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新型冠状病毒肺炎疫情和阿片类药物使用障碍:扩大丁丙诺啡治疗,并将安全防范措施与远程医疗相结合。

The COVID-19 pandemic and opioid use disorder: Expanding treatment with buprenorphine, and combining safety precautions with telehealth.

机构信息

NuLease Medical Solutions, LLC, Louisville, KY, United States of America.

University of Louisville, Department of Emergency Medicine, United States of America.

出版信息

J Subst Abuse Treat. 2022 Feb;133:108543. doi: 10.1016/j.jsat.2021.108543. Epub 2021 Jun 26.

Abstract

BACKGROUND

This study investigated the efficacy and safety of providing medication for opioid use disorder (MOUD) and individualized telehealth in Kentucky, a state severely impacted simultaneously by the opioid epidemic and the COVID-19 pandemic.

METHODS

The investigation analyzed pre- and post-COVID-19 characteristics in 191 opioid use disorder (OUD) buprenorphine outpatients who completed an 18-question survey in late 2020 related to COVID testing, OUD relapses, obstacles to maintaining abstinence, and treatment resources.

RESULTS

The study revealed no statistically significant changes in drug use before and after the onset of the COVID-19 pandemic despite monthly volume increases. Results further demonstrated statistically significant barriers to treatment, including loss of housing and transportation, food insecurity, and onset of depression. No patients required hospitalization or succumbed to OUD or COVID-19. Potentially effective resource utilization findings included clinic transportation and 24/7 crisis intervention. Respondents rated telehealth as helpful when used in an individualized hybrid model matching patient's need to available resources based on COVID-19 safety guidelines.

CONCLUSION

This report yields key clinical insights into providing outpatient MOUD care during the COVID-19 pandemic, validating in-person care as both safe and effective. Patients' experiences proved helpful in identifying and quantifying obstacles to abstinence in conjunction with facilitating continued patient access to essential clinical resources. Notably, telehealth can supplement rather than replace in-person treatment.

摘要

背景

本研究调查了在肯塔基州为阿片类药物使用障碍(MOUD)提供药物和个体化远程医疗的疗效和安全性,该州同时受到阿片类药物流行和 COVID-19 大流行的严重影响。

方法

该调查分析了 191 名接受美沙酮门诊治疗的阿片类药物使用障碍(OUD)患者在 2020 年末完成的一项 18 个问题的调查,该调查涉及 COVID 检测、OUD 复发、维持戒断的障碍以及治疗资源。

结果

尽管每月用量增加,但在 COVID-19 大流行前后,药物使用并未发生统计学上的显著变化。结果进一步表明存在统计学上显著的治疗障碍,包括住房和交通丧失、粮食不安全以及抑郁发作。没有患者需要住院治疗或死于 OUD 或 COVID-19。可能有效的资源利用发现包括诊所交通和 24/7 危机干预。受访者在根据 COVID-19 安全指南基于患者需求和可用资源匹配的个体化混合模式中使用远程医疗时,认为其有帮助。

结论

本报告为 COVID-19 大流行期间提供门诊 MOUD 护理提供了关键的临床见解,证明了亲自护理既安全又有效。患者的经验有助于确定和量化戒断障碍,并促进患者继续获得必要的临床资源。值得注意的是,远程医疗可以补充而非替代面对面治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4b1d/8233546/e90066b45ce9/gr1_lrg.jpg

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