Continuing increased access to buprenorphine in the United States via telemedicine after COVID-19

Davis, Corey S.; Samuels, Elizabeth A.

doi:10.1016/j.drugpo.2020.102905

Cited by 80 publications

(86 citation statements)

References 24 publications

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“…While our study is specific to methadone maintenance treatment in three clinics, these results may suggest a need for a better understanding of how the SAMHSA directive was implemented during COVID-19. The COVID-19 pandemic creates substantial urgency in improving and expanding access to persons seeking OUD treatment (Davis & Samuels, 2020; Peavy et al, 2020). In addition, COVID-19 presents an opportunity to re-examine dated regulations surrounding OUD treatment (del Pozo & Beletsky, 2020; Krawczyk et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…The coronavirus pandemic (COVID-19) has created an urgency for opioid treatment programs (OTPs) to respond by ensuring continued access for existing patients, promoting patient safety, and expanding to new patients (Davis & Samuels, 2020; Del Pozo et al, 2020; Khatri & Perrone, 2020; Krawczyk et al, 2020; Leppla & Gross, 2020). In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidelines allowing expanded use of take-home doses for more “stable” patients, likely relevant to those who have displayed longer durations of treatment (Substance Abuse and Mental Health Services Administration, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Take-Home Dosing Experiences among Persons Receiving Methadone Maintenance Treatment During COVID-19

Figgatt

Salazar

Day

et al. 2020

Preprint

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Purpose: Methadone maintenance treatment is a life-saving treatment for people with opioid use disorders (OUD). The coronavirus pandemic (COVID-19) introduces many concerns surrounding access to opioid treatment. In March 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued guidance allowing the expansion of take-home methadone doses. We sought to describe changes to treatment experiences from the perspective of persons receiving methadone at outpatient treatment facilities for OUD. Methods: We conducted an in-person survey among 104 persons receiving methadone from three clinics in central North Carolina. Surveys collected information on demographic characteristics, methadone treatment history, and experiences with take-home methadone doses in the context of COVID-19 (i.e., before and since March 2020). Results: Before COVID-19, the clinic-level percent of participants receiving any amount of days supply of take-home doses at each clinic varied ranged from 56% to 82%, while it ranged from 78% to 100% since COVID-19. The clinic-level percent of participants receiving a take-homes days supply of a week or longer (i.e., ≥6 days) since COVID-19 ranged from 11% to 56%. Of the 87 participants who received take-homes since COVID-19 began, only four reported selling their take-home doses. Conclusions: Our study found variation in experiences of take-home dosing by clinic and little diversion of take-home doses. While SAMSHA guidance should allow expanded access to take-home doses, adoption of these guidelines may vary at the clinic level. The adoption of these policies should be explored further, particularly in the context of benefits to patients seeking treatment for OUD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Take-Home Dosing Experiences among Persons Receiving Methadone Maintenance Treatment During COVID-19

Figgatt

Salazar

Day

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…In the future, it will be critical to examine the impacts of increased take-home doses on health outcomes among people receiving OAT. In a similar fashion, drug treatment services have adapted by extending OAT medication prescriptions for longer periods, reducing or removing urine testing, and providing mobile outreach OAT provision for the more vulnerable ( Crowley and Delargy, 2020 , Davis and Samuels, 2020 , Dunlop et al, 2020 , EMCDDA, 2020b , Samuels et al, 2020 ). These adaptations arguably begin to move drug treatment from a tool of discipline among the socially excluded ( Fraser, 2006 ) to an intervention of social inclusion , for the first time in some settings, thereby making services amenable and adaptable to people who use drugs.…”

Section: Introductionmentioning

confidence: 99%

“…Where feasible, many drug treatment services have adapted by replacing face-to-face intervention with telephone, video or internet-based alternatives ( Bruneau et al, 2020 , Davis and Samuels, 2020 , EMCDDA, 2020b , Samuels et al, 2020 ). As noted above, the development of community outreach, especially to those most socially marginalized, is a key feature of service adaptation prompted by COVID-19 ( EMCDDA, 2020b ).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and the health of people who use drugs: What is and what could be?

Grebely

Cerdá

Rhodes

2020

International Journal of Drug Policy

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SARS-CoV-2, the virus that causes COVID-19, has changed the world as we know it, and continues to do so. How COVID-19 affects people who use drugs, the environments in which they live, and capacities of response, warrants immediate attention. This special issue begins to map how COVID-19 is altering the health of people who use drugs, including in relation to patterns of drug use, service responses, harms that may relate to drug use, interventions to reduce risk of harms, COVID-19 health, and drug policies. We emphasise the need to envisage COVID-19 and its effects as a matter of intersecting ‘complex adaptive systems’: that is, the impacts of COVID-19 extend beyond the virus and related illness conditions to encompass multiple social, cultural, economic, policy and political effects; and these affect the health of people who use drugs directly as well as indirectly by altering the risk and enabling environments in which they live. We synthesize emergent evidence on the impact of COVID-19 on the health of people who use drugs. A key concern we identify is how to sustain policy and service delivery improvements prompted by COVID-19. We need to maintain an ethos of emergent adaptation and experimentation towards the creation of safer environments in relation to the health of people who use drugs.

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“…The Ryan Haight Act's restrictions can be waived for providers practicing telemedicine during any public health emergency. While the current waiver was predicated on the COVID-19 pandemic, the DEA can and should extend the current waiver to initiate buprenorphine via telemedicine, including use of the telephone only encounters where necessary, for the duration of the opioid public health emergency that has existed since late 2017 ( Davis & Samuels 2020 ).…”

mentioning

confidence: 99%

Using telehealth to improve buprenorphine access during and after COVID-19: A rapid response initiative in Rhode Island

Clark

Davis

Wightman

et al. 2021

Journal of Substance Abuse Treatment

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Continuing increased access to buprenorphine in the United States via telemedicine after COVID-19

Cited by 80 publications

References 24 publications

Take-Home Dosing Experiences among Persons Receiving Methadone Maintenance Treatment During COVID-19

Take-Home Dosing Experiences among Persons Receiving Methadone Maintenance Treatment During COVID-19

COVID-19 and the health of people who use drugs: What is and what could be?

Using telehealth to improve buprenorphine access during and after COVID-19: A rapid response initiative in Rhode Island

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