Leveraging COVID-19 to sustain regulatory flexibility in the treatment of opioid use disorder

Abstract

The U.S. government declared the opioid epidemic as a national public health emergency in 2017, but regulatory frameworks that govern the treatment of opioid use disorder (OUD) through pharmaceutical interventions have remained inflexible. The emergence of the COVID-19 pandemic has effectively removed regulatory restrictions that experts in the field of medications for opioid use disorder (MOUD) have been proposing for decades and has expanded access to care. The regulatory flexibilities implemented to avoid unnecessary COVID-related death must be made permanent to ensure that improved access to evidence-based treatment remains available to vulnerable individuals with OUD who otherwise face formidable barriers to MOUD. We must seize this moment of COVOD-19 regulatory flexibilities to demonstrate the feasibility, acceptability, and safety of delivering treatment for OUD through a low-threshold approach.

“No home to take methadone to”: Experiences with addiction services during the COVID-19 pandemic among survivors of opioid overdose in Boston

“…Early findings suggested that the regulatory changes to MOUD access and administration designed to slow the spread of COVID-19 have increased buprenorphine access ( Komaromy et al, 2020 ; Stringer et al, 2021 ), and have not led to increases in adverse events in methadone programs ( Brothers et al, 2021 ; Figgatt et al, 2021 ). Our study findings show that some participants on methadone found receiving take homes more challenging than expected, and others described telemedicine for therapy or buprenorphine treatment as less meaningful and lower quality.…”

“…For patient-centered care to be equitable, supports must be in place to ensure those facing structural marginalization can benefit from and participate in shared decision-making. Concrete steps that may have alleviated the destabilizing and unjust experiences described by our participants include: providing cell phones to those who needed them to access telemedicine and online recovery supports, transportation to health services, and expanding clinic hours to allow for social distancing and treatment access flexibility ( Harris et al, 2021 ; Stringer et al, 2021 ). For those newly housed, conducting home visits and active outreach may have identified the destabilizing impacts that changes in a daily routine had for people who were accustomed to daily methadone clinic attendance ( de Vet et al, 2013 ; Kertesz et al, 2013 ).…”

Assessing the impact of social distancing measures implemented during COVID-19 pandemic on medications for opioid use disorder in West Virginia

“…A phone-based MOUD telehealth program was similarly effective in San Francisco ( Mehtani et al, 2021 ). Some academic authors have now called for permanent easement of face to face delivery restrictions on MOUD delivery ( Stringer, Langdon, Mckenzie, Brockmann, & Marotta, 2021 ).…”

Cross-Addiction Risk Profile Associations with COVID-19 Anxiety: a Preliminary Exploratory Study

“…Nevertheless, the rates of participants who met the cut-off scores for singular and multiple addictions were relatively consistent with those reported in previous research (Beranuy et al, 2020 ; Grant & Steinberg, 2005 ; Luo et al, 2021 ). Overall, one could conclude that those assessed at higher risk for multiple addictions during the time of the COVID-19 pandemic (in this community online sample) exceeded 40% of the respondents, likely confirming that COVID-19-distress-related effects impact significant increases in addiction presentations (Arora et al, 2021 ; Rubin, 2021 ; Stringer et al, 2021 ).…”