The Miriam Hospital, Warren Alpert Medical School of Brown University, 1125 N Main St., Providence, RI 02904, United States of America.
The Miriam Hospital, Warren Alpert Medical School of Brown University, United States of America.
J Subst Abuse Treat. 2020 Dec;119:108139. doi: 10.1016/j.jsat.2020.108139. Epub 2020 Sep 21.
The COVID-19 pandemic led government regulators to relax prescribing rules for buprenorphine and methadone, the agonist medications that effectively treat opioid use disorder, allowing for take home supplies of up to 28 days. These changes prioritized the availability of these medications over concerns about their misuse and diversion, and they provided a means for overdose prophylaxis during the highly uncertain conditions of the pandemic. In considering how to capitalize on this shift, research should determine the extent to which increased diversion has occurred as a result, and what the consequences may have been. The shifts also set the stage to consider if methadone can be safely prescribed in primary care settings, and if the monthly injectable formulation of buprenorphine is a suitable alternative to increased supplies of sublingual strips if concerns about diversion persist. The disruptions of the pandemic have caused a surge in overdose deaths, so carefully considering the prophylactic potential of agonist medications, in addition to their role as a treatment, may help us address this mortality crisis.
COVID-19 大流行导致政府监管机构放宽了丁丙诺啡和美沙酮的处方规定，这两种阿片类药物激动剂可有效治疗阿片类药物使用障碍，允许携带长达 28 天的药物。这些变化优先考虑这些药物的供应，而不是担心它们被滥用和转移，它们为大流行期间高度不确定的条件下提供了预防过量的手段。在考虑如何利用这一转变时，研究应该确定由于这些变化，药物转移的程度以及可能产生的后果。这些变化也为考虑是否可以在初级保健环境中安全地开美沙酮处方，以及如果对转移的担忧持续存在，丁丙诺啡的每月注射剂型是否是增加舌下片供应的合适替代品奠定了基础。大流行的混乱导致过量死亡人数激增，因此，除了将激动剂药物作为治疗手段外，还要仔细考虑其预防作用，这可能有助于我们应对这一死亡危机。
