Shifting the demand curve: the microeconomics of low barrier buprenorphine treatment.
Working in the urban primary care safety net for nearly two decades, I've personally witnessed the growing opioid dependence problem. Hell, as a physician who trained in the era of "pain as the 5t h vital sign" I had a role in creating the problem. Fortunately, I've also played an active role in the response to this public health crisis and have been providing medication assisted opioid treatment for the past several years. One of my latest projects has been working on an innovative treatment model to deliver "low barrier" buprenorphine in unique settings, including homeless support centers and needle exchange programs. This idea is supported by data out of Boston and San Francisco that by meeting people in a non-judgmental way in a setting that removes as many hurdles as possible you see similar treatment retention and engagement rates as with traditional chemical dependency programs and at lower cost. Further, by reducing heroin use, providing naloxone f
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