Pandemic telehealth flexibilities for buprenorphine treatment: a synthesis of evidence and policy implications for expanding opioid use disorder care in the United States

Health Affairs Scholar, Год журнала: 2023, Номер 1(1)

Опубликована: Июнь 20, 2023

Buprenorphine is a highly effective treatment for opioid use disorder (OUD) and critical tool addressing the worsening US overdose crisis. However, multiple barriers to treatment-including stringent federal regulations-have historically made this medication hard reach many who need it. In 2020, under COVID-19 public health emergency, regulators substantially changed access buprenorphine by allowing prescribers initiate patients on via telehealth without first evaluating them in person. As emergency has been set expire May of 2023, Congress agencies can leverage extensive evidence from studies conducted during wake pandemic make evidence-based decisions regulation going forward. To aid policy makers, narrative review synthesizes interprets peer-reviewed research effect flexibilities uptake implementation telehealth, its impact OUD patient prescriber experiences, treatment, outcomes. Overall, our finds that took advantage including audio-only option, with wide range benefits few downsides. result, regulators-including Congress-should continue nonrestricted initiation.

Язык: Английский

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Intersecting substance use treatment and harm reduction services: exploring the characteristics and service needs of a community-based sample of people who use drugs

Harm Reduction Journal, Год журнала: 2022, Номер 19(1)

Опубликована: Авг. 24, 2022

Substance use treatment and harm reduction services are essential components of comprehensive strategies for reducing the harms drug overdose. However, these have been historically siloed, there is a need to better understand how programs that serve people who drugs (PWUD) integrating services. In this study, we compared offered by multistate sample substance service providers assessed well they align with characteristics needs clients early in COVID-19 pandemic.We recruited convenience deliver and/or ten US states. Program directors participated survey assessing at their program. We also participate range sociodemographic health characteristics, behaviors, utilization. then cross-compared client behaviors relative being through programs.We collected analyzed data from 511 attending 18 classified as either offering medications opioid disorder (MOUD) (N = 6), syringe (SSP) 8), or both MOUD SSP 4). All delivered services, & delivering greatest breadth There were discrepancies between provided reported clients: 80% without actively used 50% injected drugs; 40% sought Approximately half unemployed unstably housed, but few direct social services.In many ways, existing not meeting PWUD. Investing innovative models empower integrate accessible flexible treatment, can pave way more effective equitable system considers long-term

Язык: Английский

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Self‐reported experiences and perspectives on using psychedelics to manage opioid use among participants of two Reddit communities

Addiction, Год журнала: 2025, Номер unknown

Опубликована: Янв. 16, 2025

The opioid crisis continues to exert a tremendous toll in North America, with existing interventions often falling short of addressing ongoing needs. Psychedelics are emerging as possible alternative therapy for mental health and substance use disorders. This study aimed gather insights on how people or considering using psychedelics manage disorder (OUD), these experiences perceived impact what lessons imply future research practice. We conducted qualitative the Reddit online community platform. extracted posts that contained key psychedelic terms from two most subscribed-to subreddits dedicated discussions OUD treatment (r/OpiatesRecovery r/Methadone) 2018 2021. thematically analyzed content 151 relevant their respective comments. Two prominent themes identified were perspectives effectiveness treating OUD, mechanisms through which thought desire opioids. For many, deemed have strong via multiple mechanisms, including alleviating physical symptoms dependence, shifting motivations around opioids underlying problems reasons use. Others saw potential promise exaggerated, acknowledging many eventually return use, even considered dangerous. There appear be diverse effects treat an urgent need controlled studies better understand different they may used context treatments strategies must combined ensure safety effectiveness. Integrating who drugs will help guide toward effective person-centered enhance wellness.

Язык: Английский

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Stigma and Behavior Change Techniques in Substance Use Recovery: Qualitative Study of Social Media Narratives

JMIR Formative Research, Год журнала: 2025, Номер 9, С. e57468 - e57468

Опубликована: Март 26, 2025

Background Existing literature shows that persons with substance use disorder (SUD) experience different stages of readiness to reduce or abstain from use, and tailoring intervention change strategies these may facilitate recovery. Moreover, stigma serve as a barrier recovery by preventing SUDs seeking treatment. In recent years, the behavior technique (BCT) taxonomy has increasingly become useful for identifying potential efficacious components; however, prior not addressed extent which techniques naturally be used recover knowledge this in design future interventions. Objective We take three-step approach recovery: (1) characterizing are expressed social media data, (2) BCTs at change, (3) exploring role plays journeys. Methods collected discussion posts Reddit, popular networking site, identified subreddits forums about 3 substances (alcohol, cannabis, opioids). then performed qualitative data analysis using hybrid inductive-deductive method identify authors’ journeys, content authors they sought quit played Results examined 748 pertaining substances: alcohol (n=316, 42.2%), cannabis (n=335, 44.8%), opioids (n=135, 18%). Social representing was observed, majority (472/748, 63.1%) narratives action stage. total, 11 categories were identified. There similarities BCT across precontemplation, contemplation, preparation stages, support awareness natural consequences being most common. As people their (action stage), we observed variety BCTs, such repetition substitution healthful behaviors monitoring receiving feedback on own behavior. maintenance stage, reports diverse continue frequent, but offers also more common than previous stages. Stigma present throughout all 5 major themes manifestation stigma. Conclusions Patterns stigmatizing experiences frequently discussed media, can leveraged better understand course SUD how interventions might use. It important incorporate reduction journey.

Язык: Английский

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Which social media platforms facilitate monitoring the opioid crisis?

PLOS Digital Health, Год журнала: 2025, Номер 4(4), С. e0000842 - e0000842

Опубликована: Апрель 28, 2025

Social media can provide real-time insight into trends in substance use, addiction, and recovery. Prior studies have used platforms such as Reddit X (formerly Twitter), but evolving policies around data access threatened these platforms’ usability research. We evaluate the potential of a broad set to detect emerging opioid use disorder overdose epidemic. From these, we identified 11 high-potential platforms, for which documented regulating drug-related discussion, accessibility, geolocatability, prior opioid-related studies. quantified their volume including informal language by slang generated using large model. Beyond most commonly X/Twitter, with high surveillance are TikTok, YouTube, Facebook. Leveraging variety social instead merely one, yields broader subpopulation representation safeguards against reduced any single platform.

Язык: Английский

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Information Needs for Opioid Use Disorder Treatment Using Buprenorphine Product: A Qualitative Analysis of Suboxone-Focused Reddit Data (Preprint)

Journal of Medical Internet Research, Год журнала: 2025, Номер unknown

Опубликована: Фев. 10, 2025

Язык: Английский

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The Pursuit of Peer Support for Opioid Use Recovery on Reddit

Proceedings of the International AAAI Conference on Web and Social Media, Год журнала: 2023, Номер 17, С. 12 - 23

Опубликована: Июнь 2, 2023

Individuals suffering from Opioid Use Disorder and other socially stigmatized conditions often rely on peer support groups to find comfort motivation while treating their condition. Many may face barriers in accessing treatment, such as shame social stigma, seclusion, or mobility restrictions. In this study, we quantitatively characterize the potential of Reddit community offering these individuals an online alternative receiving support. By analyzing interactions thousands users during start opioid use recovery, uncover that a particular exhibits many characteristics similar in-person groups, featuring exchange support, trust, status, experiences. We supportive behavior nudges change personal behavior, promotes abandoning opioid-related communities favor recovery-oriented relationships. Finally, recognition, acknowledgment, knowledge are most relevant factors sustained engagement with recovery community. Given evidence, suggest constitute complement surrogate when meetings not desirable possible. Our work might inspire harm reduction policies interventions successful rehabilitation is fundamental for future research about digital media

Язык: Английский

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The estimated impact of state‐level support for expanded delivery of substance use disorder treatment during the COVID‐19 pandemic

Addiction, Год журнала: 2021, Номер 117(6), С. 1781 - 1786

Опубликована: Дек. 7, 2021

To prevent COVID-19 transmission, some United States (US) federal regulations on substance use disorder (SUD) treatment were suspended in March 2020. This study aimed to quantify the extent of state-level policy uptake and potential number people with SUD affected by these changes across US, as well assess if correlated rates already or needing treatment.Cross-sectional analysis policies implemented April 13, 2020.A total 50 US states District Columbia MEASUREMENTS: State-level implementation of: oral schedule II controlled substances emergency prescription, extended take-home doses for medication opioid disorders (MOUD), home-delivery medications, telemedicine II-IV prescriptions, buprenorphine prescribing initiation, waiver out-of-state Drug Enforcement Administration (DEA) registration. Rates per 100 000 population adults SUD, MOUD at facilities programs, based Diagnostic Statistical Manual Mental Disorders (DSM)-IV criteria, needing, but not receiving treatment.Half (n = 24) enacted no policies, leaving ~460 955 114 370 pre-pandemic uncovered any expansion. Only initiation was marginally associated rate (OR 1.003, 95% CI [1.001, 1.006]) therapy 1.006, [1.002, 1.011]) univariable analysis, associations longer significant when controlling demographics. No state-wide prevalence unmet need (P > 0.05).Twenty-four did implement least one expansion 2020, approximately half a million potentially without access risking exposure continue in-person therapies.

Язык: Английский

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Consensus recommendations for opioid agonist treatment following the introduction of emergency clinical guidelines in Ireland during the COVID-19 pandemic: A national Delphi study

International Journal of Drug Policy, Год журнала: 2022, Номер 106, С. 103768 - 103768

Опубликована: Июнь 16, 2022

Emergency contingency guidelines for opioid agonist treatment (OAT) were introduced in Ireland March 2020, to ensure rapid and uninterrupted access while mitigating COVID-19 risk. The deviated, across multiple clinical domains, from pre-pandemic published 2016. objectives of this study are (1) identify changes OAT during the pandemic; (2) develop consensus on whether new recommendations should be retained beyond pandemic, using a national Delphi methodology. Clinical guidance ('statements') generated by comparing newly established with 2016 Guidelines OAT. Over two rounds on-line testing, panel experts (people currently accessing OAT, psychiatrists, general practitioners, community pharmacists, nurse, psychologist support/key workers) independently rated their agreement each statement provided comments. Statements median score 4 or 5 lower quartile ≥4 classified as having reached consensus. Forty-eight members recruited, high participation level at Round 2 (90%, n=43). Consensus was achieved 12 19 statements 1. 7 remaining revised, statements, resulting 9 2. Four final list includes 16 statements; relating assessment, 3 drug choice dosing, 1 take-away doses, overdose prevention continuation e-prescriptions. A wide range stakeholders involved delivery receipt agreed inclusion we move rather than reverting guidelines. relate facilitating safe minimal waiting time, supporting patient-centred care promote health well-being, preventing overdose. Notably, not dosage frequency urine testing stabilisation maintenance phase care.

Язык: Английский

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Patient experiences of methadone treatment changes during the first wave of COVID-19: a national community-driven survey

Harm Reduction Journal, Год журнала: 2023, Номер 20(1)

Опубликована: Март 9, 2023

Abstract Background During COVID-19, the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed Methadone Maintenance Treatment (MMT) programs to relax in-person MMT requirements reduce COVID-19 exposure. This study examines patient-reported changes methadone clinic attendance during COVID-19. Methods From June 7, 2020, July 15, a convenience sample of patients ( N = 392) were recruited in collaboration with National Survivors Union (NSU) 43 states Washington D.C. through social media (Facebook, Reddit, Twitter, Web site pop-ups). The community-driven research (CDR) online survey collected information on how patient take-home dosing drug testing, counseling, visit frequency changed prior (before March 2020) (June 2020). Results time period, percentage respondents receiving at least 14 days doses increased from 22 53%, while one or no decreased 22.4% before 10.2% In-person counseling 82.9% 19.4%. While only 3.3% accessed telehealth this 61.7% Many (41.3%) reported visiting their clinics person once week more Conclusions first wave report use for services. However, considerable variations, many still required make frequent visits, which put risk Relaxations should be consistently implemented made permanent, experiences these explored further.

Язык: Английский

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