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Bu sayfa, 26. Dünya Psikiyatri Kongresi'nde sunulan çalışmanın yapay zekâ desteğiyle hazırlanmış Türkçe özetidir. Çalışmanın sahibi sunan yazarlardır; atıf için orijinal kaynağa başvurun.

SO260

A low-threshold mobile methadone program for people experiencing homelessness: a clinical protocol

LOW-THRESHOLD MOBILE METHADONE PROGRAM FOR PEOPLE WHO EXPERIENCE HOMELESSNESS: A CLINICAL PROTOCOL

The clinical protocol for a mobile, low-threshold methadone program that reaches people experiencing homelessness and opioid dependence on the streets is presented, and the model is reported to be feasible for improving access to care.

The poster presents the clinical protocol for a mobile opioid substitution treatment program based on harm reduction principles, launched in early 2026 in Amadora, a suburb of Lisbon, Portugal. Eligibility criteria include being aged 18 or older, having active opioid dependence, experiencing homelessness, and accepting the program’s rights and responsibilities; the program has a maximum capacity of 30 service users. Services are delivered from a minibus seven days a week, between 14:00 and 17:00; the team consists of one coordinator, three nurses, three psychosocial professionals (psychologists or social workers), two peer workers, and a physician who visits once a week. The clinical protocol comprises four phases: initial assessment (urine opioid screening, pregnancy testing if indicated, psychosocial, nursing, and medical assessments, and screening for sexually transmitted infections and tuberculosis), induction (a starting dose of 25 mg/day, increases of 5 mg daily, increases every 48 hours after reaching 45 mg, and medical assessment for doses above 100 mg), maintenance and stabilization, and referral. The safety protocol specifies withholding methadone in cases of apparent intoxication with depressant substances, adjusting doses according to the timing of vomiting, and modifying doses based on the number of missed days (1–2 days: the same dose; 3–4 days: half the previous dose; 5–6 days: one-third of the previous dose, with a minimum of 25 mg; 7 days or more: reassessment and reinduction; more than 30 days: discharge from the program). The program also provides medical and psychiatric assessments, nursing care (wound care and supervised medication administration), distribution of sterile drug use equipment and hygiene and protective supplies, water and small meals, harm reduction education including naloxone distribution, and referral to specialized services. Early implementation experience indicates that the mobile design reduces barriers to treatment entry through direct engagement in street settings; the authors state that the model is feasible for improving access to addiction and mental health care among highly vulnerable groups, while its impact and scalability will be determined through ongoing evaluation.

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