COVID-19 related substance use services policy changes: Policymaker perspectives on policy development &amp; implementation

Henry, Brandy F.; Campbell, Aimee N.C.; Hunt, Timothy; Johnson, Jessica K.; Mandavia, Amar; Chaple, Michael; Arout, Caroline A.; Wu, Elwin; Pincus, Harold Alan; Nunes, Edward V.; Lincourt, Pat; Levin, Frances R.; El‐Bassel, Nabila

doi:10.1016/j.jsat.2021.108550

Cited by 7 publications

(6 citation statements)

References 20 publications

(27 reference statements)

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“…Policymakers shifted to more inclusive approaches of co-production of recommendations. The barriers to adoption and implementation that emerged, as a result of the new regulations, included stigma, lack of integration, and overcriminalization [59]. All of the aforementioned affected negatively substance users, and the available help diminished.…”

Section: Addiction During Covid-19mentioning

confidence: 99%

The Increase in Addiction during COVID-19

Daglis

2021

Encyclopedia

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The increase in addiction during COVID-19 is a condition that emerged as an aftermath of COVID-19-related events, for instance, fear of the spread of COVID-19, self-abstention from many activities, and restrictions established by the lockdown measures. This condition includes substance addictions such as drugs and alcohol but also behavioral addictions such as gambling, gaming, pornography, and smartphone and internet misuse.

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Section: Addiction During Covid-19mentioning

confidence: 99%

The Increase in Addiction during COVID-19

Daglis

2021

Encyclopedia

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“…We undertook this work to inform our understanding of the MOUD treatment context that was impacting several of our current studies with protocols that had been designed prior to the pandemic's start. Participant perspectives such as this are a recognized gap in the literature regarding OUD treatment changes during the COVID-19 pandemic [27].…”

mentioning

confidence: 99%

Navigating intersecting public health crises: a qualitative study of people with opioid use disorders' experiences during the COVID-19 pandemic

Watson

Staton

Grella

et al. 2022

Subst Abuse Treat Prev Policy

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Background The decades-long opioid epidemic and the more recent COVID-19 pandemic are two interacting events with significant public health impacts for people with opioid use disorder (OUD). Most published studies regarding the intersection of these two public health crises have focused on community, state, or national trends using pre-existing data. There is a need for complementary qualitative research aimed at identifying how people with opioid use disorder (OUD) are understanding, experiencing, and navigating this unprecedented time. The current study examines understandings and experiences of people with OUD while they have navigated these crises. Methods The study was guided by a pragmatic lens. We conducted brief semi-structured qualitative interviews with 25 individuals in Chicago, the majority of which had received methadone treatment during the pandemic. Thematic inductive analysis was guided by primary interview questions. Results The sample represents a high-risk group, being composed mostly of older non-Hispanic African American males and having considerable socioeconomic barriers. Themes demonstrate how individuals are keeping safe despite limited knowledge of COVID-19, how the pandemic has increased treatment motivation for some, how adaptations impacted treatment and recovery supports, how the availability social support had been reduced, and difficulties individuals had keeping or obtaining financial support. Conclusions The findings can be useful for informing future public health response to ensure appropriate treatment access and supports are available. In particular are the need for treatment providers to ensure people with OUD receive appropriate and understandable health crisis-related information and ensuring funds are appropriately allocated to address mental health impacts of social isolation. Finally, there is a need for appropriate financial and infrastructure supports to ensure health and treatment access disparities are not exacerbated for those in greatest need.

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“…This value for take-home methadone flexibilities and reduced OTP visits is consistent with what has been reported in qualitative studies of other populations of people who use drugs in the US [ 92 – 95 ]. Policy makers and providers have also reported positive experiences with relaxing restrictions on take-home MOUD during the pandemic and have endorsed shifting towards “low threshold” policies and person-centered care [ 96 – 98 ]. However, stigma by some policymakers and providers continues to be a challenge to the adoption and implementation of such relaxed policies [ 98 , 99 ].…”

Section: Discussionmentioning

confidence: 99%

Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland

Patel,

Grieb,

Winiker

et al. 2024

Harm Reduct J

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Background Substance use disorder treatment and recovery support services are critical for achieving and maintaining recovery. There are limited data on how structural and social changes due to the COVID-19 pandemic impacted individual-level experiences with substance use disorder treatment-related services among community-based samples of people who inject drugs. Methods People with a recent history of injection drug use who were enrolled in the community-based AIDS Linked to the IntraVenous Experience study in Baltimore, Maryland participated in a one-time, semi-structured interview between July 2021 and February 2022 about their experiences living through the COVID-19 pandemic (n = 28). An iterative inductive coding process was used to identify themes describing how structural and social changes due to the COVID-19 pandemic affected participants’ experiences with substance use disorder treatment-related services. Results The median age of participants was 54 years (range = 24–73); 10 (36%) participants were female, 16 (57%) were non-Hispanic Black, and 8 (29%) were living with HIV. We identified several structural and social changes due the pandemic that acted as barriers and facilitators to individual-level engagement in treatment with medications for opioid use disorder (MOUD) and recovery support services (e.g., support group meetings). New take-home methadone flexibility policies temporarily facilitated engagement in MOUD treatment, but other pre-existing rigid policies and practices (e.g., zero-tolerance) were counteracting barriers. Changes in the illicit drug market were both a facilitator and barrier to MOUD treatment. Decreased availability and pandemic-related adaptations to in-person services were a barrier to recovery support services. While telehealth expansion facilitated engagement in recovery support group meetings for some participants, other participants faced digital and technological barriers. These changes in service provision also led to diminished perceived quality of both virtual and in-person recovery support group meetings. However, a facilitator of recovery support was increased accessibility of individual service providers (e.g., counselors and Sponsors). Conclusions Structural and social changes across several socioecological levels created new barriers and facilitators of individual-level engagement in substance use disorder treatment-related services. Multilevel interventions are needed to improve access to and engagement in high-quality substance use disorder treatment and recovery support services among people who inject drugs.

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COVID-19 related substance use services policy changes: Policymaker perspectives on policy development & implementation

Cited by 7 publications

References 20 publications

The Increase in Addiction during COVID-19

The Increase in Addiction during COVID-19

Navigating intersecting public health crises: a qualitative study of people with opioid use disorders' experiences during the COVID-19 pandemic

Structural and social changes due to the COVID-19 pandemic and their impact on engagement in substance use disorder treatment services: a qualitative study among people with a recent history of injection drug use in Baltimore, Maryland

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