Department of Psychiatry and Psychotherapy, Centre for Interdisciplinary Addiction Research of Hamburg University, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eur Addict Res. 2023;29(5):323-332. doi: 10.1159/000531593. Epub 2023 Aug 9.
Opioid agonist treatment (OAT) is the most common and most effective treatment option for persons with opioid use disorders (OUD). In Germany, the prescription of OAT medications is regulated by the Narcotic Drugs Prescription Ordinance. With the introduction of restrictions to contain the SARS-CoV-2 virus, the German OAT regulations have been amended to ensure a legal continuation of OAT for people with OUD. In this study, we aimed to examine the use of the OAT regulations in practice, the experience made by physicians prescribing OAT medications, and their perspective on OAT regulations.
Between September and December 2021, a questionnaire on the current situation and potential changes in the provision of OAT during the COVID-19 pandemic was sent out to 2,416 German physicians prescribing OAT medications. Differences between physicians with and without addiction medicine certification were analyzed.
The response rate of physicians was 22.8%. Their average age was 57.4 (±10.1) years, and 62.3% were male. During the COVID-19 pandemic, take-home periods for stable patients have been extended by 48.2% of physicians, and 52.6% would like to maintain this prescribing practice in the future. Most physicians (71.6%) indicated that patients handled the extended take-home prescriptions predominantly responsibly. A total of 71.8% of the physicians generally did not use video consultation. A corona pandemic-related switch of the OST medication to depot buprenorphine injection did rather not occur, as 71.2% reported no patients treated with depot buprenorphine, and only 2.6% switched first-time or more patients to depot buprenorphine due to the COVID-19 pandemic.
The corona situation opened up opportunities for physicians and patients and enabled change processes in OAT. Physicians had positive experiences implementing expanded take-home prescriptions for stable patients. Video contacts rarely took place, suggesting resistance to digital consultation. The number of depot buprenorphine prescriptions has not increased substantially since the pandemic's beginning and has remained at low levels. Further research is needed to assess to what extent the changes in OAT will be maintained over time and whether they will also lead to long-term benefits for OAT patients.
阿片类药物激动剂治疗（OAT）是治疗阿片类药物使用障碍（OUD）患者最常见和最有效的治疗选择。在德国，阿片类药物激动剂治疗药物的处方受《麻醉品处方条例》的监管。随着限制 SARS-CoV-2 病毒措施的引入，德国的 OAT 规定已进行修订，以确保 OUD 患者能够合法地继续接受 OAT。在这项研究中，我们旨在检查实践中 OAT 规定的使用情况、开处 OAT 药物的医生的经验以及他们对 OAT 规定的看法。
在 2021 年 9 月至 12 月期间，向 2416 名开处 OAT 药物的德国医生发送了一份关于 COVID-19 大流行期间 OAT 提供情况和潜在变化的现状问卷。分析了具有和不具有成瘾医学认证的医生之间的差异。
医生的回复率为 22.8%。他们的平均年龄为 57.4（±10.1）岁，62.3%为男性。在 COVID-19 大流行期间，48.2%的医生将稳定患者的带药回家时间延长，52.6%的医生希望在未来继续这种处方实践。大多数医生（71.6%）表示，患者主要负责任地处理了延长的带药回家处方。共有 71.8%的医生通常不使用视频咨询。由于 COVID-19 大流行，向 depot 丁丙诺啡注射剂转换 OST 药物的情况并没有发生，因为 71.2%的报告称没有患者接受 depot 丁丙诺啡治疗，只有 2.6%的医生因为 COVID-19 大流行首次或更多地将患者转换为 depot 丁丙诺啡。
新冠疫情为医生和患者提供了机会，并推动了 OAT 的变革进程。医生对为稳定患者实施扩大带药回家方案有积极的经验。视频联系很少发生，表明对数字咨询的抵制。自疫情开始以来，depot 丁丙诺啡的处方数量并未大幅增加，且一直处于较低水平。需要进一步研究，以评估 OAT 的这些变化在多大程度上能够持续，以及它们是否也会给 OAT 患者带来长期益处。
