Goal: The goal of low-barrier buprenorphine, a new and growing model of care for opioid use disorder (OUD), is to reduce opioid overdose deaths and improve health and quality of life for all people with OUD.
Strategy: Increase access to buprenorphine for people with OUD by creating patient-centered programs that are easy to access, offer a high quality of care, and eliminate hurdles to access or stay in care for OUD.
Rationale: Medications are the front-line treatment for opioid use disorder and are underutilized.
In Washington State, data that helped motivate this model of care included:
- No significant impact of an overdose prevention intervention on people at high risk for overdose (most with opioid use disorder and homeless/unstably housed).
- Syringe service client data that indicate:
- Most people (78%) who use opioids want to stop or reduce their use,
- The number one intervention of interest is treatment medication (69%),
- The majority of respondents (59%) needed medical care and didn’t get it, often because of being treated poorly by health care providers.
Other names for this model include: Medication first; Meds First; Rapid Access; Low Threshold; Med first, more later.
Underlying this model are core beliefs about OUD:
- Addiction is not a moral failing, it is a medical condition with important psychosocial components,
- OUD is treatable,
- Medications are the front-line treatment,
- People get better,
- Relapse is expected,
- Language matters.
These beliefs guide the low-barrier model and influence how and where care is delivered.