Drug Use and Overdose Risk Among Unstably Housed Individuals in Washington Heights Receiving Medication Assisted Treatment for Opioid Use Disorder
Name: Maxine McGredy
School: Vagelos College of Physicians and Surgeons, Class of 2023
Mentor: Silvia Cunto-Amesty, MD, MPH, MSEd
Abstract
Unintentional drug overdose is the leading cause of death among homeless individuals in the US. People with opioid use disorder may receive medication assisted treatment (MAT)—methadone or buprenorphine—but may continue to use opioids including heroin. Little is known about drug use patterns, overdose risk behaviors, rates of naloxone usage, and associated variables among unstably housed individuals receiving MAT and using heroin. This study focused on the demographics, drug use patterns, overdose risk behaviors, and rates of naloxone usage among individuals on medication assisted treatment in Washington Heights. We conducted a cross-sectional survey (N=101) among participants seeking harm reduction services who reported heroin use in the last three months. Frequency testing was performed in Excel for factors related to heroin use while receiving MAT (MAT+) vs. not receiving MAT (MAT-). The sample was predominately male (72%), unstably housed (42% homeless), Hispanic-identifying (62%), and daily heroin users (77%). MAT+ individuals were more likely to rent/own an apartment and to use drugs in their own home. MAT- individuals were more likely to live in a place “not meant for human habitation” and to use drugs in a public place. MAT+ individuals were less likely to overdose in the last 3-months (6.25%) than MAT- individuals (17.39%). Findings suggest MAT protects against overdose, despite daily heroin use. Further research should investigate whether stable housing promotes access to MAT or whether treatment engages individuals in social services. Since MAT+ individuals were equally likely to observe overdoses, participants at methadone/buprenorphine programs should be equipped with naloxone kits.