Mobile van delivery of extended-release buprenorphine and extended-release naltrexone for youth with OUD: An adaptation to the COVID-19 emergency

Wenzel, Kevin; Fishman, Marc

doi:10.1016/j.jsat.2020.108149

Cited by 21 publications

(18 citation statements)

References 11 publications

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“…extended-release naltrexone and buprenorphine). This strategy was adopted by substance use treatment clinics (Straub [ 49 ]; Komaromy et al [ 39 ], Wenzel and Fishman [ 50 ]), and even a correctional facility in New South Whales, Australia, where long-acting buprenorphine (CAM2038) was made available to help reduce the movement of people throughout the facility (Roberts et al, [ 51 ]).…”

Section: Resultsmentioning

confidence: 99%

“…A few programs described efforts to increase access to services and supplies by delivering them directly to patient homes. In one Maryland-based program, extended-release naltrexone and buprenorphine were delivered directly to patients’ residences and administered outside the home via a mobile van (Wenzel and Fishman [ 50 ]). In Ohio, some programs mailed out naloxone kits directly to persons’ residences or arranged for their pick-up at drive-through centers (Courser et al [ 42 ]).…”

Section: Resultsmentioning

confidence: 99%

“…Financial and logistical barriers persisted in some patients’ ability to access medications during the pandemic, as described by Castillo et al [ 34 ]. In cases where long-acting medications were subsidized by grant funding, such as in the study by Wenzel and Fishman, it was unclear how patients would afford long-acting buprenorphine injections following study completion [ 50 ]. Issues related to medication cost highlight the need for more prompt changes to funding mechanisms reimbursing MOUD without burdensome co-payments or prior authorization requirements that may disable access [ 66 ].…”

Section: Discussionmentioning

confidence: 99%

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

Krawczyk

Fawole

Yang

et al. 2021

Addict Sci Clin Pract

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Krawczyk

Fawole

Yang

et al. 2021

Addict Sci Clin Pract

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“…For instance, the mobile unit for urine specimen collection offered good access and obtained high satisfaction scores [ 24 ]. Mobile van delivery of extended-release medications for youth with OUD showing positive feedback, this being a promising treatment modification adapted to the COVID-19 pandemic [ 25 ▪ ]. These strategies are not complicated for OUD services, practitioners, and patients to put into effect.…”

Section: Responses and Strategies To Maintain Opioid Treatment Programs During The Pandemicmentioning

confidence: 99%

“…Youth, pregnant women and incarcerated people with OUD are taken into consideration by some authors, given that they are more vulnerable [ 25 ▪ , 45 – 47 ]. To ensure continuation of treatment for youth with OUD and to reduce COVID-19 associated risks, authors reported implementation of mobile van delivery of extended-release medications [ 25 ▪ ]. Authors suggest that the COVID-19 pandemic also created a generational opportunity to augment family involvement in tele-intervention across the youth OUD services continuum [ 45 ].…”

Section: Responses and Strategies To Maintain Opioid Treatment Programs During The Pandemicmentioning

confidence: 99%

Maintaining treatment and prevention programs for opioid use disorders during the coronavirus disease 2019 pandemic

Zhao

2021

Current Opinion in Psychiatry

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Purpose of review The current article reviews the impact of the biggest health crisis for many decades, coronavirus disease 2019 (COVID-19), on opioid treatment programs and the strategies adopted for maintaining opioid treatment programs during the pandemic. Recent findings The difficulty of access to opioid treatment services and the mental health problems accompanying opioid use disorders are the two main challenges to maintaining accessible and effective opioid treatment. Many countries and institutions issued guidance and recommendations to address these challenges. General coping strategies, loosening of policies, telemedicine, and depot buprenorphine are four main strategies to cope with the challenges posed by the pandemic. Summary There were considerable obstacles to maintaining opioid intervention programs during the COVID-19 pandemic. Strategies addressing the obstacles are identified. Research in this area needs to be strengthened.

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A Neuropharmacological Model to Explain Buprenorphine Induction Challenges

Greenwald

Herring²,

Perrone³

et al. 2022

Annals of Emergency Medicine

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Mobile van delivery of extended-release buprenorphine and extended-release naltrexone for youth with OUD: An adaptation to the COVID-19 emergency

Cited by 21 publications

References 11 publications

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

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

Maintaining treatment and prevention programs for opioid use disorders during the coronavirus disease 2019 pandemic

A Neuropharmacological Model to Explain Buprenorphine Induction Challenges

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