Opioid treatment program safety measures during the COVID-19 pandemic: a statewide survey

Abstract

Background Opioid treatment programs (OTPs) serve as daily essential services for people with opioid use disorder. This study seeks to identify modifications to operations and adoption of safety measures at Pennsylvania OTPs during the COVID-19 pandemic. Methods A 25-min online survey to clinical and administrative directors at all 103 state-licensed OTPs in Pennsylvania was fielded from September to November 2020. Survey domains included: 1) changes to services, client volume, hours and staffing during the COVID-19 pandemic 2) types of services modifications 3) safety protocols to reduce COVID-19 transmission 4) challenges to operations during the pandemic. Results Forty-seven directors responded, for a response rate of 45%. Almost all respondents reported making some service modification (96%, n = 43). Almost half (47%, n = 21) of respondents reported reductions in the number of clients served. OTPs were more likely to adopt safety protocols that did not require significant funding, such as limiting the number of people entering the site (100%, n = 44), posting COVID-safety information (100%, n = 44), enforcing social distancing (98%, n = 43), and increasing sanitation (100%, n = 44). Only 34% (n = 14) of OTPS provided N95 masks to most or all staff. Respondents reported that staff’s stress and negative mental health (86%, n = 38) and staff caregiving responsibilities (84%, n = 37) during the pandemic were challenges to maintaining OTP operations. Conclusion OTPs faced numerous challenges to operations and adoption of safety measures during the COVID-19 pandemic. Funding mechanisms and interventions to improve adoption of safety protocols, staff mental health as well as research on patient experiences and preferences can inform further OTP adaptation to the COVID-19 pandemic and future emergency planning.

Shifting Medication Treatment Practices in the COVID-19 Pandemic: A Statewide Survey of Pennsylvania Opioid Treatment Programs

“…Additional domains reported in a separate manuscript include procedures adopted for COVID safety and risk mitigation. 24 Clinical directors were asked to indicate which services and practices were used before versus after the start of the COVID-19 pandemic. These items included a combination of multiple choice and free response questions.…”

COVID‐19: Implications for Nursing and Health Care in the United States

“…The Coronavirus Aid Relief and Economic Security (CARES) Act, passed in 2020, allowed the Bureau of Prisons to release nonviolent, pretrial prisoners to expanded home confinement, which alleviated COVID‐related risks for some. However, rapid release without assurance of continuity of care placed released prisoners who struggled with opioid use disorder at risk of relapse (Bandara et al, 2022; Dadiomov et al, 2022).…”

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

“…Although prior research suggests service providers including methadone counselors at OTPs can be a source of enacted and anticipated stigma for their clients [123][124][125][126], these data suggest supportive providers can also have positive influences on their clients. Other studies have reported operational challenges in MOUD provision including staffing reductions and staff turnover at OTPs and office-based treatment programs during the pandemic [127,128], which may be disruptive to maintaining supportive relationships between clients and their providers as well as the clients' engagement in substance use disorder treatmentrelated services. Substance use disorder treatment programs need the resources to facilitate the retention of trained service providers who may have long-standing relationships with their clients.…”