Methadone and buprenorphine-related deaths among people prescribed and not prescribed Opioid Agonist Therapy during the COVID-19 pandemic in England

Aldabergenov, Daniyar; Reynolds, Laura M.; Scott, Jennifer; Kelleher, Michael J.; Strang, John; Copeland, CS; Kalk, Nicola J.

doi:10.1016/j.drugpo.2022.103877

Cited by 18 publications

(12 citation statements)

References 43 publications

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“…L’augmentation des décès liés à la méthadone en 2020 a également été retrouvée dans d’autres pays comme en Angleterre [10] ou aux États-Unis [11] , [12] , [13] . Aux États-Unis, le nombre provisoire de décès par surdose liés à la méthadone a augmenté de 2728 décès cumulés sur 12 mois entre mars 2019 et février 2020 à 3795 décès entre avril 2020 et mars 2021 [11] .…”

Section: Discussionunclassified

Augmentation des surdoses et décès en lien avec la consommation de méthadone durant la crise sanitaire liée au COVID-19 en 2020

et al. 2024

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Section: Discussionunclassified

Augmentation des surdoses et décès en lien avec la consommation de méthadone durant la crise sanitaire liée au COVID-19 en 2020

et al. 2024

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“…Whilst evaluations are ongoing, it would appear that such initiatives have the potential to increase engagement, reduce waiting times [ 93 ] and reduce experiences of stigma in the pharmacy setting [ 77 ]. However, recent research indicates that there was an increase in methadone-related mortality during the first wave of the pandemic in individuals who were not prescribed the drug [ 94 ]. Clearly, a balance needs to be sought between addressing stigma and minimising harm.…”

Section: Discussionmentioning

confidence: 99%

Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys

Carlisle

Maynard

Bagnall

et al. 2023

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(1) The harm-reduction benefits of opioid agonist treatment (OAT) are well-established; however, the UK government’s emphasis on “recovery” may be contributing to a high proportion of people leaving treatment and low retention rates. We wanted to develop a rich and nuanced understanding of the factors that might influence the treatment journeys of people who use OAT. (2) We explored factors at each level of the socioecological system and considered the ways these interact to influence treatment journeys in OAT. We carried out semi-structured interviews with people who use OAT (n = 12) and service providers (n = 13) and analysed data using reflexive thematic analysis. (3) We developed three themes representing participant perceptions of treatment journeys in OAT. These were: (1) The System is Broken; (2) Power Struggles; and (3) Filling the Void. (4) Conclusions: The data suggest that prioritisation of treatment retention is important to preserve the harm-reduction benefits of OAT. Stigma is a systemic issue which presents multiple barriers to people who use OAT living fulfilling lives. There is an urgent need to develop targeted interventions to address stigma towards people who use OAT.

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“…Supervised dispensing of OAT medications exists to ensure compliance with the prescription and to reduce the risk of medication diversion. There is emerging evidence of an increase of methadone-related deaths during the first COVID-19 ‘lockdown’ both in-treatment and among people not in treatment 38. Balancing these risks with patient-centred care remains a central element of delivering specialist treatment for opiate use disorders.…”

Section: Discussionmentioning

confidence: 99%

Patients’ perceptions of self-administered dosing to opioid agonist treatment and other changes during the COVID-19 pandemic: a qualitative study

et al. 2023

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ObjectivesDuring the COVID-19 pandemic, addiction treatment services received official guidance asking them to limit face-to-face contact with patients and to prescribe opioid agonist treatment (OAT) medication flexibly. With the aim for most patients to receive take-home supplies for self-administration rather than attendance for observed daily dosing.DesignThis was a theory-driven, clinically applied qualitative study, with data for thematic analysis collected by semi-structured, audio-recorded, telephone interviews.ParticipantsTwenty-seven adults (aged ≥18 years) enrolled in sublingual (tablet) buprenorphine and oral (liquid) methadone OAT.SettingCommunity addictions centre in the London Borough of Lambeth operated by South London and Maudsley NHS Trust.ResultsThree major themes were identified: (1) dissatisfaction and perceived stigma with OAT medication dispensing arrangements before the pandemic; (2) positive adaptations in response to COVID-19 by services; (3) participants recommended that, according to preference and evidence of adherence, OAT should be personalised to offer increasing medication supplies for self-administration from as early as 7 days after commencement of maintenance prescribing.ConclusionsIn an applied qualitative study of patients enrolled in OAT during the COVID-19 pandemic, participants endorsed their opportunity to take medication themselves at home and with virtual addiction support. Most patients described a preference for self-administration with increased dispensing supplies, from as early as 7 days into maintenance treatment, if they could demonstrate adherence to their prescription.

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Methadone and buprenorphine-related deaths among people prescribed and not prescribed Opioid Agonist Therapy during the COVID-19 pandemic in England

Cited by 18 publications

References 43 publications

Augmentation des surdoses et décès en lien avec la consommation de méthadone durant la crise sanitaire liée au COVID-19 en 2020

Augmentation des surdoses et décès en lien avec la consommation de méthadone durant la crise sanitaire liée au COVID-19 en 2020

Should I Stay or Should I Go? A Qualitative Exploration of Stigma and Other Factors Influencing Opioid Agonist Treatment Journeys

Patients’ perceptions of self-administered dosing to opioid agonist treatment and other changes during the COVID-19 pandemic: a qualitative study

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