Social Science & Medicine, Journal Year: 2024, Volume and Issue: 347, P. 116772 - 116772
Published: March 16, 2024
Language: Английский
The Lancet Public Health, Journal Year: 2023, Volume and Issue: 8(3), P. e238 - e246
Published: Feb. 23, 2023
As the USA faces a worsening overdose crisis, improving access to evidence-based treatment for opioid use disorder (OUD) remains policy priority. Federal regulatory changes in response COVID-19 pandemic substantially expanded flexibilities on take-home doses methadone OUD. These have fuelled questions about effect of new regulations OUD outcomes and potential health permanently integrating these into going forward. To aide US makers as they consider implementing permanent changes, we conducted review synthesising peer-reviewed research policies introduced during programme operations, patient provider experiences, outcomes. We interpret findings context federal rule-making process discuss avenues by which can be incorporated implemented substance
Language: Английский
Citations
56
Addiction Science & Clinical Practice, Journal Year: 2021, Volume and Issue: 16(1)
Published: Nov. 13, 2021
Abstract Background The COVID-19 pandemic has exerted a significant toll on the lives of people who use opioids (PWUOs). At same time, more flexible regulations around provision opioid disorder (OUD) services have led to new opportunities for facilitating access PWUOs. In current scoping review, we describe and service modifications implemented by treatment harm reduction programs serving PWUO, discuss implications policy practice. Methods Literature searches were conducted within PubMed, LitCovid, Embase, PsycInfo English-language studies published in 2020 that particular program, service, or intervention aimed at OUD and/or during pandemic. Abstracts independently screened two reviewers. Relevant reviewed full those met inclusion criteria underwent final data extraction synthesis (n = 25). We used narrative approach identify major themes key innovations across PWUO. Results Reviewed spanned five continents range settings from substance street outreach programs. Innovative adapt circumstances primarily involved expanded telehealth (e.g., telemedicine visits buprenorphine, virtual individual group therapy sessions, donated publicly available phones), increased take-home medication allowances methadone uptake long-acting medications (e.g. extended-release buprenorphine naltrexone), home delivery MOUD, naloxone urine drug screening), makeshift delivering MOUD naloxone, safe supply opioids. Conclusions posed multiple challenges PWUOs, while simultaneously accelerating policies, care models, technologies lower thresholds life-saving services. Such highlight novel patient-centered feasible approaches mitigating related harms. Further are needed assess long-term impact these inform policies improve
Language: Английский
Citations
78
Telemedicine Journal and e-Health, Journal Year: 2021, Volume and Issue: unknown
Published: Oct. 29, 2021
Background: A scoping review was conducted to examine the breadth of evidence related telehealth innovations being utilized in treatment opioid use disorder (OUD) with buprenorphine and its effect on patient outcomes health care delivery. Materials Methods: The authors systematically searched seven databases websites for peer-reviewed gray literature solutions published between 2008 March 18, 2021. Two reviewers screened titles abstracts articles that met inclusion criteria, according study protocol. included studies if they specifically examined interventions aimed at improving access usage OUD. Results: After screening 371 records, selected 69 full review. These satisfaction, retention rates, accessibility adherence. Conclusion: According reviewed literature, incorporation technology medication-assisted OUD is associated higher comparable rates retention, an overall reduction costs, increase both buprenorphine. This has been made possible through expansion technologies a substantial push toward relaxed federal guidelines, which were quickly escalated response COVID-19 pandemic. Future research needed fully quantify these factors; however, results appear promising thus far should urge policymakers consider making temporary policy changes permanent.
Language: Английский
Citations
46
Addictive Behaviors, Journal Year: 2021, Volume and Issue: 127, P. 107213 - 107213
Published: Dec. 18, 2021
Language: Английский
Citations
45
Substance Use & Misuse, Journal Year: 2022, Volume and Issue: 57(7), P. 1144 - 1153
Published: April 21, 2022
Background Medications for Opioid Use Disorder (MOUD) are associated with important public health benefits. Program changes implemented in response to COVID-19 hold promise as ongoing strategies improve MOUD treatment. Methods: patients on buprenorphine or methadone, providers, government regulators, and persons who use drugs not were recruited the Northeast region of United States between June October 2020 via advertisements, fliers, word mouth. Semi-structured qualitative interviews conducted. Interviews professionally transcribed thematically coded by two independent coders. Results: We conducted 13 people currently buprenorphine, 11 3 previously 4 6 used but had never been MOUD. In addition, we interviewed clinic staff, officials at agencies that regulate Most participants found increased take-home doses, home medication delivery, telehealth during be favorable, reporting these program reduced travel time clinics, facilitated retention care, stigma attendance. However, some reported negative consequences COVID-19, most notably, decreased access basic resources, such food, clothing, harm reduction materials distributed clinics. Conclusion: Access can lifesaving using drugs. COVID-19-impelled changes, including generally improved participants' experiences Making permanent could care.
Language: Английский
Citations
33
Substance Abuse Treatment Prevention and Policy, Journal Year: 2023, Volume and Issue: 18(1)
Published: Sept. 30, 2023
Abstract Background The COVID-19 pandemic led to an unprecedented relaxation of restrictions on take-home doses in opioid agonist treatment (OAT). We conducted a mixed methods systematic review explore the impact these changes program effectiveness and client experiences OAT. Methods protocol for this was registered PROSPERO (CRD42022352310). From Aug.–Nov. 2022, we searched Medline, Embase, CINAHL, PsycInfo, Web Science, Cochrane Register Controlled Trials, grey literature. included studies reporting quantitative measures retention treatment, illicit substance use, overdose, health, quality life, or satisfaction using qualitative examine with during pandemic. critically appraised Mixed Appraisal Tool. synthesized data vote-counting by direction effect presented results harvest plots. Qualitative were analyzed thematic synthesis. used convergent segregated approach integrate findings. Results Forty included. Most from North America (23/40) United Kingdom (9/40). synthesis limited potential confounding, but suggested association between increased treatment. There no evidence use overdose. findings indicated that reduced clients’ exposure unregulated substances stigma minimized work/treatment conflicts. Though some clients reported challenges managing their medication, dominant narrative one appreciation, anxiety, renewed sense agency identity. integrated analysis burden as explanation improved revealed variation individual relationships use. identified critical gap patient-important outcomes. Conclusion associated experience found despite expansion previously ineligible groups. Including outcome policy, development, planning is essential ensuring decisions around accurately reflect value clients.
Language: Английский
Citations
18
Journal of Medical Internet Research, Journal Year: 2023, Volume and Issue: 25, P. e48905 - e48905
Published: Sept. 13, 2023
Reddit's (Reddit Inc) large user base, diverse communities, and anonymity make it a useful platform for substance use research. Despite growing body of literature on Reddit, challenges limitations must be carefully considered. However, no systematic scoping review has been conducted the Reddit as data source research.This aims to investigate studying by examining previous studies' objectives, reasons, limitations, methods using Reddit. In addition, we discuss implications contributions studies identify gaps in that require further attention.A total 7 databases were searched keyword combinations including substance-related keywords April 2022. The initial search resulted 456 articles, 227 articles remained after removing duplicates. All included peer reviewed, empirical, available full text, pertinent use, they all written English. After screening, 60 met eligibility criteria review, with 57 identified from database 3 ancestry search. A codebook was developed, qualitative content analysis performed extract relevant evidence related research questions.The grown steadily since 2015, sharp increase 2021. primary objective tendencies patterns various types discussions (52/60, 87%). also used explore unique experiences, propose methodologies, interactions, develop interventions. 9 reasons study identified, such platform's anonymity, its widespread popularity, explicit topics subreddits. noted, low representativeness general population lack demographic information. Most application programming interfaces collection quantitative approaches analysis, few approaches. Machine learning algorithms are commonly natural language processing tasks. theoretical, methodological, practical summarized discussed. most prevalent investigating prevailing discussions, providing recommendations clinical practices policies, comparing across sources.This provides an overview Although considered, analyzing them can understanding experiences use. Our highlights suggests avenues future
Language: Английский
Citations
17
International Journal of Drug Policy, Journal Year: 2021, Volume and Issue: 101, P. 103537 - 103537
Published: Nov. 19, 2021
Drug overdoses surged during the COVID-19 pandemic, underscoring need for expanded and accessible substance use disorder (SUD) treatment. Relatively little is known about experiences of patients receiving treatment pandemic.We worked with 21 harm reduction drug programs in nine states District Columbia from August 2020 to January 2021. Programs distributed study recruitment cards clients. Clients responded survey by calling a hotline providing unique identification number. Our included detailed questions SUD prior since pandemic. We identified settings where individuals received and, those treated opioid disorder, we examined medications disorder. Individuals also reported whether they had telehealth pandemic related changes (e.g., more take-home methadone). calculated p-values differences pre COVID-19.We interviewed 587 whom 316 (53.8%) were both before substantial reductions in-person service start including 27 percentage point (p<.001) group counseling sessions 28 mutual aid participation (p<.001). By contrast, increase receipt overdose education Most people taking methadone high continuity (86.1% pre-COVID 87.1% since-COVID, p=.71). Almost all advantage new policy such as video/phone, increased medication, or fewer urine screens. Overall, respondents relatively satisfaction their adaptations 80.2% "I'm able get that I need").Accommodations made under federal public health emergency appear have sustained access early months Since these are set expire after official declaration, further action needed meet ongoing need.
Language: Английский
Citations
40
Substance Abuse Treatment Prevention and Policy, Journal Year: 2021, Volume and Issue: 16(1)
Published: Aug. 9, 2021
Abstract Research objective The COVID-19 pandemic disrupted healthcare delivery worldwide with likely negative effects on people who use opioids (PWUO). This scoping review of the original research literature describes impact for PWUO and identifies gaps in literature. Methods maps available knowledge regarding PWUO. We utilized methodology developed by Joanna Briggs Institute reviews, content analyses to characterize current state Results Of 14 included studies, administrative database ( n = 11), cross-sectional 1) or qualitative 2) studies demonstrated service 7), patient/provider experiences 3), patient outcomes 4). In March 2020, utilization dropped quickly, sharply increasing only reasons opioid overdose May 2020. Service existed accessing treatment new patients during due capacity infrastructure limits. Physicians reported difficulty referring begin an outpatient program increased restrictions infrastructure. Patients also uncertainty about treatment, but that telehealth initiation buprenorphine access from home. Disproportionate increases rates among African Americans were two differences race gender not examined most studies. Fatal overdoses 60% pandemic, while fatal Non-Hispanic White individuals decreased. Conclusions summary, this beginning evidence demonstrates despite early reluctance system, overdose-related throughout pandemic. medications treat OUD remained at above pre-pandemic levels, indicating ability meet demand. Yet, racial disparities are intensifying, targeted intervention high-risk groups is warranted prevent further mortality. As progresses, future must focus identifying supporting subgroups heightened risk experiencing lack care.
Language: Английский
Citations
35
International Journal of Drug Policy, Journal Year: 2022, Volume and Issue: 110, P. 103877 - 103877
Published: Oct. 4, 2022
The coronavirus pandemic resulted in many changes which had the potential to impact mortality related opioid agonist therapy (OAT; methadone, buprenorphine), including prescribing and dispensing of OAT patterns drug availability use. We aimed assess first lockdown (initiated March 23rd 2020) on methadone- buprenorphine-related deaths England people both prescribed not using data from National Programme Substance Abuse Deaths.This was a retrospective post-mortem toxicology study OAT-related occurred 3-month period June 22nd years 2016-2020. Provisional regarding numbers accessing treatment for use disorder provided by Drug Treatment Monitoring System.We found 64% increase methadone-related 2020 compared 2019 (2019 n = 96; projected 157). There were increases rate in-treatment decedents (22% increase; 45; an exponential smoothing model 2016-19 trend [α=0.5] predicted 44 2020, 55 reported) methadone (74% 46; 43 80 reported). no 9/529; 11/566). where other opioids or multiple substances detected, levels detected. Numbers did decrease relative previous (p >0.05).Methadone-related non-prescribed individuals, but increased considerably above annual forecast during COVID-19 England. Further studies are thus needed understand this difference.
Language: Английский
Citations
25