In response to the national opioid epidemic, Oregon Health & Science University has opened a new clinic that provides same-day, walk-in access to buprenorphine, a proven medication to treat opioid use disorder.
The new clinic began operating Oct. 28 and is open weekdays from 4 to 7:30 p.m. in the Physicians Pavilion on OHSU’s Marquam Hill Campus.
The goal is to increase access to drug treatment by removing common barriers. Many treatment programs require patients to wait for an intake appointment, attend counseling sessions, or commit to abstinence from all drugs and alcohol before beginning treatment.
OHSU’s clinic is designed as an urgent response to an epidemic that is killing an average of five Oregonians every week from overdoses.
“We’ll start them on buprenorphine and continue them until we can find a place that will continue their care,” said Jessica Gregg, M.D., Ph.D., an associate professor of medicine (general internal medicine and geriatrics) in the OHSU School of Medicine, who specializes in addiction medicine. “This is such a devastating crisis, let’s just do it.”
Known as Harm Reduction and Bridges to Care, or HRBR, the clinic provides immediate, life-saving medication to people suffering from addiction while also helping each patient form a long-term plan for continuing their care at a primary or specialty clinic in their community. The clinic employs a full-time care transitions coordinator and a peer-recovery mentor, along with a part-time nurse practitioner and medical director.
“We want to provide medication, and we also want to provide connection,” Gregg said.
Right now, people with heroin or opioid use disorder turn up in hospital emergency rooms with a variety of acute medical conditions. Unfortunately, they too often leave the hospital with their broken bones set but lacking the proven medications that can treat their addiction.
The clinic follows a model developed by Massachusetts General Hospital and Boston Medical Center.
Buprenorphine, approved by the Food and Drug Administration in 2002, relieves withdrawal symptoms, cravings and pain. Also known as Suboxone, it also normalizes brain function by acting on the same target in the brain as prescription opioids or heroin. It’s one of three medicines approved by the FDA for treatment of opioid dependence, along with methadone and naltrexone.
In contrast to methadone, which must be administered daily in a clinic, patients can leave the clinic with a longer-term prescription for buprenorphine.
Gregg said the goal is to get patients started on medication and provide them with a welcoming space where staff can help connect them with ongoing care with a primary or specialty care clinic that also has the ability to prescribe buprenorphine. Prescribing buprenorphine requires clinicians to obtain a waiver under federal law.