Low-threshold Buprenorphine Treatment in a Syringe Services Program: Program Description and Outcomes

Andrea Jakubowski, Brianna L. Norton, Benjamin T. Hayes, Brent E. Gibson, Christine Fitzsimmons, L. Synn Stern, Franklin Ramirez, Mercedes Guzman, Susan Spratt, Pia Marcus, Aaron D. Fox

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Objectives Low-threshold buprenorphine treatment aims to reduce barriers to evidence-based opioid use disorder treatment. We aimed to describe the treatment philosophy, practices, and outcomes of a low-threshold syringe services program (SSP)-based buprenorphine program developed through an SSP-academic medical center partnership. Methods We included all SSP participants who received 1 or more buprenorphine prescription from Feb 5, 2019 to October 9, 2020. We collected data on patient characteristics, substance use, buprenorphine prescriptions, and urine drug tests (UDTs). We evaluated buprenorphine treatment retention using prescription data and buprenorphine adherence using UDTs. We used 2 retention definitions: (1) percentage of patients with buprenorphine prescriptions at 30, 90, and 180 days; and (2) total percentage of days "covered" with buprenorphine prescriptions through 180 days. Results One-hundred and eighteen patients received 1 or more buprenorphine prescriptions. Patients were largely middle-aged (mean age 44, standard deviation 11), male (68%), Hispanic (31%) or Non-Hispanic Black (32%), with heroin (90%) and crack/cocaine (62%) use, and injection drug use (59%). Retention was 62%, 43%, and 31% at 30, 90, and 180 days, respectively. The median percentage of days covered with buprenorphine prescriptions through 180 days was 43% (interquartile range 8%-92%). Of the 82 patients who completed 2 or more UDTs, the median percentage of buprenorphine-positive UDTs was 71% (interquartile range 40%-100%). Conclusions In an SSP-based low-threshold buprenorphine treatment program, approximately one-third of patients continued buprenorphine treatment for 180 days or more, and buprenorphine adherence was high. SSPs can be a pathway to buprenorphine treatment for patients at high risk for opioid-related harms.

Original languageEnglish (US)
Pages (from-to)447-453
Number of pages7
JournalJournal of addiction medicine
Issue number4
StatePublished - Jul 1 2022


  • harm reduction
  • low-threshold buprenorphine treatment
  • syringe services programs

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)


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