Substance Use Disorders and Telehealth in the COVID-19 Pandemic Era

Oesterle, Tyler S.; Kolla, Bhanuprakash; Risma, Cameron J.; Breitinger, Scott; Rakocevic, Daniela B.; Loukianova, Larissa L.; Hall‐Flavin, Daniel K.; Gentry, Melanie T.; Rummans, Teresa A.; Chauhan, Monika; Gold, Mark S.

doi:10.1016/j.mayocp.2020.10.011

Cited by 107 publications

(78 citation statements)

References 45 publications

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“…Despite evidence that the COVID-19 pandemic has exacerbated psychiatric and substance use symptoms, the ability of services and practitioners to provide, and patients to access, treatment has been limited by public health responses introduced in efforts to reduce the transmission of COVID-19. With healthcare systems under pressure and under resourced, there is the risk that people with chronic co-occurring psychiatric and substance use disorders may be even more marginalized by a health system prioritizing the urgency of COVID-19 patients [ 15 , 48 ]. Patients with these disorders may find it difficult to continue current treatment, access medications or attend new treatment if symptoms recur or become exacerbated with some services not accepting new patients [ 15 , 33 , 41 , 49 , 50 ▪▪ , 51 ▪▪ ].…”

Section: Challenges and Opportunities For The Provision Of Evidence-based Treatmentmentioning

confidence: 99%

Substance use, mental disorders and COVID-19: a volatile mix

Marel

Mills

Teesson

2021

Current Opinion in Psychiatry

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Purpose of review The COVID-19 pandemic and associated restrictions have uniquely and disproportionately affected vulnerable populations. This review summarizes recent evidence on the relationship between psychiatric disorders, substance use disorders and COVID-19, highlighting acute and long-term risks, pharmacotherapy interactions and implications regarding appropriate and timely evidence-based treatment. Recent findings Evidence points to a complex relationship between psychiatric and substance use disorders and COVID-19. A range of risk factors associated with psychiatric and substance use disorders increases the risk of exposure to, and complications arising from, the COVID-19 virus. COVID-19 infection has been indicated as having acute and potential long-term impacts on both psychiatric and substance use disorders. Social disruption associated with restrictions imposed to curb transmission has also been identified as a risk factor for new onset of disorders and recurrence and exacerbation of existing conditions. Summary Early recognition and intervention are key to preventing chronic disability associated with psychiatric disorders, substance use disorders, and their co-occurrence. It is critical that those most in need of services do not fall through the cracks of our healthcare systems. The pandemic has fast tracked the opportunity for widespread implementation of digital health interventions but ensuring these are accessible and available to all, including our most vulnerable, will be a critical task for our future health and social ecosystems.

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Section: Challenges and Opportunities For The Provision Of Evidence-based Treatmentmentioning

confidence: 99%

Substance use, mental disorders and COVID-19: a volatile mix

Marel

Mills

Teesson

2021

Current Opinion in Psychiatry

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“…Some OAT services rapidly revised their policies related to take-away doses and telehealth consultations to reduce barriers to continuing care. 34 Other strategies for managing overdose risk during the COVID-19 pandemic include increasing distribution of naloxone (ie, a short-acting opioid antagonist that reverses respiratory depression in opioid overdose), providing access to safe drug supply, and expanding availability of new tech nologies for harm reduction. 35 Even so, changes or disruptions to treatment and preven tion services com pounded with other mental health disorders, isolation, stress, and economic uncertainty during the pandemic might put individuals with opioid use disorder at higher risk of overdose than before the pandemic.…”

Section: Global Trends In Opioid Use and Overdosementioning

confidence: 99%

Big data and predictive modelling for the opioid crisis: existing research and future potential

Bharat

Hickman

Barbieri

et al. 2021

The Lancet Digital Health

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A need exists to accurately estimate overdose risk and improve understanding of how to deliver treatments and interventions in people with opioid use disorder in a way that reduces such risk. We consider opportunities for predictive analytics and routinely collected administrative data to evaluate how overdose could be reduced among people with opioid use disorder. Specifically, we summarise global trends in opioid use and overdoses; describe the use of big data in research into opioid overdose; consider the potential for predictive modelling, including machine learning, for prevention and monitoring of opioid overdoses; and outline the challenges and risks relating to the use of big data and machine learning in reducing harms that are related to opioid use. Future research for improving the coverage and provision of existing interventions, treatments, and resources for opioid use disorder requires collaboration of multiple agencies. Predictive modelling could transport the concept of stratified medicine to public health through novel methods, such as predictive modelling and emulated trials for evaluating diagnoses and prognoses of opioid use disorder, predicting treatment response, and providing targeted treatment recommendations.

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“…Treatments that prioritize and maximize the quality of life [48]. Psychoeducation and support groups for patients and caregivers [49] [50,51]. Screen and treat for sensory deficits, an independent predictor of social isolation [44] Development Factors in one's development may contribute to vulnerability to the "D's" encountered later in life.…”

Section: Deadly Meansmentioning

confidence: 99%

Understanding Vulnerability to Late-Life Suicide

Ding

Kennedy

2021

Curr Psychiatry Rep

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Purpose of Review We review recent evidence on suicide among older adults, examine risk factors contributing to vulnerability to late-life suicide, and summarize possible interventions. Recent Findings We found a steadily increasing rate of late-life suicide in the USA in the past decade. Evidence supporting the integration of depression care managers into primary care for risk reduction is among the strongest to date. Pharmacologic and neuromodulation studies should be considered in geriatric depression complicated by suicidality. Broad societal campaigns about suicide education, as well as active outreach to psychiatric patients after discharge or a suicidal crisis, prevent suicidal behavior. Growing research supports an integrative multidisciplinary approach. Summary Suicide is a complex and multifaceted behavior with numerous casual points for intervention. Access to deadly means, presence of depression, disease, disability, and social disconnection are factors that increase vulnerability. Quality geriatric care, regular screening in primary and emergency care settings, and a multidisciplinary approach are necessary to mitigate risk factors. The COVID-19 pandemic amplifies need for a more aggressive approach.

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Substance Use Disorders and Telehealth in the COVID-19 Pandemic Era

Cited by 107 publications

References 45 publications

Substance use, mental disorders and COVID-19: a volatile mix

Substance use, mental disorders and COVID-19: a volatile mix

Big data and predictive modelling for the opioid crisis: existing research and future potential

Understanding Vulnerability to Late-Life Suicide

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