Krawczyk Noa, Bunting Amanda M, Frank David, Arshonsky Joshua, Gu Yuanqi, Friedman Samuel R, Bragg Marie A
Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York NY, 10016, USA.
Section on Tobacco, Alcohol, & Drug Use, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, New York NY, 10016, USA.
Int J Drug Policy. 2021 Jun;92:103140. doi: 10.1016/j.drugpo.2021.103140. Epub 2021 Feb 6.
The COVID-19 pandemic poses significant challenges to people with opioid use disorder (OUD). As localities enforce lockdowns and pass emergency OUD treatment regulations, questions arise about how these changes will affect access and retention in care. In this study, we explore the influence of COVID-19 on access to, experiences with, and motivations for OUD treatment through a qualitative analysis of public discussion forums on Reddit.
We collected data from Reddit, a free and international online platform dedicated to public discussions and user-generated content. We extracted 1000 of the most recent posts uploaded between March 5th and May 13th, 2020 from each of the two most popular opioid subreddits "r/Opiates" and "r/OpiatesRecovery" (total 2000). We reviewed posts for relevance to COVID-19 and opioid use and coded content using a hybrid inductive-deductive approach. Thematic analysis identified common themes related to study questions of interest.
Of 2000 posts reviewed, 300 (15%) discussed topics related to the intersection of opioid use and COVID-19. Five major themes related to OUD treatment were identified: Concern about closure of OUD treatment services; transition to telehealth and virtual care; methadone treatment requirements and increased exposure to COVID-19; reactions to changing regulations on medications for OUD; and influences of the pandemic on treatment motivation and progress.
In the face of unprecedented challenges due to COVID-19, reactions of Reddit opioid forum users ranged from increased distress in accessing and sustaining treatment, to encouragement surrounding new modes of treatment and opportunities to engage in care. New and less restrictive avenues for treatment were welcomed by many, but questions remain about how new norms and policy changes will be sustained beyond this pandemic and impact OUD treatment access and outcomes long-term.
新冠疫情给阿片类物质使用障碍（OUD）患者带来了重大挑战。随着各地实施封锁并通过紧急的阿片类物质使用障碍治疗规定，人们开始质疑这些变化将如何影响治疗的可及性和持续性。在本研究中，我们通过对Reddit上的公共讨论论坛进行定性分析，探讨新冠疫情对阿片类物质使用障碍治疗的可及性、体验及动机的影响。
我们从Reddit收集数据，这是一个免费的国际性在线平台，致力于公共讨论和用户生成内容。我们从两个最热门的阿片类物质相关子版块“r/Opiates”和“r/OpiatesRecovery”中，提取了2020年3月5日至5月13日期间上传的各1000条最新帖子（共2000条）。我们审查帖子与新冠疫情和阿片类物质使用的相关性，并采用归纳-演绎混合方法对内容进行编码。主题分析确定了与感兴趣的研究问题相关的共同主题。
在审查的2000条帖子中，300条（15%）讨论了与阿片类物质使用和新冠疫情交叉相关的话题。确定了与阿片类物质使用障碍治疗相关的五个主要主题：对阿片类物质使用障碍治疗服务关闭的担忧；向远程医疗和虚拟护理的转变；美沙酮治疗要求及新冠病毒暴露增加；对阿片类物质使用障碍药物监管变化的反应；以及疫情对治疗动机和进展的影响。
面对新冠疫情带来的前所未有的挑战，Reddit阿片类物质论坛用户的反应不一，从获取和维持治疗时的更多困扰，到对新治疗模式和参与治疗机会的鼓励。许多人欢迎新的、限制较少的治疗途径，但关于新规范和政策变化在疫情之后如何持续以及如何长期影响阿片类物质使用障碍治疗的可及性和结果，问题依然存在。
