• Dennis C Wendt, Stéphanie Marsan, Daniel Parker, Karen E Lizzy, Jessica Roper, Christopher Mushquash, Kamilla L Venner, Alice Lam, Jennifer Swansburg, Nancy Worth, Nicholas Sorlagas, Tania Quach, Kristapore Manoukian, Payton Bernett, and Sandra M Radin.
• Department of Educational and Counselling Psychology, McGill University, 3700 McTavish St., Room 614, Montreal, Quebec H3A 1Y2, Canada. Electronic address: dennis.wendt@mcgill.ca.
• J Subst Abuse Treat. 2021 Feb 1; 121: 108165.

AbstractThis commentary focuses on how some Indigenous communities in the United States (U.S.) and Canada are addressing the opioid epidemic within the context of the COVID-19 pandemic, from the perspective of the co-authors as researchers, clinicians, and pharmacists working within or among Indigenous communities in three eastern Canadian provinces and two western U.S. states. The pandemic has likely exacerbated opioid use problems among Indigenous communities, especially for individuals with acute distress or comorbid mental illness, or who are in need of withdrawal management or residential services. In response to the pandemic, we discuss first how greater prescription flexibility has facilitated and even increased access to medications for opioid use disorder. Second, we describe how Indigenous-serving clinics have expanded telemedicine services, albeit not without some challenges. Third, we note challenges with restricted participation in traditional Indigenous healing practices that can be helpful for addiction recovery. Fourth, we mention providers' worries about the pandemic's impact on their patients' mental health and safety. We argue that certain treatment transformations may be helpful even after the pandemic is over, through enhancing access to community-grounded treatment, decreasing stigma, and promoting patient self-efficacy.Copyright © 2020 Elsevier Inc. All rights reserved.

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