Addressing the Opioid Crisis During COVID-19

Addressing the Opioid Crisis During COVID-19

Publication date: May 24, 2020

For those who experience addiction and mental health concerns, the additional stress can pose a serious risk to health — especially in the midst of an opioid crisis in North America.

Prior to COVID-19, people with opioid addiction already struggled to obtain comprehensive care due to widespread stigma and misinformation, in addition to systemic and socioeconomic barriers.

Now, a health dilemma is afoot: The rightful and necessary need to respect physical distancing has unfortunately also resulted in social isolation and increased levels of stress for many people, including those who use opioids.

The current situation is quickly producing additional barriers to accessing evidence-based care: such as pharmacotherapy, psychotherapy, harm reduction services, addiction medicine, and social supports.

These medications, known as opioid agonist therapies (OATs), maintain tolerance, improve treatment retention, reduce risk of relapse, and importantly, reduce overdose risk compared to abstinence only-based approaches to opioid addiction treatment.

These stigmatizing beliefs are inaccurate, cheapen the complexity of addiction treatment, and discourage people from seeking evidence-based care.

It is estimated that 50%-75% of people who experience addiction — including opioid addiction — meet criteria for one or more mental health disorders, such as post-traumatic stress disorder, anxiety, and depressive disorders.

The benefits from treatment in opioid addiction are more likely to happen when people receive integrated treatment for both addiction and mental health at the same time.

In many geographical areas, few evidence-based treatment options exist for people who use opioids.

People with opioid addiction who are prescribed OATs are more likely to be abstinent from illicit opioid use in comparison to placebo or programs where no medication is offered.

This is problematic because if a person subsequently relapses to opioids, then they are at serious risk for health complications, particularly if they use the same dose of opioids that they used prior to starting the treatment program.

Several approaches can be taken to improve access to evidence-based treatment for opioid addiction, such as OATs.

We suggest exploring a number of adaptations to standard care: removing witnessed doses, which can reduce cost and improve retention to treatment; temporarily stopping the use of urine drug screening; and allowing people to begin the use of buprenorphine/naloxone at home in collaboration with their physician — known as home induction.

These changes strike a balance between evidence-based opioid treatment and respect for physical distancing, with a view towards reducing the risk of viral spread to our most vulnerable populations.

Concepts Keywords
Abstinence Healthcare workers
Addiction Treatment services
Agonist Protective equipment
Alberta Social services
Alcohol Reduction services
Anxiety Strain healthcare systems
Buprenorphine Depressive disorders
Bureaucracy Diabetes
Calgary Pharmacotherapy
Clinical Psychologist Psychotherapy
Concurrent Opioids
Coronavirus Drugs
Depression Psychoactive drugs
Diabetes RTT
Fentanyl Morphinans
Gold Standard Euphoriants
Graduate Assistant Substance abuse
Harm Reduction Drug rehabilitation
Healthcare Opioid use disorder
Heroin Buprenorphine
Imagine Methadone
Imperative Drug screening
Insulin
Mental Disorders
Methadone
Naloxone
North America
Notorious
Opioid
Opioid Addiction
Opioids
Overdose
Pandemic
Pharmacies
Pharmacist
Pharmacotherapy
PhD
Philosophy
Physician
Placebo
Psychiatric Disorders
Psychotherapy
Public Health
Relapse
Remission
Remote Access
Social Isolation
Social Services
Society
Socioeconomic
Socioeconomic Status
Stigma
Stress
United States
Urine
Viral
Viruses

Semantics

Type Source Name
disease MESH opioid addiction
drug DRUGBANK Buprenorphine
drug DRUGBANK Naloxone
drug DRUGBANK Methadone
disease MESH relapse
drug DRUGBANK Diamorphine
drug DRUGBANK Fentanyl
disease MESH death
drug DRUGBANK Creatinolfosfate
disease MESH post-traumatic stress disorder
disease MESH anxiety
disease MESH depressive disorders
disease MESH complications
drug DRUGBANK Ethanol
disease MESH infections
drug DRUGBANK Isoxaflutole
drug DRUGBANK Gold
drug DRUGBANK Methylphenidate
disease MESH depression
disease MESH psychiatric disorders

Original Article

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