Evidence map›Paper›PMID 40148731›Full record

ArticleJournal of urban health : bulletin of the New York Academy of Medicine2025

Barriers to Buprenorphine Treatment Among People Experiencing Homelessness: A Qualitative Study from the Provider Perspective.

Carmen L Masson, Kelly R Knight, Emily A Levine, Joseph A Spillane, Ya Chi Angelina Liang, Leslie W Suen, Maggie M Chen, Barry Zevin, Robert P Schwartz, Phillip O Coffin and 1 more

Abstract read
In one paragraph

Article in Journal of urban health : bulletin of the New York Academy of Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Carmen L MassonDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA. carmen.masson@ucsf.edu.
Kelly R KnightDepartment of Humanities and Social Sciences and Center for Vulnerable Populations, University of California, San Francisco, San Francisco, CA, USA.
Emily A LevineDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Joseph A SpillaneDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Ya Chi Angelina LiangDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Leslie W SuenDepartment of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Maggie M ChenDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
Barry ZevinSan Francisco Department of Public Health, San Francisco, CA, USA.
Robert P SchwartzFriends Research Institute, Los Angeles, CA, USA.
Phillip O CoffinDepartment of Medicine, University of California, San Francisco, San Francisco, CA, USA.
James L SorensenDepartment of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.

Funding

Western States Node of the National Drug Abuse Treatment Clinical Trials Network (TMS for CUD) UG1DA015815 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Keith N. Humphreys, Philip Todd Korthuis · 2015 to 2026
$24.6M
A Longitudinal Qualitative Study of Fentanyl-Stimulant Polysubstance Use Among People Experiencing Homelessness (Administrative supplement)R01DA057672 · NIDA · YALE UNIVERSITY · PI KNIGHT, KELLY RAY, MCNEIL, RYAN · 2022 to 2023
$2.7M
Midcareer K24 Award for Mentoring and Patient-Oriented ResearchK24DA042720 · NIDA · SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH · PI PHILLIP O COFFIN · 2016 to 2026
$1.6M
Enhancing buprenorphine low dose initiation (COPILOT)K23DA060329 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Leslie W. Suen · 2024 to 2026
$593k
Expanding Access to Buprenorphine Treatment among Homeless Persons with Opioid Use DisorderR21DA050038 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MASSON, CARMEN L · 2020 to 2021
$446k
AHRQ HHS K12 HS026383AHRQ HHS K12HS026383NIDA NIH HHS K23 DA060329NIDA NIH HHS K24 DA042720NIDA NIH HHS R01 DA057672NIDA NIH HHS R01DA057672NIDA NIH HHS R21 DA050038NIDA NIH HHS R21DA050038NIDA NIH HHS UG1 DA015815NIDA NIH HHS UG1DA015815
6 · The paper itself

Abstract

People experiencing homelessness (PEH) face a high risk of opioid-related deaths, yet there is limited qualitative data on the barriers encountered when accessing buprenorphine treatment for opioid use disorder (OUD). To address this gap, we interviewed 28 clinicians, outreach workers, and administrators from organizations serving PEH with OUD. Our goal was to understand the barriers and facilitators at the patient, clinic, and institutional levels and gather recommendations for improvement. Interviews, conducted via Zoom and analyzed through thematic analysis, revealed several barriers. At the patient level, themes related to barriers included knowledge and experience (e.g., limited knowledge about buprenorphine options; rejection of buprenorphine due to prior experience with precipitated withdrawal); concerns about the medication and its administration (e.g., distrust of injectable medications; concerns about treatment control, and a prolonged informed consent process for extended-release injectable buprenorphine); and challenges due to homelessness (e.g., identification requirement to access medication at pharmacies, difficulties managing buprenorphine while unsheltered). At the clinic level, themes centered around staffing (e.g., lack of training and experience in treating PEH and staffing shortages) and health care-related stigma (e.g., discriminatory attitudes toward PEH with OUD). Institutional-level themes included state-regulatory factors (e.g., practice regulations limiting clinical pharmacists' ability to prescribe buprenorphine) and access factors (e.g., stigmatization of buprenorphine prescribing, limited low-barrier buprenorphine access, and care system complexity). Recommendations included educational programs for patients and clinicians to increase understanding and reduce stigma, integrating buprenorphine treatment into non-traditional settings, and providing housing with treatment.

Indexed as

BuprenorphineHealth Services AccessibilityIll-Housed PersonsNarcotic AntagonistsOpiate Substitution TreatmentOpioid-Related DisordersAdultFemaleHumansInterviews as TopicMaleMiddle AgedQualitative ResearchBuprenorphineNarcotic AntagonistsBarriersBuprenorphineCliniciansCommunity-based providersHomelessnessOpioid use disorder

Identifiers

PMID40148731
PMCPMC12031702

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.