Mobile opioid agonist treatment and public funding expands treatment for disenfranchised opioid-dependent individuals

J Subst Abuse Treat. 2014 Apr;46(4):511-5. doi: 10.1016/j.jsat.2013.11.002. Epub 2013 Dec 2.

Abstract

The New Jersey Medication Assisted Treatment Initiative (NJ-MATI) sought to reduce barriers to treatment by providing free, opioid agonist treatment (OAT, methadone or buprenorphine) via mobile medication units (MMUs). To evaluate barriers to OAT, logistic regression was used to compare opioid dependent patients enrolled in NJ-MATI to those entering treatment at fixed-site methadone clinics or non-medication assisted treatment (non-MAT). Client demographic and clinical data were taken from an administrative database for licensed treatment providers. The MMUs enrolled a greater proportion of African-American, homeless, and uninsured individuals than the fixed-site methadone clinics. Compared to non-MAT and traditional methadone clients, NJ-MATI patients were more likely to be injection drug users and daily users but less likely to have a recent history of treatment. These observations suggest that the patient-centered policies associated with NJ-MATI increased treatment participation by high severity, socially disenfranchised patients who were not likely to receive OAT.

Keywords: Access to health care; Methadone; Mobile health services.

MeSH terms

  • Adolescent
  • Adult
  • Black or African American / statistics & numerical data
  • Buprenorphine / administration & dosage
  • Databases, Factual
  • Female
  • Financing, Government
  • Health Services Accessibility*
  • Humans
  • Ill-Housed Persons / statistics & numerical data
  • Logistic Models
  • Male
  • Medically Uninsured / statistics & numerical data
  • Methadone / administration & dosage
  • Middle Aged
  • Mobile Health Units / economics
  • Mobile Health Units / organization & administration*
  • New Jersey
  • Opiate Substitution Treatment / economics
  • Opiate Substitution Treatment / methods
  • Opioid-Related Disorders / economics
  • Opioid-Related Disorders / rehabilitation*
  • Substance Abuse, Intravenous / economics
  • Substance Abuse, Intravenous / epidemiology
  • Substance Abuse, Intravenous / rehabilitation
  • Young Adult

Substances

  • Buprenorphine
  • Methadone