Maintaining treatment and prevention programs for opioid use disorders during the coronavirus disease 2019 pandemic

Abstract

Purpose of review The current article reviews the impact of the biggest health crisis for many decades, coronavirus disease 2019 (COVID-19), on opioid treatment programs and the strategies adopted for maintaining opioid treatment programs during the pandemic. Recent findings The difficulty of access to opioid treatment services and the mental health problems accompanying opioid use disorders are the two main challenges to maintaining accessible and effective opioid treatment. Many countries and institutions issued guidance and recommendations to address these challenges. General coping strategies, loosening of policies, telemedicine, and depot buprenorphine are four main strategies to cope with the challenges posed by the pandemic. Summary There were considerable obstacles to maintaining opioid intervention programs during the COVID-19 pandemic. Strategies addressing the obstacles are identified. Research in this area needs to be strengthened.

The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy

“…While studies examining clinician attitudes have typically identified general barriers providing OAT (eg, concerns about “difficult” patients) rather than barriers associated with specific medications (eg, sublingual buprenorphine versus naltrexone), 96 methadone is subject to unique stigma 6 that may be compounded by its strict regulation. Retaining and expanding regulatory changes implemented during the COVID-19 pandemic to aid continuity of care 97 , 98 is increasingly been recognised an important step in developing innovative models of care to address the opioid crisis, 98 , 99 and may also reduce the stigma associated with methadone if treatment is made more accessible.…”

Emerging patterns of substance abuse and related treatment in China

“…These mental health issues lead to an enormous burden on the mental health system (MHS) in China. Min et al [7] review the impact of COVID-19 on opioid treatment programs in China. They find the biggest challenge is the difficulty of accessing opioid treatment services, including MMT, needle and syringe exchange programs.…”

“…Several strategies were effective in maintaining opioid treatment programs during the COVID-19 pandemic. For example, we can allow patients with OUD take medication to home for a longer time, the mental health of people with OUD should not be neglected, and the psychological counseling for patients on MMT need to be strengthen during the COVID-19 epidemic to reduce the risk of substance abuse [7].…”

“…The world has been under the major impact of the COVID-19 pandemic since 2020, various strategies to reduce the spread of COVID-19 including lockdown and stay-at-home order have brought unprecedented impacts on drug use in China. The COVID-19 pandemic has grave impact on people with substance use disorders and on healthcare workers who provide essential health services [7,12]. These mental health issues lead to an enormous burden on the mental health system (MHS) in China.…”

“…The services in China's MMT programs mainly targeting physical health, psychological health, social support and life-management ability are currently insufficient. It is urgent that China optimisms the treatment and increases funding and staff training for MMT [7,10,11].…”