Impact of Buprenorphine Inquiries and Treatment on an Urban Community Health Center

Although the number of persons receiving buprenorphine treatment is increasing, treatment availability lags behind need. This may be due, in part, to practitioners’ concern regarding their ability to provide access to large volumes of patients. An additional concern for community health centers may be that patients will come from unusually great distances, possibly disturbing their community-oriented milieu. In an observational study conducted from 2006–2008, researchers recorded all patient inquiries about, as well as all initiations of, buprenorphine treatment at a community health center in the Bronx, NY. The health center, its 6 participating physicians, and 1 participating pharmacist conducted community outreach during the study period to generate referrals.

• Of the 324 persons who made inquiries about buprenorphine treatment, 180 (56%) initiated treatment. This proportion did not change significantly over time.

• Eighty percent of persons making inquiries resided within 3 miles of the health center.

• Common referral sources included community-based organizations (32%), the community health center and its affiliated medical center (21%), the media, i.e., internet, print, and telephone hotlines (21%), family or friends (13%), drug treatment programs (8%), and other health-care facilities (4%).

Comments:

These data suggest that the volume of inquiries and new initiations of buprenorphine treatment in an urban community health center are manageable both for the center and its participating physicians. Such data may allay concerns of similar sites that they will be unable to provide access to the volume of new patients if they offer buprenorphine treatment. These findings are limited, however, by the lack of data comparing the characteristics of inquirers and initiators, by the lack of comparison of the clinic population as a whole to the subset receiving buprenorphine treatment, and by the lack of data indicating what proportion of the total clinic volume the 180 new patients receiving buprenorphine represented.

Marc N. Gourevitch, MD, MPH

Reference:

Cunningham CO, Giovanniello A, Sacajiu G, et al. Inquiries about and initiation of buprenorphine treatment in an inner-city clinic. Subst Abus. 2009;30(3):261–262.