Addiction Medicine Coming To San Francisco's Homeless Community

By Victoria Kim 08/21/18

The outreach program is a response to the “striking increase” in the number of people who inject drugs in public spaces.

homeless man sitting by the bay in San Francisco.

The city of San Francisco is rolling out a program that will bring buprenorphine, a medication used to treat opioid use disorder, to its homeless community. City officials say it’s time to start meeting this community where they’re at.

Back in May when the outreach program was introduced, Mayor Mark Farrell told the San Francisco Chronicle, “The consequences of standing still on this issue are unacceptable. Drug abuse is rampant on our streets, and the recipe of waiting for addicts to come into a clinic voluntarily is not working. Plain and simple. So we’re going to take a different approach.”

Dr. Barry Zevin, medical director for Street Medicine and Shelter Health, who has provided medical care to the city’s homeless community since 1991, echoed the mayor’s sentiment.

In a new interview with the New York Times, Zevin explained that meeting the homeless where they’re at may expedite the healing process, rather than waiting for them to seek help. He noted that this population, in particular, has a dire need for mental health and substance abuse services, as well as medical care.

“On the street there are no appointments, and no penalties or judgments for missing appointments,” said Zevin.

Following a yearlong pilot program, 20 out of the 95 participants were still using buprenorphine under the care of the city’s Street Medicine Team, the NYT noted.

With a two-year budget of $6 million, the program is setting out with a goal of providing buprenorphine to 250 more people—just a fraction of the estimated 22,500 injection drug users in San Francisco, but a start.

Zevin noted that there is a concern that the same-day buprenorphine prescriptions may end up being abused, but said that the city is prepared to deal with it on a case by case basis.

“I do have to worry about diversion, but I want to individualize care for each person and not say that the worry is more important than my patient in front of me, whose life is at stake,” he told the NYT.

The outreach program is a response to the “striking increase” in the number of people who inject drugs in public spaces.

“Ultimately, this is about helping these individuals, but it’s also about improving the conditions of our streets,” said Mayor Farrell.

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