“How will I get my next week's script?” Reactions of Reddit opioid forum users to changes in treatment access in the early months of the coronavirus pandemic

Krawczyk, Noa; Bunting, Amanda M.; Frank, David; Arshonsky, Joshua; Gu, Yuanqi; Friedman, Samuel R.; Bragg, Marie A.

doi:10.1016/j.drugpo.2021.103140

Cited by 46 publications

(48 citation statements)

References 40 publications

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“…Finally, due to Health Insurance Portability and Accountability Act (HIPAA) concerns, surveys were administered verbally at the end of each encounter. Although this type of strategy may compromise the patients’ anonymity in this process and secondarily inflate satisfaction scores ( 8 , 34 , 38 ), provider reporting of patient satisfaction corroborated this study’s findings.…”

Section: Discussionsupporting

confidence: 81%

“…Further, their mental health needs are highly dependent on the consistent delivery of services and relationship-based connections. As residents were required to shelter in place, patients with SUD voiced anxiety around viral exposure, isolation, and fear that a change in their routine and accountability could impact their outcomes ( 8 ). Many providers, who prior to COVID-19 would order in-person observed urine drug testing (urinalysis [UA]) for patients, stopped doing so.…”

Section: Introductionmentioning

confidence: 99%

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Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

Brett¹,

Foster²,

Joseph³

et al. 2021

Journal of Patient Experience

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Patients with substance use disorder (SUD) rely upon urine drug testing to support treatment adherence and to mitigate relapse. Before the onset of coronavirus 2019 (COVID-19), the logistical challenges of randomized observed collections for urine drug testing for the patient were significant. During COVID-19, these barriers were often insurmountable. Since SUD patients represent a population at a higher risk for complications from COVID-19, an alternative strategy to support COVID-19 testing was urgently needed. We designed and deployed a telehealth-based solution in which patients could use mobile devices to connect with trained collection professionals to perform observed urine collections, often referred to a UA (urinalysis). The solution was designed with patient-centered best practices for telehealth, stigma prevention, trauma-informed, empathy and compassion, and to remove barriers to access to care. This approach demonstrated high patient satisfaction scores thereby proving that it is possible to provide urine collection services in the patient’s home via a telehealth technology, while still upholding SUD testing integrity best practices. This study lays the path for a more patient-centered way to support this population.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

Brett¹,

Foster²,

Joseph³

et al. 2021

Journal of Patient Experience

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“…Access to OUD services has become especially precarious during the COVID-19 pandemic, as service closures, lower staff availability, and concerns around COVID-19 transmission have led to reduced service availability or utilization at a time when these services are needed most [ 18 , 19 ]. At the same time, relaxed regulations and emergency mandates around OUD treatment and harm reduction services introduced during the pandemic have brought new hope for the possibility of expanding lower threshold care options during the pandemic [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review

Krawczyk

Fawole

Yang

et al. 2021

Addict Sci Clin Pract

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Background The COVID-19 pandemic has exerted a significant toll on the lives of people who use opioids (PWUOs). At the same time, more flexible regulations around provision of opioid use disorder (OUD) services have led to new opportunities for facilitating access to services for PWUOs. In the current scoping review, we describe new services and service modifications implemented by treatment and harm reduction programs serving PWUO, and discuss implications for policy and practice. Methods Literature searches were conducted within PubMed, LitCovid, Embase, and PsycInfo for English-language studies published in 2020 that describe a particular program, service, or intervention aimed at facilitating access to OUD treatment and/or harm reduction services during the COVID-19 pandemic. Abstracts were independently screened by two reviewers. Relevant studies were reviewed in full and those that met inclusion criteria underwent final data extraction and synthesis (n = 25). We used a narrative synthesis approach to identify major themes around key service modifications and innovations implemented across programs serving PWUO. Results Reviewed OUD treatment and harm reduction services spanned five continents and a range of settings from substance use treatment to street outreach programs. Innovative service modifications to adapt to COVID-19 circumstances primarily involved expanded use of telehealth services (e.g., telemedicine visits for buprenorphine, virtual individual or group therapy sessions, provision of donated or publicly available phones), increased take-home medication allowances for methadone and buprenorphine, expanded uptake of long-acting opioid medications (e.g. extended-release buprenorphine and naltrexone), home delivery of services (e.g. MOUD, naloxone and urine drug screening), outreach and makeshift services for delivering MOUD and naloxone, and provision of a safe supply of opioids. Conclusions The COVID-19 pandemic has posed multiple challenges for PWUOs, while simultaneously accelerating innovations in policies, care models, and technologies to lower thresholds for life-saving treatment and harm reduction services. Such innovations highlight novel patient-centered and feasible approaches to mitigating OUD related harms. Further studies are needed to assess the long-term impact of these approaches and inform policies that improve access to care for PWUOs.

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“…These forums provide an online community where people can ask questions and share their lives with like-minded peers. Research has already analysed discussion forums to understand how pandemic relates to opioid use (Krawczyk et al, 2021 ), specific health (Brewer & Stratton, 2020 ) and mental health (Brewer et al, 2021 ) conditions, and intimate partner violence (Lyons & Brewer, 2021 ). In addition, discussion forums have been used in mental health research into experiences of a first episode of psychosis (Spikol & Murphy, 2019 ), and the use of language in psychosis (Lyons et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

"COVID-19 spreads round the planet, and so do paranoid thoughts". A qualitative investigation into personal experiences of psychosis during the COVID-19 pandemic

et al. 2021

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The COVID-19 pandemic is likely to affect people who have had previous experiences of psychosis – either positively or negatively. A research gap exists in looking at qualitative experiences of the pandemic. In the present study, we address the research gap in those who self-identified as having psychosis via Reddit discussion forum posts, collecting data from a popular online community. Sixty-five posts were analysed using inductive thematic analysis. Five overarching themes were identifie; declining mental health, changed psychosis experiences, personal coping experiences, social connectedness and disconnectedness, and COVID-19 as a metaphor. The data show that there are varied experiences associated with the pandemic. People who have experiences of psychosis do not only have vulnerabilities but may also perceive themselves as having strengths that allow them to cope better.

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“How will I get my next week's script?” Reactions of Reddit opioid forum users to changes in treatment access in the early months of the coronavirus pandemic

Cited by 46 publications

References 40 publications

Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

Patient-Centered Telehealth Solution for Observed Urine Collections in Substance Use Disorder Care Delivery During COVID-19 and Beyond

Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review

"COVID-19 spreads round the planet, and so do paranoid thoughts". A qualitative investigation into personal experiences of psychosis during the COVID-19 pandemic

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