Opioid Substitution Treatment Planning in a Disaster Context: Perspectives from Emergency Management and Health Professionals in Aotearoa/New Zealand

Abstract

Opioid Substitution Treatment (OST) is a harm reduction strategy enabling opiate consumers to avoid withdrawal symptoms and maintain health and wellbeing. Some research shows that within a disaster context service disruptions and infrastructure damage affect OST services, including problems with accessibility, dosing, and scripts. Currently little is known about planning for OST in the reduction and response phases of a disaster. This study aimed to identify the views of three professional groups working in Aotearoa/New Zealand about OST provision following a disaster. In-depth, semi-structured interviews were conducted with 17 service workers, health professionals, and emergency managers in OST and disaster planning fields. Thematic analysis of transcripts identified three key themes, namely "health and wellbeing", "developing an emergency management plan", and "stock, dose verification, and scripts" which led to an overarching concept of "service continuity in OST preparedness planning". Participants viewed service continuity as essential for reducing physical and psychological distress for OST clients, their families, and wider communities. Alcohol and drug and OST health professionals understood the specific needs of clients, while emergency managers discussed the need for sufficient preparedness planning to minimise harm. It is concluded that OST preparedness planning must be multidisciplinary, flexible, and inclusive.

Opioid Use Disorder Treatment Disruptions during the COVID-19 Pandemic and Other Disasters: A Scoping Review Addressing Dual Public Health Emergencies

“…• Efforts to ensure access to OAT include: Provision of take home dosing, guest dosing at clinics other than the patients' usual clinic, delivering/mailing of medication to patients, mobile units and communication strategies (e.g., individual phone calls, hotlines and social media) to keep people informed on how to access treatment (44,45) Other supports include:…”

Stigma and disaster risk reduction among vulnerable groups: Considering people receiving opioid substitution treatment

“…This in turn will diminish anxiety and fear of discrimination for people needing treatment. More inclusive collaboration with broader social service agencies and users would be beneficial, including community pharmacists who have a pivotal role in OST provision and who have demonstrated that they go beyond their core role in a disaster to ensure safety and medical care [27,53]. Drawing on participatory action approaches that are founded on community empowerment values may better serve and strengthen disaster risk reduction capacity.…”

“…In Aotearoa New Zealand, following the 2011 Canterbury earthquake, health professionals reported that nobody went without a prescribed OST dose. This was an accomplishment, although as conveyed by Blake and Lyons [27], across the country government officials, health professionals, and emergency managers still considered service continuity, communication, dosing and record keeping, stock, transport issues and service accessibility to be potential problems during a disaster. Blake [28] further reported that people receiving OST in Aotearoa New Zealand remained concerned about the inability to access medications following a disaster because of the potential physical and emotional distress.…”

COVID-19 and Substance Use Disorders as Brain Diseases: Recommendations to a Comprehensive Healthcare Response. An International Society of Addiction Medicine (ISAM) Practice and Policy Interest Group Position Paper

“…Opioid Substitution Therapy (OST) is among a category of treatment modalities that is normally considered to need regular and frequent supervision of patients, especially early in treatment. It is recommended that a more flexible OST program needs to be taken into account during the COVID pandemic ( Blake & Lyons, 2016 ).…”