Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review

Abstract Background The COVID-19 pandemic has exerted a significant toll on the lives of people who use opioids (PWUOs). At the same time, more flexible regulations around provision of opioid use disorder (OUD) services have led to new opportunities for facilitating access to services for PWUOs. In...

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Autores principales:	Noa Krawczyk, Adetayo Fawole, Jenny Yang, Babak Tofighi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Opioids Opioid use disorder Treatment Harm reduction COVID-19 Telehealth Medicine (General) R5-920 Social pathology. Social and public welfare. Criminology HV1-9960
Acceso en línea:	https://doaj.org/article/859133be9a3d4fbfb0d6ac7727168bf6
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spelling	oai:doaj.org-article:859133be9a3d4fbfb0d6ac7727168bf62021-11-14T12:37:06ZEarly innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review10.1186/s13722-021-00275-11940-0640https://doaj.org/article/859133be9a3d4fbfb0d6ac7727168bf62021-11-01T00:00:00Zhttps://doi.org/10.1186/s13722-021-00275-1https://doaj.org/toc/1940-0640Abstract Background The COVID-19 pandemic has exerted a significant toll on the lives of people who use opioids (PWUOs). At the same time, more flexible regulations around provision of opioid use disorder (OUD) services have led to new opportunities for facilitating access to services for PWUOs. In the current scoping review, we describe new services and service modifications implemented by treatment and harm reduction programs serving PWUO, and discuss implications for policy and practice. Methods Literature searches were conducted within PubMed, LitCovid, Embase, and PsycInfo for English-language studies published in 2020 that describe a particular program, service, or intervention aimed at facilitating access to OUD treatment and/or harm reduction services during the COVID-19 pandemic. Abstracts were independently screened by two reviewers. Relevant studies were reviewed in full and those that met inclusion criteria underwent final data extraction and synthesis (n = 25). We used a narrative synthesis approach to identify major themes around key service modifications and innovations implemented across programs serving PWUO. Results Reviewed OUD treatment and harm reduction services spanned five continents and a range of settings from substance use treatment to street outreach programs. Innovative service modifications to adapt to COVID-19 circumstances primarily involved expanded use of telehealth services (e.g., telemedicine visits for buprenorphine, virtual individual or group therapy sessions, provision of donated or publicly available phones), increased take-home medication allowances for methadone and buprenorphine, expanded uptake of long-acting opioid medications (e.g. extended-release buprenorphine and naltrexone), home delivery of services (e.g. MOUD, naloxone and urine drug screening), outreach and makeshift services for delivering MOUD and naloxone, and provision of a safe supply of opioids. Conclusions The COVID-19 pandemic has posed multiple challenges for PWUOs, while simultaneously accelerating innovations in policies, care models, and technologies to lower thresholds for life-saving treatment and harm reduction services. Such innovations highlight novel patient-centered and feasible approaches to mitigating OUD related harms. Further studies are needed to assess the long-term impact of these approaches and inform policies that improve access to care for PWUOs.Noa KrawczykAdetayo FawoleJenny YangBabak TofighiBMCarticleOpioidsOpioid use disorderTreatmentHarm reductionCOVID-19TelehealthMedicine (General)R5-920Social pathology. Social and public welfare. CriminologyHV1-9960ENAddiction Science & Clinical Practice, Vol 16, Iss 1, Pp 1-15 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Opioids Opioid use disorder Treatment Harm reduction COVID-19 Telehealth Medicine (General) R5-920 Social pathology. Social and public welfare. Criminology HV1-9960
spellingShingle	Opioids Opioid use disorder Treatment Harm reduction COVID-19 Telehealth Medicine (General) R5-920 Social pathology. Social and public welfare. Criminology HV1-9960 Noa Krawczyk Adetayo Fawole Jenny Yang Babak Tofighi Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review
description	Abstract Background The COVID-19 pandemic has exerted a significant toll on the lives of people who use opioids (PWUOs). At the same time, more flexible regulations around provision of opioid use disorder (OUD) services have led to new opportunities for facilitating access to services for PWUOs. In the current scoping review, we describe new services and service modifications implemented by treatment and harm reduction programs serving PWUO, and discuss implications for policy and practice. Methods Literature searches were conducted within PubMed, LitCovid, Embase, and PsycInfo for English-language studies published in 2020 that describe a particular program, service, or intervention aimed at facilitating access to OUD treatment and/or harm reduction services during the COVID-19 pandemic. Abstracts were independently screened by two reviewers. Relevant studies were reviewed in full and those that met inclusion criteria underwent final data extraction and synthesis (n = 25). We used a narrative synthesis approach to identify major themes around key service modifications and innovations implemented across programs serving PWUO. Results Reviewed OUD treatment and harm reduction services spanned five continents and a range of settings from substance use treatment to street outreach programs. Innovative service modifications to adapt to COVID-19 circumstances primarily involved expanded use of telehealth services (e.g., telemedicine visits for buprenorphine, virtual individual or group therapy sessions, provision of donated or publicly available phones), increased take-home medication allowances for methadone and buprenorphine, expanded uptake of long-acting opioid medications (e.g. extended-release buprenorphine and naltrexone), home delivery of services (e.g. MOUD, naloxone and urine drug screening), outreach and makeshift services for delivering MOUD and naloxone, and provision of a safe supply of opioids. Conclusions The COVID-19 pandemic has posed multiple challenges for PWUOs, while simultaneously accelerating innovations in policies, care models, and technologies to lower thresholds for life-saving treatment and harm reduction services. Such innovations highlight novel patient-centered and feasible approaches to mitigating OUD related harms. Further studies are needed to assess the long-term impact of these approaches and inform policies that improve access to care for PWUOs.
format	article
author	Noa Krawczyk Adetayo Fawole Jenny Yang Babak Tofighi
author_facet	Noa Krawczyk Adetayo Fawole Jenny Yang Babak Tofighi
author_sort	Noa Krawczyk
title	Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review
title_short	Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review
title_full	Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review
title_fullStr	Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review
title_full_unstemmed	Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review
title_sort	early innovations in opioid use disorder treatment and harm reduction during the covid-19 pandemic: a scoping review
publisher	BMC
publishDate	2021
url	https://doaj.org/article/859133be9a3d4fbfb0d6ac7727168bf6
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Early innovations in opioid use disorder treatment and harm reduction during the COVID-19 pandemic: a scoping review

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