Buprenorphine Dispensing in Pennsylvania During the COVID-19 Pandemic, January to October 2020

Chalasani, Rohan; Shinabery, Jared M; Goetz, Carrie Thomas; Chang, Chung‐Chou H.; Yang, Qianru; Suda, Katie J.; Gellad, Walid F.

doi:10.1007/s11606-021-07083-y

Cited by 10 publications

(17 citation statements)

References 5 publications

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“… 28 In Pennsylvania, a reduction in rates of both existing patients and new patients initiating buprenorphine treatment were observed; however, there was no overall change in the number of patients with active buprenorphine prescriptions, and the mean days’ supply increased at the same time. 29 These studies provide a plausible mechanism for the increasing supply of buprenorphine amid the pandemic.…”

Section: Discussionmentioning

confidence: 95%

“…Access to medication treatment is crucial for patients with OUD, and the COVID-19 pandemic was associated with disrupted access to care, although the extent and geography of this disruption has been difficult to quantify. Although studies suggest that there has been relatively little disruption to the supply of buprenorphine during the pandemic, 19,20,28,29 less is known about methadone access during the pandemic. A study examining methadone clinics in the US and Canada found that 1 of 10 clinics were not accepting new patients, and nearly half of those not accepting new patients named Change in methadone supply was calculated from quarter 3 (Q3) of 2020 to Q2 of 2021 and Q1 to Q4 of 2019; change in buprenorphine supply, from Q3 of 2020 to Q2 of 2021 and Q1 to Q4 of 2019.…”

Section: Discussionmentioning

confidence: 99%

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Changes in Buprenorphine and Methadone Supplies in the US During the COVID-19 Pandemic

2022

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IMPORTANCEThe opioid crisis has been exacerbated by the COVID-19 pandemic in the US, with concerns over major disruptions to medication treatment of opioid use disorder. OBJECTIVE To investigate whether the COVID-19 pandemic was associated with disruption of buprenorphine and methadone supplies in the US. DESIGN, SETTING, AND PARTICIPANTS This repeated cross-sectional study used ARCOS (Automated Reports and Consolidated Ordering System) data, which monitor the flow of controlled substances in the US, from January 1, 2012, through June 30, 2021. Manufacturers and point of sale or distribution at the dispensing or retail level, including hospitals, retail pharmacies, clinicians, midlevel clinicians, and teaching institutions, were included in the analysis. EXPOSURES COVID-19 pandemic. MAIN OUTCOMES AND MEASURES Quarterly supplies of buprenorphine and methadone per capita in milligrams. RESULTSThe per capita supply of methadone dropped from 13.2 mg in the first quarter of 2020 to 10.5 mg in the second quarter of 2020, whereas the per capita supply of buprenorphine increased from 3.6 mg to 3.7 mg in the same period. The per capita supply of methadone declined 20% (−2.7 mg) in the second quarter of 2020 compared with the first quarter of 2020, and the supply had not returned to 2019 levels as of June 2021, whereas the supply of buprenorphine per person increased consistently during the same period. There were considerable state disparities in the reduction of the methadone supply during the pandemic, with many states experiencing pronounced per capita supply decreases, including reductions as great as 50% in New Hampshire and Florida. These decreases in per capita methadone supply were not compensated by proportional increases in the per capita buprenorphine supply (linear fit, 0.17 [95% CI, −0.43 to 0.76]; P = .47). CONCLUSIONS AND RELEVANCEThis cross-sectional study of buprenorphine and methadone supplies during the COVID-19 pandemic found a pronounced decline in the methadone supply but no disruption to the buprenorphine supply. Future research is needed to explain the pronounced state disparities in the methadone supply.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Changes in Buprenorphine and Methadone Supplies in the US During the COVID-19 Pandemic

2022

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“…While COVID-19 has introduced several challenges throughout the healthcare system ( Chalasani et al, 2021 ), it has also provided an opportunity to dramatically reimagine service delivery to promote the safety of staff and patients. Standard buprenorphine medication management before COVID-19 typically included mandatory in-person inductions and weekly clinic-based urine drug toxicology screenings.…”

Section: Discussionmentioning

confidence: 99%

Impact of reduced restrictions on buprenorphine prescribing during COVID-19 among patients in a community-based treatment program

Ward

Scheim

Wang

et al. 2022

Drug and Alcohol Dependence Reports

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“…Across states, MOUD services connections varied highly during a comparable timeframe. A Pennsylvania study analyzing claims from January to October in both 2019 and 2020 found that the onset of the COVID-19 pandemic was associated with a reduction in both the number of new patients initiating MOUD treatment and the number of patients filling buprenorphine prescriptions [ 30 ]. In contrast, a Texas study utilizing the Prescription Drug Monitoring Program (PDMP) found a marked increase in new buprenorphine patients in the first 90 days of the pandemic [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

A Qualitative Exploration of the Functional, Social, and Emotional Impacts of the COVID-19 Pandemic on People Who Use Drugs

Kelly

Reed

Schoenauer

et al. 2022

IJERPH

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Since 2020, people who use drugs (PWUD) experienced heightened risks related to drug supply disruptions, contamination, overdose, social isolation, and increased stress. This study explored how the lives of PWUD changed in Philadelphia over a one-year period. Using semi-structured interviews with 20 participants in a Housing First, low-barrier medication for opioid use (MOUD) program in Philadelphia, the effects of the first year of the COVID-19 pandemic on the daily lives, resources, functioning, substance use, and treatment of PWUD were explored. Interviews were analyzed using a combination of directed and conventional content analysis. Six overarching themes emerged during data analysis: (1) response to the pandemic; (2) access to MOUD and support services; (3) substance use; (4) impacts on mental health, physical health, and daily functioning; (5) social network impacts; and (6) fulfillment of basic needs. Participants reported disruptions in every domain of life, challenges meeting their basic needs, and elevated risk for adverse events. MOUD service providers offset some risks and provided material supports, treatment, social interaction, and emotional support. These results highlight how there were significant disruptions to the lives of PWUD during the first year of the COVID-19 pandemic and identified critical areas for future intervention and policies.

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Buprenorphine Dispensing in Pennsylvania During the COVID-19 Pandemic, January to October 2020

Cited by 10 publications

References 5 publications

Changes in Buprenorphine and Methadone Supplies in the US During the COVID-19 Pandemic

Changes in Buprenorphine and Methadone Supplies in the US During the COVID-19 Pandemic

Impact of reduced restrictions on buprenorphine prescribing during COVID-19 among patients in a community-based treatment program

A Qualitative Exploration of the Functional, Social, and Emotional Impacts of the COVID-19 Pandemic on People Who Use Drugs

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