National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, United States of America; U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States of America; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States of America.
Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, United States of America.
J Subst Abuse Treat. 2021 Mar;122:108222. doi: 10.1016/j.jsat.2020.108222. Epub 2020 Dec 3.
The COVID-19 pandemic struck in the midst of an ongoing opioid epidemic. To offset disruption to life-saving treatment for opioid use disorder (OUD), several federal agencies granted exemptions to existing federal regulations. This included loosening restrictions on medications for OUD (MOUD), including methadone and buprenorphine. In this commentary, we briefly review policy and practice guidelines for treating OUD prior to the onset of the COVID-19 pandemic. We then outline specific MOUD treatment policy and practice exemptions that went into effect in February and March 2020, and discuss the ways in which these unprecedented changes have dramatically changed MOUD treatment. Given the unprecedented nature of these changes, and unknown outcomes to date, we advocate for a data-driven approach to guide future policy and practice recommendations regarding MOUD. We outline several critical clinical, research, and policy questions that can inform MOUD treatment in a post-COVID-19 era.
新冠疫情在阿片类药物流行期间爆发。为了避免中断救命的阿片类药物使用障碍(OUD)治疗,几个联邦机构对现有的联邦法规给予了豁免。这包括放宽对 OUD 药物(MOUD)的限制,包括美沙酮和丁丙诺啡。在这篇评论中,我们简要回顾了 COVID-19 大流行之前治疗 OUD 的政策和实践指南。然后,我们概述了 2020 年 2 月和 3 月生效的具体 MOUD 治疗政策和实践豁免,并讨论了这些前所未有的变化如何极大地改变了 MOUD 治疗。鉴于这些变化的空前性质,以及迄今为止的未知结果,我们主张采取数据驱动的方法来指导未来关于 MOUD 的政策和实践建议。我们概述了几个关键的临床、研究和政策问题,可以为后 COVID-19 时代的 MOUD 治疗提供信息。