Lessons from COVID 19: Are we finally ready to make opioid treatment accessible?

Krawczyk, Noa; Fingerhood, Michael; Agus, Deborah

doi:10.1016/j.jsat.2020.108074

Cited by 27 publications

(29 citation statements)

References 9 publications

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“…The COVID-19 pandemic has created an urgent need to improve and expand access for persons seeking OUD treatment ( Davis & Samuels, 2020 ; Peavy et al, 2020 ). In addition, COVID-19 presents an opportunity to re-examine dated regulations surrounding OUD treatment ( del Pozo & Beletsky, 2020 ; Krawczyk et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…The coronavirus pandemic (COVID-19) has created an urgency for opioid treatment programs (OTPs) to ensure continued access for existing patients, promote patient safety, and expand to new patients ( Davis & Samuels, 2020 ; Del Pozo, Beletsky, & Rich, 2020 ; Khatri & Perrone, 2020 ; Krawczyk, Fingerhood, & Agus, 2020 ; Leppla & Gross, 2020 ). In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidelines allowing expanded use of take-home doses for more “stable” patients, likely relevant to those who have displayed longer durations of treatment ( Substance Abuse and Mental Health Services Administration, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Take-home dosing experiences among persons receiving methadone maintenance treatment during COVID-19

Figgatt

Salazar²,

Day³

et al. 2021

Journal of Substance Abuse Treatment

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Purpose Methadone maintenance treatment is a life-saving treatment for people with opioid use disorders (OUD). The coronavirus pandemic (COVID-19) has introduced many concerns surrounding access to opioid treatment. In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidance allowing for the expansion of take-home methadone doses. We sought to describe changes to treatment experiences from the perspective of persons receiving methadone at outpatient treatment facilities for OUD. Methods We conducted an in-person survey among 104 persons receiving methadone from three clinics in central North Carolina in June and July 2020. Surveys collected information on demographic characteristics, methadone treatment history, and experiences with take-home methadone doses in the context of COVID-19 (i.e., before and since March 2020). Results Before COVID-19, the clinic-level percent of participants receiving any amount of days' supply of take-home doses at each clinic ranged from 56% to 82%, while it ranged from 78% to 100% since COVID-19. The clinic-level percent of participants receiving a take-homes days' supply of a week or longer (i.e., ≥6 days) since COVID-19 ranged from 11% to 56%. Among 87 participants who received take-homes since COVID-19, only four reported selling their take-home doses. Conclusions Our study found variation in experiences of take-home dosing by clinic and little diversion of take-home doses. While SAMSHA guidance should allow expanded access to take-home doses, adoption of these guidelines may vary at the clinic level. The adoption of these policies should be explored further, particularly in the context of benefits to patients seeking OUD treatment.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Take-home dosing experiences among persons receiving methadone maintenance treatment during COVID-19

Figgatt

Salazar²,

Day³

et al. 2021

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

show abstract

“…Novel interventions that address disruptions in healthcare access while maximizing recovery are urgently needed to reduce morbidity and mortality in the community. The COVID-19 pandemic may provide the impetus needed to bring systematic change to modernize MOUD delivery, including access to telehealth, reduced drug screening, and increased patient decision-making ( Krawczyk et al, 2020 ). Such efforts should consider the unique needs of patients with polysubstance use to effectively identify and address barriers to healthcare delivery.…”

Section: Discussionmentioning

confidence: 99%

Impacts of the COVID-19 pandemic on healthcare access among patients receiving medication for opioid use disorder

Jacka

Janssen

Garner

et al. 2021

Drug and Alcohol Dependence

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Background The COVID-19 pandemic significantly altered treatment delivery for opioid treatment programs (OTPs) dispensing medications for opioid use disorder (MOUD). We aimed to identify patterns of substance use among MOUD patients and examine whether COVID-19-related impacts on access to healthcare varied across subgroups. Methods This analysis was embedded within a type 3 hybrid trial that enrolled patients across eight OTPs at the start of the pandemic. Enrolled patients reported on past-30 day use of multiple substances during their baseline assessment. Participants re-contacted in May–July 2020 completed a survey about COVID-19-related impacts on various life domains. Using latent class analysis we identified patient subgroups, and then examined group differences on a set of negative and positive COVID-19 impacts related to healthcare access. Results Of the 188 trial participants, 135 (72%) completed the survey. Latent class analysis identified three MOUD patient subgroups: minimal use (class probability: 0.25); opioid use (class probability: 0.34); and polysubstance use (class probability: 0.41). Compared to the minimal use group, the polysubstance use group reported increased substance use and difficulty accessing sterile needles, naloxone, and preferred substance. The opioid use group reported increased substance use and difficulty accessing their preferred substance. There were no significant group differences related to accessing routine or specialized healthcare or medication; or paying attention to their health. Conclusions During COVID-19, many MOUD patients reported challenges accessing care, particularly harm reduction services for patients with polysubstance use. Additional efforts, like providing wraparound support, may be necessary to serve the needs of MOUD patients.

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“…The COVID-19 pandemic creates substantial urgency in improving and expanding access to persons seeking OUD treatment (Davis & Samuels, 2020; Peavy et al, 2020). In addition, COVID-19 presents an opportunity to re-examine dated regulations surrounding OUD treatment (del Pozo & Beletsky, 2020; Krawczyk et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…The coronavirus pandemic (COVID-19) has created an urgency for opioid treatment programs (OTPs) to respond by ensuring continued access for existing patients, promoting patient safety, and expanding to new patients (Davis & Samuels, 2020; Del Pozo et al, 2020; Khatri & Perrone, 2020; Krawczyk et al, 2020; Leppla & Gross, 2020). In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidelines allowing expanded use of take-home doses for more “stable” patients, likely relevant to those who have displayed longer durations of treatment (Substance Abuse and Mental Health Services Administration, 2020).…”

Section: Introductionmentioning

confidence: 99%

Take-Home Dosing Experiences among Persons Receiving Methadone Maintenance Treatment During COVID-19

Figgatt

Salazar

Day

et al. 2020

Preprint

View full text Add to dashboard Cite

Purpose: Methadone maintenance treatment is a life-saving treatment for people with opioid use disorders (OUD). The coronavirus pandemic (COVID-19) introduces many concerns surrounding access to opioid treatment. In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidance allowing the expansion of take-home methadone doses. We sought to describe changes to treatment experiences from the perspective of persons receiving methadone at outpatient treatment facilities for OUD. Methods: We conducted an in-person survey among 104 persons receiving methadone from three clinics in central North Carolina. Surveys collected information on demographic characteristics, methadone treatment history, and experiences with take-home methadone doses in the context of COVID-19 (i.e., before and since March 2020). Results: Before COVID-19, the clinic-level percent of participants receiving any amount of days supply of take-home doses at each clinic varied ranged from 56% to 82%, while it ranged from 78% to 100% since COVID-19. The clinic-level percent of participants receiving a take-homes days supply of a week or longer (i.e., ≥6 days) since COVID-19 ranged from 11% to 56%. Of the 87 participants who received take-homes since COVID-19 began, only four reported selling their take-home doses. Conclusions: Our study found variation in experiences of take-home dosing by clinic and little diversion of take-home doses. While SAMSHA guidance should allow expanded access to take-home doses, adoption of these guidelines may vary at the clinic level. The adoption of these policies should be explored further, particularly in the context of benefits to patients seeking treatment for OUD.

show abstract

Lessons from COVID 19: Are we finally ready to make opioid treatment accessible?

Cited by 27 publications

References 9 publications

Take-home dosing experiences among persons receiving methadone maintenance treatment during COVID-19

Take-home dosing experiences among persons receiving methadone maintenance treatment during COVID-19

Impacts of the COVID-19 pandemic on healthcare access among patients receiving medication for opioid use disorder

Take-Home Dosing Experiences among Persons Receiving Methadone Maintenance Treatment During COVID-19

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