Table 2 OUD treatment and harm reduction service adaptations in response to COVID-19; Peer-reviewed literature, 2020
Author, month, location | Name of clinic/organization | Care setting | Primary OUD services discussed | Innovative strategies to adapt to COVID-19 |
|---|---|---|---|---|
Samuel et al., May, 2020 Rhode Island, United States | Brown University and Rhode Island Department of Health | Substance Use Treatment | Buprenorphine | 24-h telehealth-based bridge program for buprenorphine initiation and referral to ongoing care |
Peavy et al., September, 2020 Washington, USA | Evergreen Treatment Services | Substance Use Treatment | Methadone | Increased take-homes for methadone provided along with smartphone application to allow video-directly observed therapy |
Hazan et al., September, 2020 London, United Kingdom | Department of Addiction Psychiatry, Barnet & Haringey Mental Health Trust and Camden & Islington Foundation Trust | Substance Use Treatment | Buprenorphine, Methadone | Extended take-home supplies and lengths of prescriptions; removed supervised consumption and suspended psychosocial services; offered delivery of medications to isolated patients |
Straub et al., September, 2020 Victoria, Australia | Long-Acting Injectable Buprenorphine (LAIB) Program St. Vincents Hospital Melbourne | Substance Use Treatment | Buprenorphine | Establishment of rapid access clinic to administer long-acting injectable buprenorphine to reduce travel and crowding |
Ghosh, October, 2020 India | National Healthcare System Opioid Agonist Treatment (OAT) Services | Substance Use Treatment | Buprenorphine | Increased number of take-home buprenorphine doses; Increased days and hours of operation; dispensed buprenorphine to family member |
Trujols et al., October, 2020 Catelonia, Spain | Methadone Center at Santa Creu i Sant Pau Hospital | Substance Use Treatment | Methadone | Increased number of take-home doses per patient |
Basu et al., May, 2020 Chandigarh, India | Drug De-addiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research (PGIMER) | Substance Use Treatment | Buprenorphine, Methadone | Suspended group counseling and urine drug screening; switched psychosocial services to virtual platforms; Increased number of take-home buprenorphine doses prescribed to patients; suspended initiations of new patients; |
Vecchio et al., July, 2020 Piedmont, Italy | SUD Specialist Treatment Centre in Biella | Substance Use Treatment | Buprenorphine, Methadone | Suspended or switched psychosocial services to virtual platform; conducted patient assessments and triage via phone/video calls; Increased take home doses of medications for OUD |
Quinones et al., November, 2020 Puerto Rico | Corporacion SANOS Clinic, Coalicio´n de Coaliciones Clinic, Clinica Pitirre Iniciativa Comunitaria Clinic | Substance Use Treatment | Buprenorphine, Methadone | Provided psychosocial services via telemedicine; home delivery for medications for OUD; Increased number of days that OUD care was provided to reduce crowding; allowed for telemedicine appointments through patients and providers sitting in separate rooms |
Komaromy et al., December, 2020 Massachusetts, USA | The Grayken Center for Addiction at Boston Medical Center-affiliated SUD programs | Substance Use Treatment | Buprenorphine, naloxone, sterile syringe equipment | Offered buprenorphine visits via telehealth; offered harm-reduction interventions for overdose prevention and sterile injection equipment Distributed donated phones to patients who lacked access for telehealth; Extended length of buprenorphine prescriptions; Increased use of extended-release injectable buprenorphine; Created 24-h call-line for addiction treatment; Text messaging or ‘‘on the fly’’ telehealth visits to stay connected with young patients; Addiction consult services switched to telehealth consultations |
Hughto et al., October, 2020 Rhode Island, USA | VICTA—Privately owned outpatient substance abuse and mental health treatment program | Substance Use Treatment | Counseling for MOUD patients | Switched counseling of OUD patients to virtual platforms; provided clinicians with laptops to engage in telehealth |
McKiever et al., August, 2020 Ohio, USA | Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine | Substance Use Treatment | Psychosocial services for pregnant women receiving OUD treatment | Switched to telehealth for individual and group therapy |
Singh and Tikka, October, 2020 Chhattisgarh, India | The Opioid Substitution Clinic at the All India Institute of Medical Sciences (AIIMS), Raipur | Substance Use Treatment | Buprenorphine | Suspended intakes and managed new patients via telehealth; Suspended random urine screening; implemented COVID-19 safety precautions in clinic |
Crowley et al., April, 2020 Ireland | The Irish College of General Practitioners and the National Health Service Executive office for Social Inclusion | Primary Care/General Practitioner | Buprenorphine, Methadone | Telephone-based assessment and triage to general practitioner who conducts remote medical management of MOUD following a single in-person visit |
Tringale et al., October, 2020 California, United States | Homeless Health Care Los Angeles | Outreach/Harm Reduction Program | Buprenorphine | Telehealth-based buprenorphine treatment through access to sanitized glass telephone booths |
Harris et al., May, 2020 Massachusetts, USA | Boston Medical Center-affiliated community drop-in center | Outreach/Harm Reduction Program | Buprenorphine | Telehealth-based buprenorphine initiation through smartphone provided by harm reduction specialist at drop-in clinic |
Marcus et al., August, 2020 Tshwane, South Africa | University of Pretoria’s Department of Family Medicine | Outreach/Harm Reduction Program | Methadone | Provided methadone doses in temporary pandemic homeless shelter; Moving stable patients from daily observed treatment to weekly take home dosing |
MacKinnon et al., October, 2020 British Columbia, Canada | Medical services within supportive housing units in Vancouver, affiliated with University of British Columbia | Outreach/Harm Reduction Program | Safe supply of opioids, Supervised injection, Methadone, Buprenorphine | Provided pharmaceutical grade alternative to toxic illicit drug supply termed ‘pandemic withdrawal management’; modified supervised injection spaces; Longer MOUD prescriptions; Increasing the number of take-home MOUD doses; switched to virtual platforms for clinical encounters |
Castillo et al., November, 2020 Florida, USA | TeleMOUD, University of Miami Miller School of Medicine | Outreach/Harm Reduction Program | Buprenorphine | Telehealth-based buprenorphine treatment initiation advertised via a syringe exchange program and online platform |
Courser et al., December, 2020 Ohio, USA | Community Based Take Home Naloxone Programs | Outreach/Harm Reduction Program | Naloxone | Provided individual and group naloxone trainings via telephone and video conferences; promoted naloxone via social media, offered drive through events for naloxone education and distribution, sent mail-order naloxone kits |
Nordeck et al., November, 2020 Maryland, USA | Behavioral Health Leadership Institute | Outreach/Harm Reduction Program | Buprenorphine, Naloxone | Telehealth for buprenorphine initiation and maintenance, daily distribution of naloxone kits via a drop-off basket |
Wenzel and Fishman, September, 2020 Maryland, USA | Youth Opioid Recovery Support (YORS) NIH HEAL Initiative | Mobile Clinic | Buprenorphine, Naltrexone | Delivered extended-release buprenorphine and extended-release naltrexone via a mobile van that traveled to patient homes |
Warrington et al., September, 2020 Vermont, USA | Commercial Laboratory, Aspenti Health | Mobile Clinic | Urine drug testing for OUD patients | Deployed mobile unit to patient homes to conduct urine drug testing on the mobile van |
Duncan et al., October, 2020 Minnesota, United States | Hennepin County Jail | Correctional Facility | Buprenorphine | Telehealth-based buprenorphine encounters using a computer in jail medical unit |
Roberts et al., September, 2020 New South Whales, Australia | New South Whales Correctional Centers | Correctional Facility | Buprenorphine | Began offering injectable long-acting buprenorphine to people in detention to reduce movement |