Opioid Use Disorder and COVID-19: Biological Plausibility for Worsened Outcomes

Schimmel, Jonathan; Manini, Alex F.

doi:10.1080/10826084.2020.1791184

Cited by 56 publications

(64 citation statements)

References 13 publications

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“…In case of infection, physician should be aware that patients with comorbid COVID-19 and OUD present specificities, including drug interactions between methadone and other medications such as hydroxychloroquine or antiviral agents. Recently, three plausible biological mechanisms for potentially worsened outcomes were suggested ( Schimmel and Manini, 2020 ): opioid-related respiratory depression (amplify risks of hypoxemia), complex opioid immune modulation (may impact host response to the virus), and finally drug-drug interactions, particularly due to cardiac adverse effects. Based on pre-clinical studies, Coppola et al recently suggested an efficacy of hesperidin (antiretroviral drug with an affinity for opioid receptor), but it remains to be tested ( Coppola and Mondola, 2020 ).…”

Section: Results and Observationsmentioning

confidence: 99%

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Mallet

Dubertret

Strat

2021

Progress in Neuro-Psychopharmacology and Biological Psychiatry

129

116

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Background In the context of the COVID-19 worldwide pandemic, an up-to-date review of current challenges in addictions is necessary. While large scale disasters may have an impact on substance use and addictions, the use of some substances is also likely to modify the risk of COVID-19 infection or course. Many countries have imposed lockdowns. Whether this quarantine or the end of lockdown measures will have an impact on substance use is discussed. The aim of this review is to gather knowledge for clinicians and to guide public health policies during/after lockdown. Methods PubMed was reviewed in August 6th (2020), to determine the current evidences and observations concerning the addictions and SARS-CoV2. We used all the names of the severe acute respiratory syndrome of coronavirus 2 (SARS-CoV2 previously 2019 nCoV), the name of the coronavirus disease 2019 (COVID-19), and common substances of abuse. For the physiopathological parts, searches were conducted using key words such as “infection” or “pneumonia”. For the lockdown effects, key words such as “quarantine”, “disaster” or “outbreak” were used. Results Overall, pathophysiological data showed an increased risk of infections for individuals with Substance Use Disorders (SUD) and a possible protective role of nicotine. During lockdown, there is a substantial risk of increasing SUDs. Individuals with opioid use disorder are particularly at risk of relapse or of involuntary withdrawal. After lockdown, increase of use may be observed as far as years after. Individuals with addictions are at higher risk of multimorbidity and mortality during COVID outbreak. Conclusion This review describes useful strategies in clinical practice, including a systematic assessment of addiction comorbidity during this almost worldwide lockdown/pandemic. This review also highlights important areas for future research.

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Section: Results and Observationsmentioning

confidence: 99%

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Mallet

Dubertret

Strat

2021

Progress in Neuro-Psychopharmacology and Biological Psychiatry

129

116

View full text Add to dashboard Cite

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“…Consequently, as of March 13, 2020, our methadone clinic increased the number of take-home doses per patient on a case-by-case basis after a thorough risk/benefit assessment. During the COVID-19 outbreak, we incorporated and emphasized new factors in such risk/benefit analysis: i) the increased syndemic vulnerability to SARS-CoV-2 transmission among people who inject drugs ( Vasylyeva et al, 2020 ); ii) the potentially worsened outcomes in patients with opioid use disorder who contract COVID-19 ( Schimmel & Manini, 2020 ); and iii) the facilitation of MMT patients' adherence to lockdown restrictions and social distancing measures.…”

mentioning

confidence: 99%

Increased flexibility in methadone take-home scheduling during the COVID-19 pandemic: Should this practice be incorporated into routine clinical care?

Trujols

Larrabeiti

Sànchez

et al. 2020

Journal of Substance Abuse Treatment

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In the context of the COVID-19 pandemic and the state of emergency that the government of Spain declared, the rapid adaptation of health services is of paramount importance to preserve access to and continuity of service delivery. This research note underscores the importance of ensuring a sufficient quantity of methadone take-home doses for patients on methadone maintenance treatment (MMT) to maximize their adherence to government-imposed lockdown restrictions and social distancing measures designed to curtail the spread of SARS-CoV-2. We evaluate the impact of COVID-19 on take-home medication (number of days provided) in a methadone clinic in Barcelona (Catalonia, Spain). This work conveys that we should consider maintaining the take-home practices that we adopted in response to the pandemic, even after the pandemic has abated.

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“…Due to the implementation of SARS-CoV-2 policies and precautions, especially social distancing, patients with SUD are at an increased vulnerability to adverse outcomes related to substance use (Douglas, et al 2020). Increased isolation worsens comorbid mental health disorders and symptoms, increasing the risk of use and overdose (Schimmel, et al 2020). Further, social isolation creates an environment in which people are more likely to use alone, without a partner monitoring them.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on New Mexico Harm Reduction Services: Challenges and Recommendations

Reta¹,

Nelson²,

Rose³

et al. 2021

Preprint

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Evidence is emerging indicating persons with substance use disorders (SUD) are at particular risk of adverse health outcomes during the Sars-CoV2 pandemic crisis, especially compounded if those persons are underrepresented minorities. New Mexico has unique demographic characteristics being predominantly rural and minority populated. We attempted to survey harm reduction (HR) sites across the state to understand and document the effects the current health crisis has had on their operations. Sites reported a significant decrease (p=0.05) in clients served between the time periods of November 2019-January 2020 and March-May 2020, supply shortages, and anecdotal reports of increasing street drug prices. Future research should focus on rates of overdose during public health crises, its effects on medication assisted treatment (MAT) clinics, and in continued efforts to curtail rates of SUD overall.

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Opioid Use Disorder and COVID-19: Biological Plausibility for Worsened Outcomes

Cited by 56 publications

References 13 publications

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Addictions in the COVID-19 era: Current evidence, future perspectives a comprehensive review

Increased flexibility in methadone take-home scheduling during the COVID-19 pandemic: Should this practice be incorporated into routine clinical care?

Impact of COVID-19 on New Mexico Harm Reduction Services: Challenges and Recommendations

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