University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA.
Subst Use Misuse. 2023;58(14):1855-1865. doi: 10.1080/10826084.2023.2257305. Epub 2023 Oct 31.
: The COVID-19 pandemic rapidly changed how substance use disorder (SUD) treatment services are delivered. In this qualitative study, we examined what changes SUD treatment programs in Arkansas implemented in response to the pandemic, what factors influenced their ability to implement these changes, and their reflections, outlook, and future recommendations. : Between May and August 2020, we conducted semi-structured phone interviews with 29 leaders at 21 SUD programs throughout Arkansas. Interview questions focused on what changes programs implemented in response to the pandemic, barriers and facilitators to implementation, and future outlook. Interviews were thematically analyzed. : Programs implemented similar infection control practices, including COVID-19 screening at entry, masks, hand hygiene, and social distancing. Residential programs discontinued outside visitations and capped admissions, and outpatient programs implemented telehealth services. Clients generally responded well to the changes, however many experienced difficulties (e.g., anxiety, lack of access to telehealth). While programs welcomed additional financial support (e.g., CARES act) and looser regulatory restrictions (e.g., telehealth use), many struggled economically due to lower demand and insufficient reimbursement. Programs varied in leadership and staff responses to the pandemic, and in their capacity to implement the changes (e.g., facilities, staffing). Finally, interviewees acknowledged they were unprepared for the pandemic and were uncertain about the future. : The insights from the COVID-19 pandemic and SUD programs' responses helps researchers, policymakers and practitioners understand what has happened during the pandemic, how to prepare for future crises, and how to build more resilient SUD and public health systems.
: 新冠疫情迅速改变了物质使用障碍（SUD）治疗服务的提供方式。在这项定性研究中，我们研究了阿肯色州的 SUD 治疗项目针对疫情实施了哪些改变，哪些因素影响了他们实施这些改变的能力，以及他们的反思、展望和未来建议。: 2020 年 5 月至 8 月，我们对阿肯色州 21 个 SUD 项目的 29 名领导人进行了半结构化电话访谈。访谈问题集中在项目针对疫情实施了哪些改变、实施的障碍和促进因素，以及未来展望。访谈采用主题分析法进行分析。: 各项目实施了类似的感染控制措施，包括在入口处进行 COVID-19 筛查、佩戴口罩、保持手部卫生和保持社交距离。住宿项目停止了外部探视和限制收容人数，门诊项目则实施了远程医疗服务。客户对这些改变普遍反应良好，但许多人遇到了困难（例如，焦虑、无法获得远程医疗服务）。尽管项目欢迎更多的财政支持（例如，CARES 法案）和更宽松的监管限制（例如，远程医疗的使用），但由于需求减少和报销不足，许多项目在经济上陷入困境。各项目在领导层和员工对疫情的反应以及实施改变的能力（例如，设施、人员配置）方面存在差异。最后，受访者承认他们对疫情毫无准备，对未来感到不确定。: 从新冠疫情和 SUD 项目的应对中获得的见解，有助于研究人员、政策制定者和从业者了解疫情期间发生的情况，为未来的危机做好准备，并建立更具弹性的 SUD 和公共卫生系统。
