# Rapid initiation of buprenorphine/naloxone to optimize MAT utilization in Philadelphia

> **NIH ALLCDC R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $747,512

## Abstract

With nearly 10% of the City’s population estimated to have an opioid use disorder and over 1200
overdose deaths recorded in 2017, Philadelphia is an urban epicenter of the opioid epidemic in
the United States. The City has the highest rate of opioid overdose deaths of any of the largest
cities in the country and there were more than 15,000 overdose responses made by the
emergency medical services in 2017. Despite the prevalence of opioid use disorder and broad
based support for treatment expansion, approximately 20% of the City’s medication assisted
treatment capacity goes unused each year. While this treatment gap is multiply determined, the
delays embedded in the typical screening and enrollment process, distance to treatment facilities,
and the inherent ambivalence to initiate treatment among opioid dependent individuals, combine
to serve as a significant barrier to treatment engagement. The proposed 3-year effort will
evaluate a new, mobile strategy for rapid initiation of buprenorphine/naloxone, counseling, peer
support and case management as a method for linkage to long term, evidence based medication
assisted treatment. Inductions will be initiated in the individual’s home community, either on our
mobile medical facility or via home visits. The mobile team will be led by a nurse practitioner (able
to prescribe buprenorphine/naloxone in PA) and include a peer recovery specialist, and a case
manager. The team will rapidly confirm opioid use disorder, complete informed consent, and
begin induction procedures for a “transitional” (one month) course of treatment with
buprenorphine/naloxone. During this time, the team will work with the participant to become
engaged in existing medication assisted treatment programs. The type of ongoing treatment will
be determined on an individual basis and will include options of methadone maintenance,
buprenorphine/naloxone treatment, or extended release naltrexone (XR-NTX). Rates of
treatment engagement and overdoses at six months will be compared to those participants
recruited from the City’s existing assessment and linkage centers. A detailed cost analyses will
be conducted to inform future use of this model should it produce positive results. Implementation
partners will be Prevention Point Philadelphia and the Public Health Management Corporation.
Scientific support will be provided by the University of Pennsylvania Injury Science Center, the
Center for Health Economics of Treatment Interventions for Substance Use Disorders, HIV, and
HCV and the Center for Studies of Addiction. A Community Advisory Board comprised of
consumers, providers and advocates for the health of people with opioid use disorder will help to
guide the implementation of the project.

## Key facts

- **NIH application ID:** 10003120
- **Project number:** 5R01CE003049-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** DAVID S METZGER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2020
- **Award amount:** $747,512
- **Award type:** 5
- **Project period:** 2018-09-30 → 2021-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10003120

## Citation

> US National Institutes of Health, RePORTER application 10003120, Rapid initiation of buprenorphine/naloxone to optimize MAT utilization in Philadelphia (5R01CE003049-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10003120. Licensed CC0.

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