“The post-COVID era”: challenges in the treatment of substance use disorder (SUD) after the pandemic

Abstract

Background Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks. Main body Renewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three “best buys” of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information. Conclusion The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.

Rapid evidence review of harm reduction interventions and messaging for people who inject drugs during pandemic events: implications for the ongoing COVID-19 response

“…Much of the evidence makes recommendations around telehealth [ 14 , 25 , 32 , 33 ] as well as describing other technology that HR services could utilize, including smartphone and web-based interventions, text messaging for continuing contact and care, machine learning and wearable devices, including digital phenotyping and ecological momentary assessment, biofeedback and virtual reality [ 34 , 35 ]. Lead time and availability of technology (for both services and clients) will limit implementation of these options in the short term with text-messaging, smartphone and web-based interventions being the most simple and quick to roll-out.…”

“…Links to social and economic services were also emphasized as important. For instance, ‘Housing First’ was highlighted as an approach which can facilitate social distancing and provide stability for PWID to engage in HR and manage extended OST take home doses appropriately [ 33 , 34 ]. With increased duration of take home OST, one review concluded that accommodation for the homeless should have capacity for the safe storage of medications and space to designate as a safer use room [ 38 ].…”

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

“…The second, the topics and references. Category Topic and references Change to medical practice Mental health care [254] , [257] , [261] , [273] , [274] , [275] ; Emergency care [276] , [277] ; Substance abuse [253] , [263] , [278] , [279] , [280] ; Oncological care [264] , [281] Health care practices [255] , [259] , [262] , [282] , [283] , [284] ; Pediatric care [283] , [285] Other care [256] , [260] , [268] , [286] , [287] , [288] Modeling Modeling approaches [28] , [265] , [289] , [290] , [291] , [292] , [293] ; Transmission dynamics [294] , [295] , [296] , [297] , [298] Mobile phone data [29] ; estimation [258] Effect of NPIs Effects on: children ...…”

“…This is the largest group of comments and/or perspectives. We find articles focused on a range of medical specialities: mental health care [254] , [257] , [261] , [273] , [274] , [275] , emergency care [276] , [277] , substance abuse [253] , [263] , [278] , [279] , [280] , oncological care [264] , [281] , health care practices [255] , [259] , [262] , [282] , [283] , [284] , pediatric care [283] , [285] , and other care [256] , [260] , [268] , [286] , [287] , [288] .…”

The Mediating Role of Internalized Stigma and Shame on the Relationship between COVID-19 Related Discrimination and Mental Health Outcomes among Back-to-School Students in Wuhan

“…Ashamed individuals might blame themselves rather than others, believing that failures reflect inadequacy in themselves. Shame often originates from incorrect perception or belief in particular events, and it may be an underlying mechanism in which stigma is enacted [ 27 ]. Concerning infectious disease-perceived discrimination, individuals may exhibit feelings of shame and stigmatization synchronously.…”