Low-threshold Buprenorphine: Proposing the Ideal Service Model to Engage People With Severe Opioid Use Disorder

Low-threshold buprenorphine treatment has been described as a general approach to office-based buprenorphine treatment that prioritizes access to care, flexibility, and patient-centeredness. Proposed principles have included same-day treatment entry, flexible policies and procedures, a harm reduction orientation, and availability in unconventional settings. This commentary, which summarizes critical insights from practitioners of low-threshold buprenorphine treatment, expands on these principles by describing clinical and social services that have been included in successful programs. Potential critiques of low-threshold buprenorphine treatment are also addressed. The main goal of the commentary is to describe the ideal components of low-threshold buprenorphine treatment that could inform the development, evaluation, and dissemination of these innovative programs.