBT intervention. 3) To examine treatment outcomes (opioid use, HIV risk behaviors, treatment retention) of a community-based buprenorphine treatment intervention. We will compare change in opioid use and HIV risk behaviors before and 30 days after initiating buprenorphine treatment in clients who received the CBBT intervention with clients who did not. We will also compare 30-day treatment retention. If CBBT is feasible and can improve treatment outcomes, it could positively impact the opioid and HIV epidemics. Pilot data from this project will guide our R01 grant application, to conduct a large-scale rigorous study of the effectiveness of our CBBT intervention.
With increasing rates of opioid addiction, our innovative project will develop, test the feasibility of, and preliminarily examine treatment outcomes of a community-based buprenorphine treatment intervention. Ultimately, this intervention has the potential to improve access to opioid addiction treatment with buprenorphine and improve buprenorphine treatment outcomes (reduce opioid use, reduce HIV risk behaviors, and improve retention in buprenorphine treatment). This study's findings will be used to guide a large-scale study of our community-based buprenorphine treatment intervention.
|Shah, Pooja A; Cunningham, Chinazo O; Brisbane, Mia T et al. (2017) Use of Smoking Cessation Methods Among Patients Receiving Office-based Buprenorphine Maintenance Treatment. J Addict Med 11:494-497|
|Fox, Aaron D; Sohler, Nancy L; Frost, Taeko et al. (2017) Development and evaluation of a community-based buprenorphine treatment intervention. Harm Reduct J 14:23|
|Felsen, Uriel R; Bellin, Eran Y; Cunningham, Chinazo O et al. (2016) Unknown HIV Status in the Emergency Department: Implications for Expanded Testing Strategies. J Int Assoc Provid AIDS Care 15:313-9|
|Fox, Aaron D; Chamberlain, Adam; Frost, Taeko et al. (2015) Harm Reduction Agencies as a Potential Site for Buprenorphine Treatment. Subst Abus 36:155-60|
|Earnshaw, Valerie A; Smith, Laramie R; Cunningham, Chinazo O et al. (2015) Intersectionality of internalized HIV stigma and internalized substance use stigma: Implications for depressive symptoms. J Health Psychol 20:1083-9|
|Fox, Aaron D; Chamberlain, Adam; Sohler, Nancy L et al. (2015) Illicit buprenorphine use, interest in and access to buprenorphine treatment among syringe exchange participants. J Subst Abuse Treat 48:112-6|
|Nahvi, Shadi; Blackstock, Oni; Sohler, Nancy L et al. (2014) Smoking cessation treatment among office-based buprenorphine treatment patients. J Subst Abuse Treat 47:175-9|
|Starrels, Joanna L; Wu, Bryan; Peyser, Deena et al. (2014) It made my life a little easier: primary care providers' beliefs and attitudes about using opioid treatment agreements. J Opioid Manag 10:95-102|
|Bachhuber, Marcus A; Southern, William N; Cunningham, Chinazo O (2014) Profiting and providing less care: comprehensive services at for-profit, nonprofit, and public opioid treatment programs in the United States. Med Care 52:428-34|
|Felsen, Uriel R; Bellin, Eran Y; Cunningham, Chinazo O et al. (2014) Development of an electronic medical record-based algorithm to identify patients with unknown HIV status. AIDS Care 26:1318-25|
Showing the most recent 10 out of 18 publications