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Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers

BACKGROUND: Access to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OU...

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Autores principales: Gittins, Rosalind, Teck, Joseph Tay Wee, Knowles, Rebecca, Clarke, Nicole, Baldacchino, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10400437/
https://www.ncbi.nlm.nih.gov/pubmed/37547196
http://dx.doi.org/10.3389/fpsyt.2023.1224376
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author Gittins, Rosalind
Teck, Joseph Tay Wee
Knowles, Rebecca
Clarke, Nicole
Baldacchino, Alexander
author_facet Gittins, Rosalind
Teck, Joseph Tay Wee
Knowles, Rebecca
Clarke, Nicole
Baldacchino, Alexander
author_sort Gittins, Rosalind
collection PubMed
description BACKGROUND: Access to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OUD such that they never reached a level of engagement that permitted opportunities to meet their healthcare or housing needs. Barriers to accessing care provision include an itinerant lifestyle, difficulties with travel at unpredictable hours, impacting upon adherence to medication regimens including daily supervised consumption. OBJECTIVES: To use a co-produced, “health at the margins” approach, to reach the sex-working population in Leeds, and support informed choices about the potential to receive buprenorphine prolonged-release injection (BPRI) as a treatment option for OUD. METHODS: BPRI was introduced using a theory of change model and improvements in sex-worker care delivery was reviewed. Strategies included buprenorphine micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based and trauma-informed approach. RESULTS: Benefits of BPRI included removal of the need for daily pharmacy visits, reducing the risk of diversion, improved medication adherence, stability and engagement with treatment and supportive services. CONCLUSION: BPRI may offer an additional option for pharmacological interventions for people with OUD where there may be increased barriers to accessing treatment for example due to sex-working. Strategies for effective BPRI include micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based approach.
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spelling pubmed-104004372023-08-05 Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers Gittins, Rosalind Teck, Joseph Tay Wee Knowles, Rebecca Clarke, Nicole Baldacchino, Alexander Front Psychiatry Psychiatry BACKGROUND: Access to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OUD such that they never reached a level of engagement that permitted opportunities to meet their healthcare or housing needs. Barriers to accessing care provision include an itinerant lifestyle, difficulties with travel at unpredictable hours, impacting upon adherence to medication regimens including daily supervised consumption. OBJECTIVES: To use a co-produced, “health at the margins” approach, to reach the sex-working population in Leeds, and support informed choices about the potential to receive buprenorphine prolonged-release injection (BPRI) as a treatment option for OUD. METHODS: BPRI was introduced using a theory of change model and improvements in sex-worker care delivery was reviewed. Strategies included buprenorphine micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based and trauma-informed approach. RESULTS: Benefits of BPRI included removal of the need for daily pharmacy visits, reducing the risk of diversion, improved medication adherence, stability and engagement with treatment and supportive services. CONCLUSION: BPRI may offer an additional option for pharmacological interventions for people with OUD where there may be increased barriers to accessing treatment for example due to sex-working. Strategies for effective BPRI include micro-induction, shared decision-making, collaborative multi-agency working and supporting a strengths-based approach. Frontiers Media S.A. 2023-07-20 /pmc/articles/PMC10400437/ /pubmed/37547196 http://dx.doi.org/10.3389/fpsyt.2023.1224376 Text en Copyright © 2023 Gittins, Teck, Knowles, Clarke and Baldacchino. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Gittins, Rosalind
Teck, Joseph Tay Wee
Knowles, Rebecca
Clarke, Nicole
Baldacchino, Alexander
Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
title Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
title_full Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
title_fullStr Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
title_full_unstemmed Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
title_short Implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
title_sort implementing buprenorphine prolonged-release injection using a health at the margins approach for transactional sex-workers
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10400437/
https://www.ncbi.nlm.nih.gov/pubmed/37547196
http://dx.doi.org/10.3389/fpsyt.2023.1224376
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