San Francisco City Health Workers Helping Homeless Addicts Right on the Street

In San Francisco, city health workers are taking to the streets to find homeless people with opioid use disorder and offering them buprenorphine prescriptions on the spot. The city is spending $6 million on the program in the next two years, partly in response to a striking increase in the number of people injecting drugs on sidewalks and in other public areas. Most of the money will go toward hiring 10 new clinicians for the city’s Street Medicine Team, which already provides medical care for the homeless. Members of the team will travel around the city offering buprenorphine prescriptions to addicted homeless people, which they can fill the same day at a city-run pharmacy.

At the end of a recent yearlong pilot, about 20 of the 95 participants were still taking buprenorphine under the care of the street medicine team. Dr. Barry Zevin, the city’s medical director for Street Medicine and Shelter Health, hopes to provide buprenorphine to 250 more people through the program. That’s only a tiny fraction of the estimated 22,500 people in San Francisco who actively inject drugs, he said, but it’s a start.

Most health care for the homeless happens under the model of waiting for people to come in to a health center. But a lot of people never come in. There are a lot of mental health, substance abuse and cognitive problems in this population, a lot of chronic illness. Appointments are the enemy of homeless people. On the street there are no appointments, and no penalties or judgments for missing appointments.

Reference: https://www.nytimes.com/2018/08/18/health/san-francisco-opioid-addiction.html?action=click&module=RelatedCoverage&pgtype=Article&region=Footer
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