Medication for Opioid Use Disorder in Harm Reduction Housing
“In light of increasing consideration of encampment sweeps as a policy approach to homelessness, our findings suggest that offering low-threshold housing that incorporates MOUD access in conjunction to sweeps is important.”
Research faculty and staff in the Section of General Internal Medicine—Avik Chatterjee, Andrew Rolles, and Sarah Kosakowski—recently published findings from interviews with displaced people in harm reduction housing sites set up by the City of Boston after sweeping encampments. The qualitative study was conducted in collaboration with colleagues from Brandeis University, University of Massachusetts Lowell, Brown School of Medicine, and Brown School of Public Health.
As explained in the abstract, the “sweeping of encampments is one policy approach to the growing visibility of homelessness and substance use in U.S. cities, but is associated with increased overdose deaths. In 2022, to mitigate the impacts of a sweep, the City of Boston created seven harm reduction housing (HRH) sites to accommodate displaced individuals. HRH sites offered on-site or off-site medications for opioid use disorder (MOUD).” The research team recruited residents from these HRH sites and interviewed them on their experiences with housing, the HRH site, substance use, access to services, overdose, MOUD, and more.
Analysis of the interview data revealed four themes: “(1) HRH sites afforded participants on-site access and linkages that facilitated MOUD initiation and retention; (2) when off-site, location, transportation and accessibility issues limited MOUD access; (3) MOUD prescribing policies at HRH sites were uniquely low-threshold; and (4) HRH-related MOUD engagement shaped health-related outcomes.”
The authors conclude that “an innovative harm reduction housing intervention approach with on-site MOUD or linkage to such medications may facilitate access to and retention on a life-saving treatment for a population at high risk for overdose death.”