Expanding accessibility: Outpatient intensive treatment for substance use disorder during covid-19 pandemic (original) (raw)
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Pharmaceuticals, 2020
As the world endures the coronavirus disease 2019 (COVID-19) pandemic, the conditions of 35 million vulnerable individuals struggling with substance use disorders (SUDs) worldwide have not received sufficient attention for their special health and medical needs. Many of these individuals are complicated by underlying health conditions, such as cardiovascular and lung diseases and undermined immune systems. During the pandemic, access to the healthcare systems and support groups is greatly diminished. Current research on COVID-19 has not addressed the unique challenges facing individuals with SUDs, including the heightened vulnerability and susceptibility to the disease. In this systematic review, we will discuss the pathogenesis and pathology of COVID-19, and highlight potential risk factors and complications to these individuals. We will also provide insights and considerations for COVID-19 treatment and prevention in patients with SUDs.
Emerging Challenges in COVID-19 With Substance Use Disorders
Addictive disorders and their treatment, 2021
Background and Objective: People with substance use disorder (SUD) may be easily vulnerable to coronavirus disease-19 (COVID-19). Given the impaired lung function caused by COVID-19 may exacerbate the symptoms of patients already having preexisting opioids or central nervous system stimulants use disorder. This narrative review highlights the risks of interactions between COVID-19 and SUD. Methods: This article has systematically reviewed and collated relevant papers and articles identified through PubMed focusing on SUD and COVID-19. Results: SUD is characterized by an array of combined mental, physical, and behavioral symptoms, which is undoubtedly of great public health concern especially in the context of the recent advent of the COVID-19 pandemic. The myriad of physiological changes caused by COVID-19 and SUD may be additive or synergistic on various organ functions, hence this review has highlighted potential challenges and possible outcomes because of these interactions. Systematic delineation to parse out the combined COVID-19 and SUD pathology on a given organ function is crucial. Moreover, the primary measures to tackle the COVID-19 pandemic like home confinement and lack of social support may be a significant predictor of relapse in already sober individuals, thus alternate methodologies may be needed to confine this problem. Conclusion: This review highlights the importance of the intertwined epidemics interactions and proposes early measures to recognize the scope of problem at the individual level to prevent future challenges.
Substance use and substance use disorder, in relation to COVID-19: protocol for a scoping review
Systematic Reviews, 2021
Background The COVID-19 pandemic is creating severe issues for healthcare and broad social structures, exposing societal vulnerabilities. Among the populations affected by COVID-19 are people engaged in substance use, such as people who smoke; vape (e-cigarette use); use opioids, cannabis, alcohol, or psychoactive prescription drugs; or have a substance use disorder (SUD). Monitoring substance use and SUD during the pandemic is essential, as people who engage in substance use or present with SUD are at greater risk for COVID-19, and the economic and social changes resulting from the pandemic may aggravate SUD. There have been several reviews focused on COVID-19 in relation to substance use and SUD. Reviews generally did not consider on a large range of substance use variants or SUDs. We plan a scoping review that seeks to fill gaps in our current understanding of substance use and SUD, in the COVID-19 era. Methods A scoping review focused on substance use and SUD, in relation to COV...
COVID-19 Period on Patients With Substance Use Disorders: We Are All in This Together
2020
Introduction: Coronavirus Disease 2019 (COVID-19) results from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). it is now a pandemic that affects us all. For patients referring to the addiction care systems, this pandemic can create additional vulnerabilities. A great deal of effort has made to re-organize the care systems for patients with addiction. Our study focuses on the voice of our patients, on clues to adapt treatment, and on the impact of the pandemic on the therapeutic alliance. Methods: A qualitative design was used to develop a description and understanding of general and clinically relevant aspects of the impact of the COVID-19 pandemic. Fifteen addicted patients (11 under treatment and 4 in recovery) were interviewed by 4 interviewers according to the COREQ (consolidated criteria for reporting qualitative research). Results: COVID-19 has had a serious impact on thoughts, feelings, and behaviors. Interviewees shared their anxieties about their health and the health of their relatives. Frightening thoughts were associated with a range of negative feelings and behaviors, such as stress, anger, avoidance, and isolation. The use of psychoactive substances differed between the patients in treatment with those who are in stable recovery. In the former, all succeeded in staying abstinent. They have experienced that solidarity and connectedness were essential in sustaining their recovery. Those still in treatment were fighting against the temptation to start using again; they felt emotionally isolated and sometimes patronized by health care workers. Conclusion: The elaboration of the interviewees on the therapeutic relationship provides promising clues to optimize that relationship. Remembering this common expression, “we are all in this together,” shared decision making could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the COVID-19 epidemic.
“The post-COVID era”: challenges in the treatment of substance use disorder (SUD) after the pandemic
BMC Medicine, 2020
Background: Citizens affected by substance use disorders are high-risk populations for both SARS-CoV-2 infection and COVID-19-related mortality. Relevant vulnerabilities to COVID-19 in people who suffer substance use disorders are described in previous communications. The COVID-19 pandemic offers a unique opportunity to reshape and update addiction treatment networks. Main body: Renewed treatment systems should be based on these seven pillars: (1) telemedicine and digital solutions, (2) hospitalization at home, (3) consultation-liaison psychiatric and addiction services, (4) harm-reduction facilities, (5) person-centered care, (6) promote paid work to improve quality of life in people with substance use disorders, and (7) integrated addiction care. The three "best buys" of the World Health Organization (reduce availability, increase prices, and a ban on advertising) are still valid. Additionally, new strategies must be implemented to systematically deal with (a) fake news concerning legal and illegal drugs and (b) controversial scientific information. Conclusion: The heroin pandemic four decades ago was the last time that addiction treatment systems were updated in many western countries. A revised and modernized addiction treatment network must include improved access to care, facilitated where appropriate by technology; more integrated care with addiction specialists supporting non-specialists; and reducing the stigma experienced by people with SUDs.
2020
Introduction: As one of the major health problems in the present century, the COVID-19 pandemic affected all parts of the global communities and the health of substance users are potentially at a greater risk of harm. This global study has been designed and conducted by the International Society of Addiction Medicine Practice and Policy Interest Group (ISAM-PPIG) to understand better the health related issues of people with Substance Use Disorders (SUD) as well as responses of the relevant health care systems during the pandemic. Methods: This is a cross-sectional study using convenient sampling. The data gathering was carried out with two follow-up stages each two months apart through an online conducted survey prepared using Google platform. The survey started by emergence of COVID-19 as a pandemic in March 2020 and respondents were followed till September 2020 when most of the initial lockdowns by most countries are supposed to be reopened. Ethics and Dissemination: The study was approved by the ethics committee of University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. The results will be published in relevant peer reviewing journals and communicated with different international stakeholders.
Adaptation of a System of Treatment for Substance Use Disorders During the COVID-19 Pandemic
Journal of Addiction Medicine, 2020
Services to develop Opioid Urgent Care Centers [1NTF230M03163724179] (Taylor). Frontlines of Communities in the United States (FOCUS) grant from Gilead Sciences that supports HIV, hepatitis C virus, and hepatitis B virus screening and linkage to care. Gilead Sciences had no role in the development of this adaptations paper (Ruiz-Mercado). Dr. Komaromy receives partial salary support from the American Society for Addiction Medicine for curriculum development. The company ''TracFone Wireless'' donated the cell phones that are referred to in the manuscript to Boston Medical Center.
COVID-19 - Enacting a ‘new normal’ for people who use drugs
International Journal of Drug Policy, 2020
Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.