San Francisco tests real-time opioid use prescriptions for homeless people

A new pilot program aims to connect unhoused people with prescription medication to treat fentanyl addiction via telehealth at night.

Why it matters: Medications for opioid use disorder are highly effective and can lower the risk of death by 50%, studies have shown. Though they also increase the likelihood that a person will remain in treatment , fewer than half of retail pharmacies in San Francisco carry buprenorphine .

How it works: A street care team with the San Francisco Department of Public Health provides real-time telehealth sessions with a doctor who can prescribe buprenorphine or methadone daily from 7pm to 3am.

• To ensure the prescription is filled and taken, the pilot program offers a place to sleep overnight when accommodations are available as well as medical and service support with a case worker.

State of play: In the first four weeks of the pilot in March, over 55 people started medication for opioid use disorder or entered residential treatment, officials said.

• Telehealth visits were provided for 173 people and over 134 buprenorphine prescriptions issued, with 33% of those prescriptions filled.
• The program is a partnership with several groups, including Code Tenderloin and the San Francisco Department for Homelessness and Supportive Housing.

What they're saying: Connecting people to this kind of medication is a key starting point for helping them on their path to recovery, health department director Grant Colfax said in a press release .

• "Off the streets, participants have the time, space and resources to plan their next steps toward a healthier life."

The big picture: The presence of fentanyl in the illicit drug supply has driven an increase in drug overdoses in San Francisco since 2015.

• The city recorded 810 overdose deaths in 2023 , up from 649 in 2022 . Most were due to fentanyl.
• White people made up the largest percentage of overdose deaths, which were most likely to occur among people ages 55 to 64.
• Gov. Gavin Newsom announced in October a new joint law enforcement task force that will investigate opioid-linked deaths and poisonings in the city.

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