Bringing Buprenorphine to the Streets: A Community Outreach Event to Expand Access to Treatment for Opioid Use Disorder

Background : The opioid overdose crisis in the United States continues to escalate, largely driven by fentanyl. Medications for opioid use disorder (MOUD), including buprenorphine and methadone, reduce mortality, yet access remains limited, particularly for people experiencing homelessness and other structural barriers to care. We evaluated the implementation and early outcomes of a field-based outreach event designed to increase awareness of and engagement with MOUD among individuals with opioid use disorder (OUD) in a neighborhood with a high burden of opioid overdoses. Methods : We conducted a retrospective observational cohort study of individuals who expressed interest in MOUD during a 3-day community outreach clinic held in a Seattle park in September 2025. The event was organized by community outreach partners and the Seattle Fire Department Mobile Integrated Health team. Participants interested in treatment underwent screening and were offered MOUD options, including a 3-day injectable-only overlapping buprenorphine induction protocol that did not require opioid abstinence or preceding sublingual buprenorphine. The primary outcome was MOUD initiation within 7 days, defined as receipt of monthly long-acting injectable buprenorphine (LAIB), prescription of sublingual buprenorphine ≥ 16 mg, or linkage to a methadone opioid treatment program. Results : Forty-seven individuals completed screening and assessment for MOUD, and 35 expressed interest in initiating medications. Among those interested in buprenorphine (n = 34), the median age was 31.5 years; 62% identified as men, 79% were unsheltered or in shelter, and 68% self-identified with underrepresented racial or ethnic groups. Most participants (82%) had a history of incarceration, and 82% had previously received MOUD. Overall, 21 of 35 individuals (62%) initiated MOUD: 17 received monthly LAIB, 3 initiated high-dose sublingual buprenorphine, and 1 linked to methadone treatment. Among those who selected the 3-day injectable-only protocol (n = 28), 15 (54%) completed induction to monthly LAIB. Conclusions : A brief field-based outreach event successfully engaged individuals who were not actively seeking treatment and facilitated MOUD initiation for most participants. Targeted, low-barrier outreach combined with flexible LAIB initiation protocols may expand access to treatment for populations disproportionately affected by overdose. Further evaluation is needed to assess scalability and integration with housing, community partnerships, and carceral health systems.