Policy implications of integrating buprenorphine/naloxone treatment and HIV care

Ruth Finkelstein, Julie Netherland, Laurie Sylla, Marc Gourevitch, Adan Cajina, Laura Cheever

Research output: Contribution to journalArticle

Abstract

Researchers, practitioners, and policymakers have long recognized the potential benefits of providing integrated substance abuse and medical care services, particularly for special populations such as people living with HIV/AIDS. Buprenorphine, an office-based pharmacological treatment for opioid dependence, offers new opportunities for integrating drug treatment into HIV care settings. However, the historical separation between the drug treatment and medical care systems has resulted in a host of policy barriers. The Buprenorphine and HIV Care Evaluation and Support initiative, a multisite demonstration project to assess the feasibility and effectiveness of integrating buprenorphine/naloxone into HIV care settings, provided an opportunity to evaluate if and how policy barriers affect efforts to integrate HIV care and addiction treatment. We found that financing issues, workforce and training issues, and the operational consequences of some conceptual differences between HIV care and addiction treatment are barriers to the full integration of buprenorphine into HIV care. We recommend changes to financing and reimbursement policies, programs to strengthen the addiction treatment skills of physicians, and cross training between the fields of addiction, medicine, drug treatment, and HIV medicine. By addressing some of the policy barriers to integration, this promising new treatment can help the thousands of people living with HIV/AIDS who are also opioid dependent.

Original languageEnglish (US)
JournalJournal of Acquired Immune Deficiency Syndromes
Volume56
Issue numberSUPPL. 1
DOIs
StatePublished - Mar 1 2011

Fingerprint

HIV
Buprenorphine
Therapeutics
Opioid Analgesics
Substance-Related Disorders
Acquired Immunodeficiency Syndrome
Medicine
Naloxone Drug Combination Buprenorphine
Pharmaceutical Preparations
Research Personnel
Pharmacology
Physicians
Population

Keywords

  • buprenorphine/naloxone
  • HIV/AIDS
  • opioid treatment
  • policy
  • substance-use treatment

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Policy implications of integrating buprenorphine/naloxone treatment and HIV care. / Finkelstein, Ruth; Netherland, Julie; Sylla, Laurie; Gourevitch, Marc; Cajina, Adan; Cheever, Laura.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 56, No. SUPPL. 1, 01.03.2011.

Research output: Contribution to journalArticle

Finkelstein, Ruth ; Netherland, Julie ; Sylla, Laurie ; Gourevitch, Marc ; Cajina, Adan ; Cheever, Laura. / Policy implications of integrating buprenorphine/naloxone treatment and HIV care. In: Journal of Acquired Immune Deficiency Syndromes. 2011 ; Vol. 56, No. SUPPL. 1.
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