Implementing a Service Bundle in High-Impact Settings for People Who Use Drugs: Successes and Promising Practices

CONTEXT: Testing and treatment services to prevent, mitigate, and treat infectious disease complications related to drug use are available. However, more work is needed to identify strategies that can improve service access in settings that serve people who use drugs (PWUD). OBJECTIVE: We aimed to identify successful strategies for implementing integrated infectious disease and substance use disorder (SUD) treatment services in various high-impact settings (eg, syringe services programs, SUD treatment centers, mobile clinics) to PWUD. DESIGN: Thematic analysis of successes and resolved challenges reported by 17 health departments that supported services in high-impact settings during October 2021-September 2024. The Consolidated Framework for Implementation Research (CFIR) was used to contextualize themes developed. SETTING: Seventeen state and local health departments throughout the United States and their service partners. PARTICIPANTS: Health department staff and community providers of services for PWUD. INTERVENTION: The PWUD service bundle includes: viral hepatitis and HIV testing and linkage to care/treatment; syringe services; assessment and linkage to treatment for opioid use disorder; hepatitis A and hepatitis B vaccination; and treatment for bacterial and/or fungal infections. MAIN OUTCOME MEASURES: Themes that summarize the most common strategies reported by health departments implementing the PWUD service bundle in high-impact settings. RESULTS: We identified the following 4 themes that reflected the inner setting, outer setting, and implementation process domains from the CFIR: 1) service delivery models and practices, 2) partnerships and collaborations, 3) data collection and use to track services and inform program improvement, and 4) provider education and capacity building. CONCLUSIONS: Staff at health departments and high-impact settings can apply a variety of best practices (eg, peer navigation, telehealth, provider training, building partnerships with community organizations, and developing data feedback loops) to engage PWUD and tailor infectious disease and SUD treatment services.