COVID-19 Pandemic and People Who Use Opioids in India: Opportunities and Evolutions

Parmar, Arpit; Kumari, Richa; Padhy, Susanta Kumar

doi:10.1177/0253717620965882

Cited by 7 publications

(4 citation statements)

References 12 publications

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“…34,40 . During the COVID-19 pandemic, recognizing care-seeking challenges during periods of uncontrolled transmission and lockdowns 55,56 , ICCs briefly shifted away from daily observed buprenorphine treatment to alternative prescribing schedules (such as providing a week or fortnight’s supply of medications at a time) 57 . Although ICCs have now reverted to daily observed treatment, there is a need to evaluate the impact of more convenient prescription schedules coupled with adequate dosing or longer acting buprenorphine formulations on retention and quality of engagement.…”

Section: Discussionmentioning

confidence: 99%

Buprenorphine treatment receipt characteristics and retention among people who inject drugs at Integrated Care Centers in India

Ganapathi

McFall

Greco

et al. 2022

Preprint

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BackgroundIndia is facing an alarming rise in the injection of opioids leading to burgeoning HIV epidemics among people who inject drugs (PWID) in several cities. Integrated Care Centers (ICCs) provide free single-venue HIV services and substance use treatment to PWID and have been established across 8 Indian cities. We evaluated engagement of PWID in buprenorphine treatment at ICCs to inform interventions.MethodsWe retrospectively analyzed 1-year follow-up data for PWID initiating buprenorphine between 1 January – 31 December 2018 across 7 ICCs. We used descriptive statistics to evaluate buprenorphine uptake, receipt frequency, treatment interruptions (no buprenorphine receipt for 60 consecutive days but with subsequent re-engagement in treatment), and treatment drop-out (no buprenorphine receipt for 60 consecutive days without subsequent re-engagement), and explore differences between historical opioid epidemic regions (i.e., Northeast cities (NEC)) and emerging opioid epidemic regions (i.e., North/Central/Northwest cities (NCC)). We used a multivariable logistic regression model to determine predictors of treatment drop-out by 6 months.Results1312 PWID initiated buprenorphine (76% NCC vs. 24% NEC). 31% of PWID in NCC, and 25% in NEC experienced ≥ 1 treatment interruption. About a third (34%) of PWID in NCC vs. half (50%) in NEC dropped-out by 6 months (p<0.0001). Over 6 months, 48% of PWID in NCC vs. 60% in NEC received buprenorphine ≤2 times/week on average (p<0.0001). In multivariable models, living in NEC was associated with increased odds of treatment drop-out while receipt of counseling was associated with decreased odds of treatment drop-out.ConclusionsPWID at ICCs, particularly those in NEC have low buprenorphine receipt and retention. Patient-centered interventions adapted to regional contexts are urgently needed to ameliorate these gaps.

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Section: Discussionmentioning

confidence: 99%

Buprenorphine treatment receipt characteristics and retention among people who inject drugs at Integrated Care Centers in India

Ganapathi

McFall

Greco

et al. 2022

Preprint

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“…5 It is more important given the COVID-19 pandemic leading to the practice of providing take-home dosages of this medicine across different settings. 6 (Table 2 continued It is also praiseworthy that all these medications are recommended for availability at primary, secondary, and tertiary levels. This implies that managing opioid and tobacco dependence can be and should be done at the primary healthcare level.…”

Section: New Additionsmentioning

confidence: 99%

National List of Essential Medicines 2022 of India: Perspectives from Psychiatrists

Parmar

Pal

Sharma

2023

Indian Journal of Psychological Medicine

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“…Similarly, drugs such as benzodiazepines and opioids are included in Schedule X, that is, fall under the NDPS Act and hence cannot be prescribed through teleconsultation. 36,37 The latter poses a significant problem, since excluding certain benzodiazepines (e.g., Lorazepam, Diazepam, and Chlordiazepoxide) from teleprescription makes managing patients with alcohol withdrawal syndrome difficult if they present in a teleconsultation seeking help. Along with the fact that anti-craving agents (mentioned before) cannot be prescribed in the first teleconsultation, it might prevent patients with SUDs from a remote area from seeking help (due to the unavailability of proper long term pharmacological maintenance therapy).…”

Section: National Programs Related To Drug Usementioning

confidence: 99%

National Drug Laws, Policies, and Programs in India: A Narrative Review

Parmar

Narasimha

Nath

2023

Indian Journal of Psychological Medicine

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Background: Drug use is a major public health issue in India. Significant changes in the approach toward drug use have happened in the last few decades. Despite this, no systematic attempt has been made to document the same in the scientific literature. This narrative review attempts to discuss the major drug laws, policies, and national programs of the Government of India (GoI). Methods: A thorough search was conducted to look for policies, programs, acts, and notifications related to substance use/drug use on various websites of different ministries of the GoI. Acts, programs, and policies addressing substance use were identified. Results: Various drug laws, programs, and acts from the GoI provide a multipronged approach to curbing the procurement of drug use along with its prevention and cure. The Ministry of Social Justice and Empowerment (MoSJE) is the nodal ministry for drug demand reduction. The enactment of the Narcotic Drugs and Psychotropic Substances (NDPS) Act 1985 and Policy 2012 and the implementation of India’s Drug De-Addiction Program (DDAP) are important landmarks in this journey. Conclusion: The GoI initiatives for reducing the mental health burden in this country in general and substance use disorders (SUDs), in particular, are immense. The acts/statutes/laws/notifications are all interlinked. Stakeholders in mental health, public health, and policy-making need to upgrade themselves with the relevant statutes to curb the menace of drug use.

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COVID-19 Pandemic and People Who Use Opioids in India: Opportunities and Evolutions

Cited by 7 publications

References 12 publications

Buprenorphine treatment receipt characteristics and retention among people who inject drugs at Integrated Care Centers in India

Buprenorphine treatment receipt characteristics and retention among people who inject drugs at Integrated Care Centers in India

National List of Essential Medicines 2022 of India: Perspectives from Psychiatrists

National Drug Laws, Policies, and Programs in India: A Narrative Review

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