A pilot program that offers on-demand treatment for fentanyl addiction is showing positive results, the San Francisco Department of Public Health said.
The Friday assessment came the same day that the Office of the Chief Medical Examiner said fentanyl was behind the majority of San Francisco’s 66 drug overdose deaths in May.
A “Night Navigation street care team” walks the streets of the Tenderloin every night offering immediate drug addiction treatment to unhoused people addicted to fentanyl and other opioids, the health department said.
The team can connect users in real-time with a doctor who can prescribe medication by telephone. From March to May, 440 people were put in touch with doctors, and 369 got prescriptions. About 40% of those prescriptions were filled.
Most received buprenorphine, which is as effective as methadone but more accessible, said Dr. Hillary Kunins, director of behavioral health services and mental health at the department.
Methadone can only be dispensed by a licensed opioid treatment center, while buprenorphine can be prescribed by any medical provider and picked up at a pharmacy.
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Buprenorphine is highly effective at controlling cravings, said Dr. Joanna Eveland, chief medical officer for people experiencing homelessness. However patients can experience withdrawal symptoms if they take too much, too early while they still have a strong opioid in their system, like fentanyl.
To combat this risk, the pilot program is instituting micro-dosing of buprenorphine, starting patients with a small dose and gradually increasing it each day.
Patients who accept the first prescription are given a safe place to sleep that night to ensure the prescription is filled and the medication is taken. The next morning, patients are provided a caseworker and offered a week-long shelter stay. Nearly 100 people took up the offer to stay for a week of intensive treatment.
Half of those who stayed in the week-long care went on to residential treatment or were placed in longer-term shelters or housing, the department said.
“We are seeing the impact every day in the faces of people who view the pilot for what it is: A lifeline out of addiction,” said Donna Hillard, executive director of Code Tenderloin. Code Tenderloin is an organization that aims to remove barriers that keep people from securing long-term employment. The Night Navigation street care team is staffed by Code Tenderloin in partnership with the health department.
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