Buprenorphine By the Book (BBB)
San Diego Public Library
Innovation Synopsis
The San Diego Public Library (SDPL), San Diego State University’s School of Social Work (SDSU), and Father Joe’s Village (FJV) collaborated to provide buprenorphine to people experiencing opioid addiction from 2023-2024. SDSU researchers hypothesized that telehealth at the library would increase buprenorphine treatment uptake compared to a traditional clinic. The library offered tablets, dedicated space, and a support network for telehealth visits. Participants were recruited at the Central and Mission Valley Libraries, with half assigned to FJV and half to the library telehealth group. 40 participants were recruited. The study found that telehealth participants at the library were more likely to reduce substance abuse and take buprenorphine, suggesting the program could be scaled up and replicated by other public libraries.
Challenge/Opportunity
SDPL staff and security were seeing frequent overdoses in the library and outside in the surrounding area. Opioid overdose deaths have increased in San Diego County in the last decade, and in 2022 the rate of opioid-related overdose deaths was highest among residents of San Diego County’s Health and Human Services Agency (HHSA) Central Region, in which several SDPL branches are located.
Key Elements of Innovation
In response to the increase in opioid use, SDPL partnered with SDSU’s School of Social Work and FJV, a non-profit that supports unhoused communities, to provide buprenorphine to people experiencing opioid addiction. The Central and Mission Valley Libraries were sites where participants could use tablets to attend telehealth appointments, have dedicated space for the visits, and see a network of researchers and students from the School of Social Work for support. SDPL was an unconventional healthcare setting, but its facilitation in helping patients take the drug worked despite being a non-clinical environment.
Achieved Outcomes
The telehealth visits at the library were successful, proving it was feasible to provide the service at the public library. After 12 weeks, 48% of the group tested positive for buprenorphine, with 62% from the telehealth group, compared to 32% of the group that went to the clinic at FJV. The researchers concluded that the telehealth group was 2 times more likely to take buprenorphine, and 2.5 times more likely to see a medical provider more than once compared to the FJV clinic. They learned that the library-facilitated telehealth program helped the patients, with one of the participants stating that buprenorphine “helped me sleep and has cleared my head...able to think much better. The biggest change...has been my lack of craving for using [drugs].”
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