Table 3.

Summary of key findings reported by articles included in the scoping review (n = 68)

Type of intervention (number of articles)	Summary of key findings
Substance use disorder treatment interventions
Telemedicine-based MOUD induction and maintenance (n = 24)	• Majority of articles focused on buprenorphine [52, 54, 56, 65, 68–70, 72–75, 78, 81, 93, 100, 106, 107, 109, 110] • Telemedicine facilitated increased access and reduced barriers to MOUD [54, 81, 75, 100, 107, 110] • Technology access can be a barrier for PEH [52, 69, 75, 100]. This barrier can be mitigated by strategies including “facilitated” telemedicine [65, 70, 75, 107, 109], telephone provision [101], and audio-only visits [74, 100, 106] • Reported impacts on retention rates were largely positive [69, 100, 110] though one study suggested PEH may not receive equal benefits to people who are housed [103]
Telemedicine-based SUD counseling (n = 7)	• Telemedicine can increase engagement with SUD services for PEH [82] • Some articles noted retention challenges for PEH for telemedicine counseling [97, 99]
Mobile unit and street outreach-based MOUD induction and maintenance (n = 7)	• Articles noted successes of programs designed to literally “reach people where they are” (e.g., on the streets via street outreach) in connecting PEH to SUD treatment including MOUD [58, 62, 67, 73]
Buprenorphine and methadone provision in pandemic homeless services settings (n = 21)	• New models of onsite delivery and provision of MOUD were started during the pandemic in sites serving PEH (e.g., I&Q sites, protective hotel sites, shelters) [49, 51—53, 55, 56, 59, 61, 64, 71, 84, 92, 94–96, 98, 102, 105, 111–113] • Articles noted success in promoting treatment initiation [64, 95, 111, 113] and retention/adherence for those already taking buprenorphine or methadone [64, 96, 112]
Methadone take-home dosing and low-barrier provision (n = 14)	• Thirteen articles described expansion of take-home doses (TDHs) [53, 63, 75, 77–79, 82, 85, 87, 88–90, 116] and one article examined a low-barrier approach to methadone treatment [104] • Patients newly accessing take-home doses (THDs) reported feeling more control and autonomy [79, 82, 87, 90] • Articles noted potential destabilizing effect of THDs versus daily retrievals for some PEH [79, 82] • Some PEH were unable to access THDs due to their housing status [78]
Treatment for alcohol use disorder (n = 4)	• AUD treatment was offered at I&Q sites and protective hotels [51, 56, 96] and via telemedicine [54]
Benzodiazepine maintenance treatment (n = 1)	• One article discussed benzodiazepine maintenance for patients with benzodiazepine dependence; reported benefits were improved health and behavior, and facilitation of isolation/protective hotel stays [63]
Harm reduction interventions
Managed alcohol programs (n = 9)	• MAPs provided set doses of alcohol to patients at I&Q sites [51, 94,95, 64, 66, 76, 105] and protective hotels [66, 113, 84] • Articles noted success of MAPs in preventing withdrawal and hospitalization [64, 76], with few reported adverse events 64, 66, 105]
Alcohol withdrawal management (n = 8)	• Articles most commonly discussed pharmacological alcohol withdrawal prevention and management (e.g., with benzodiazepines) in I&Q and protective sites serving PEH [50, 51, 55, 64, 91] • Articles reported acceptability and apparent successes of these programs in preventing severe withdrawal [64]
Supervised consumption services (n = 4)	• Articles described programs located in I&Q sites for PEH and shelters in Canada [51, 83, 98, 115] • Articles noted success in preventing overdose deaths [51, 115] without reported adverse events • Appeared to be widely used [83, 115]
Safer supply prescribing (n = 5)	• All articles described programs located in I&Q sites for PEH, shelters, or in hospital settings in Canada [51, 52, 98, 105, 108] • Programs appeared to be acceptable [105, 108], with few reported adverse events [105]

AUD alcohol use disorder, I&Q isolation and quarantine, MAP managed alcohol program, MOUD medications for opioid use disorder, PEH people experiencing homelessness, SUD substance use disorder, THD take-home dose